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Govindharajulu R, Syed NK, Sukumaran B, Seshadri PR, Mathivanan S, Ramkumar N. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024; 25:114-117. [PMID: 38514407 DOI: 10.5005/jp-journals-10024-3642] [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] [Indexed: 03/23/2024]
Abstract
AIM The study aims is to evaluate the antibacterial effect of vitamin D3 against the red complex bacteria, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia in chronic periodontitis patients. MATERIALS AND METHODS The study comprised 98 participants with chronic periodontitis. All clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and a microbiological assay of P. gingivalis, T. denticola, T. forsythia were assessed at the baseline. All study participants who underwent scaling and root planning were divided into two groups, A and B, each with 49 patients and only group B patients were advised to take vitamin D supplementation of 60,000 IU granules, once daily for 2 months. All the patients of both the groups were recalled at the end of 2nd month and all the clinical and microbiological parameters were reassessed. RESULTS After two months, there was a reduction in all the clinical markers in both groups, but the group B patients showed more improvement following non-surgical treatment vitamin D intake. There was also a statistical reduction in P. gingivalis, T. denticola, and T. forsythia following administration of vitamin D in group B patients compared to group A. CONCLUSION These discoveries proposed that vitamin D has a superb antimicrobial impact against red complex periodontal microbes and might be considered a promising compound in the counteraction of periodontal disease. CLINICAL SIGNIFICANCE Vitamin D is considered to possess anti-inflammatory and antimicrobial activity, which may help to delay the progression of periodontitis. So, vitamin D3 can be used as a potential supplement that could be employed to stop the advancement of periodontal disease. How to cite this article: Govindharajulu R, Syed NK, Sukumaran B, et al. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024;25(2):114-117.
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Affiliation(s)
- Ramaprabha Govindharajulu
- Department of Periodontology, GRS Dental Clinic, Mayiladuthurai, Tamil Nadu, India, Phone: +91 9245196777, e-mail:
| | - Nubesh K Syed
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Al-Qassim, Kingdom of Saudi Arabia
| | - Binsu Sukumaran
- Department of Prosthetic Dental Sciences, Benser Dental Clinic, Kerala, India
| | - Pavithra R Seshadri
- Department of Periodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Narayane Ramkumar
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
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Jervøe-Storm PM, Eberhard J, Needleman I, Worthington HV, Jepsen S. Full-mouth treatment modalities (within 24 hours) for periodontitis in adults. Cochrane Database Syst Rev 2022; 6:CD004622. [PMID: 35763286 PMCID: PMC9239328 DOI: 10.1002/14651858.cd004622.pub4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Periodontitis is a highly prevalent, chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Conventional treatment is quadrant scaling and root planing (the second step of periodontal therapy), which comprises scaling and root planing of teeth in one quadrant of the mouth at a time, with the four different sessions separated by at least one week. Alternative protocols for anti-infective periodontal therapy have been introduced to help enhance treatment outcomes: full-mouth scaling (subgingival instrumentation of all quadrants within 24 hours), or full-mouth disinfection (subgingival instrumentation of all quadrants in 24 hours plus adjunctive antiseptic). We use the older term 'scaling and root planing' (SRP) interchangeably with the newer term 'subgingival instrumentation' in this iteration of the review, which updates one originally published in 2008 and first updated in 2015. OBJECTIVES To evaluate the clinical effects of full-mouth scaling or full-mouth disinfection (within 24 hours) for the treatment of periodontitis compared to conventional quadrant subgingival instrumentation (over a series of visits at least one week apart) and to evaluate whether there was a difference in clinical effects between full-mouth disinfection and full-mouth scaling. SEARCH METHODS An information specialist searched five databases up to 17 June 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) lasting at least three months that evaluated full-mouth scaling and root planing within 24 hours, with or without adjunctive use of an antiseptic, compared to conventional quadrant SRP (control). Participants had a clinical diagnosis of (chronic) periodontitis according to the International Classification of Periodontal Diseases from 1999. A new periodontitis classification was launched in 2018; however, we used the 1999 classification for inclusion or exclusion of studies, as most studies used it. We excluded studies of people with systemic disorders, taking antibiotics or with the older diagnosis of 'aggressive periodontitis'. DATA COLLECTION AND ANALYSIS Several review authors independently conducted data extraction and risk of bias assessment (based on randomisation method, allocation concealment, examiner blinding and completeness of follow-up). Our primary outcomes were tooth loss and change in probing pocket depth (PPD); secondary outcomes were change in probing attachment (i.e. clinical attachment level (CAL)), bleeding on probing (BOP), adverse events and pocket closure (the number/proportion of sites with PPD of 4 mm or less after treatment). We followed Cochrane's methodological guidelines for data extraction and analysis. MAIN RESULTS We included 20 RCTs, with 944 participants, in this updated review. No studies assessed the primary outcome tooth loss. Thirteen trials compared full-mouth scaling and root planing within 24 hours without the use of antiseptic (FMS) versus control, 13 trials compared full-mouth scaling and root planing within 24 hours with adjunctive use of an antiseptic (FMD) versus control, and six trials compared FMS with FMD. Of the 13 trials comparing FMS versus control, we assessed three at high risk of bias, six at low risk of bias and four at unclear risk of bias. We assessed our certainty about the evidence as low or very low for the outcomes in this comparison. There was no evidence for a benefit for FMS over control for change in PPD, gain in CAL or reduction in BOP at six to eight months (PPD: mean difference (MD) 0.03 mm, 95% confidence interval (CI) -0.14 to 0.20; 5 trials, 148 participants; CAL: MD 0.10 mm, 95% CI -0.05 to 0.26; 5 trials, 148 participants; BOP: MD 2.64%, 95% CI -8.81 to 14.09; 3 trials, 80 participants). There was evidence of heterogeneity for BOP (I² = 50%), but none for PPD and CAL. Of the 13 trials comparing FMD versus control, we judged four at high risk of bias, one at low risk of bias and eight at unclear risk of bias. At six to eight months, there was no evidence for a benefit for FMD over control for change in PPD or CAL (PPD: MD 0.11 mm, 95% CI -0.04 to 0.27; 6 trials, 224 participants; low-certainty evidence; CAL: 0.07 mm, 95% CI -0.11 to 0.24; 6 trials, 224 participants; low-certainty evidence). The analyses found no evidence of a benefit for FMD over control for BOP (very low-certainty evidence). There was no evidence of heterogeneity for PPD or CAL, but considerable evidence of heterogeneity for BOP, attributed to one study. There were no consistent differences in these outcomes between intervention and control (low- to very low-certainty evidence). Of the six trials comparing FMS and FMD, we judged two trials at high risk of bias, one at low risk of bias and three as unclear. At six to eight months, there was no evidence of a benefit of FMD over FMS for change in PPD or gain in CAL (PPD: MD -0.11 mm, 95% CI -0.30 to 0.07; P = 0.22; 4 trials, 112 participants; low-certainty evidence; CAL: MD -0.05 mm, 95% CI -0.23 to -0.13; P = 0.58; 4 trials, 112 participants; low-certainty evidence). There was no evidence of a difference between FMS and FMD for BOP at any time point (P = 0.98; 2 trials, 22 participants; low- to very low-certainty evidence). There was evidence of heterogeneity for BOP (I² = 52%), but not for PPD or CAL. Thirteen studies predefined adverse events as an outcome; three reported an event after FMD or FMS. The most important harm identified was an increase in body temperature. We assessed the certainty of the evidence for most comparisons and outcomes as low because of design limitations leading to risk of bias, and the small number of trials and participants, leading to imprecision in the effect estimates. AUTHORS' CONCLUSIONS The inclusion of nine new RCTs in this updated review has not changed the conclusions of the previous version of the review. There is still no clear evidence that FMS or FMD approaches provide additional clinical benefit compared to conventional mechanical treatment for adult periodontitis. In practice, the decision to select one approach to non-surgical periodontal therapy over another should include patient preference and the convenience of the treatment schedule.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Jörg Eberhard
- Faculty of Dentistry, The University of Sydney, Sydney Dental Hospital, Sydney, Australia
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
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Vinel A, Al Halabi A, Roumi S, Le Neindre H, Millavet P, Simon M, Cuny C, Barthet JS, Barthet P, Laurencin-Dalicieux S. Non-surgical Periodontal Treatment: SRP and Innovative Therapeutic Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:303-327. [DOI: 10.1007/978-3-030-96881-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chava V, Pulivarthi P, Gunupati S. Salivary tumor necrosis factor-alpha levels in periodontitis associated with diabetes mellitus after low level laser therapy as an adjunct to scaling and root planning: A randomized clinical trial. J Indian Soc Periodontol 2022; 26:236-244. [PMID: 35602530 PMCID: PMC9118935 DOI: 10.4103/jisp.jisp_150_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/18/2021] [Accepted: 09/19/2021] [Indexed: 11/06/2022] Open
Abstract
Context: Tumor necrosis factor-alpha (TNF-α) has been shown to play a critical role in the pathogenesis of periodontitis and diabetes. Nonsurgical periodontal therapy was shown to reduce inflammation and improves glycemic status. Recently, adjunctive low level laser therapy (LLLT) has been shown to alter the inflammatory process. Aim: To evaluate and compare the alteration in TNF-α levels before and after treatment in patients with periodontitis with and without type 2 diabetes mellitus (T2DM). Settings and Design: Randomised clinico-biochemical study was carried out for 8 weeks from September 2019 to December 2020. Materials and Methods: Sixty-four participants were divided into Groups A (periodontitis) and B (periodontitis associated with T2DM), based on probing depth ≥5 mm, clinical attachment level ≥2 mm, and history of T2DM. Later were subdivided into A1, A2, B1, B2, based on assigned treatments. Clinical periodontal parameters and salivary TNF-α levels were evaluated and compared at baseline to 8 weeks. Statistical Analysis: Multiple group comparisons were done using analysis of variance, intra group comparisons were made using t-tests. Results: Comparison of periodontal parameters and salivary TNF-α levels from baseline to 8 weeks showed statistically significant difference (P < 0.05) in all groups, indicating a positive effect of scaling and root planing (SRP) and adjunctive LLLT. Conclusion: Both SRP and SRP with adjunctive LLLT effectively altered TNF-α levels, correlating reduced periodontal inflammation.
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Stein JM, Yekta-Michael SS, Schittenhelm F, Reichert S, Kupietz D, Dommisch H, Kasaj A, Wied S, Vela OC, Stratul SI. Comparison of three full-mouth concepts for the non-surgical treatment of stage III and IV periodontitis: A randomized controlled trial. J Clin Periodontol 2021; 48:1516-1527. [PMID: 34517434 DOI: 10.1111/jcpe.13548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/29/2022]
Abstract
AIM To evaluate the clinical efficacy of full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP) compared to quadrant-wise debridement (Q-SRP) in patients with periodontitis stage III/IV. METHODS In this four-arm parallel, prospective, randomized, controlled multi-centre study, changes of pocket probing depths (PPDs), clinical attachment level (CAL), bleeding on probing (BOP), and proportion of closed pockets (PPD ≤4 mm without BOP) were evaluated at baseline and after 3 and 6 months. RESULTS From 190 randomly participating patients, 172 were included in the final analysis. All groups showed significant (p < .05) improvements in all clinical parameters over 3 and 6 months. During the study period, FMDAP showed significantly higher reductions of mean PPD in teeth with moderate (PPD 4-6 mm) and deep (PPD > 6 mm) pockets and significantly increased proportions of pocket closure than Q-SRP. Patients treated with FMD had significantly greater PPD reduction in deep pockets and a higher percentage of pocket closure after 3 months but not after 6 months compared to Q-SRP. CAL and BOP changes did not significantly differ among all groups. Efficiency of treatment (time effort to gain one closed pocket) was significantly higher for FMDAP, FMD, and FMS compared to Q-SRP (6.3, 8.5, 9.5 vs. 17.8 min per closed pocket; p < .05). CONCLUSIONS All treatment modalities were effective, without significant differences between full-mouth approaches. FMDAP showed improved clinical outcomes over Q-SRP for moderate and deep pockets after 6 months. Full-mouth protocols were more time-efficient than conventional Q-SRP. CLINICAL SIGNIFICANCE The trial was registered in a clinical trial database (ClinicalTrials.gov: NCT03509233).
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Affiliation(s)
- Jamal M Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | | | - Florian Schittenhelm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - David Kupietz
- Department of Operative Dentistry and Periodontology, Martin Luther University, Mainz, Germany
| | - Henrik Dommisch
- Department of Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Adrian Kasaj
- Department of Periodontology and Operative Dentistry, University Medical Center, Mainz, Germany
| | - Stephanie Wied
- Department of Medical Statistics, University Hospital (RWTH), Aachen, Germany
| | - Octavia-Carolina Vela
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Anton Sculean Center for Research and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, Romania
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Suvan J, Leira Y, Moreno Sancho FM, Graziani F, Derks J, Tomasi C. Subgingival instrumentation for treatment of periodontitis. A systematic review. J Clin Periodontol 2021; 47 Suppl 22:155-175. [PMID: 31889320 DOI: 10.1111/jcpe.13245] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/03/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the efficacy of subgingival instrumentation (PICOS-1), sonic/ultrasonic/hand instruments (PICOS-2) and different subgingival instrumentation delivery protocols (PICOS-3) to treat periodontitis. METHODS Systematic electronic search (CENTRAL/MEDLINE/EMBASE/SCOPUS/LILACS) to March 2019 was conducted to identify randomized controlled trials (RCT) reporting on subgingival instrumentation. Duplicate screening and data extraction were performed to formulate evidence tables and meta-analysis as appropriate. RESULTS As only one RCT addressed the efficacy of subgingival instrumentation compared with supragingival cleaning alone (PICOS-1), baseline and final measures from 9 studies were considered. The weighted pocket depth (PD) reduction was 1.4 mm (95%CI: 1.0 1.7) at 6/8 months, and the proportion of pocket closure was estimated at 74% (95%CI: 64-85). Six RCTs compared hand and sonic/ultrasonic instruments for subgingival instrumentation (PICOS-2). No significant differences were observed between groups by follow-up time point or category of initial PD. Thirteen RCTs evaluated quadrant-wise versus full-mouth approaches (PICOS-3). No significant differences were observed between groups irrespective of time-points or initial PD. Five studies reported patient-reported outcomes, reporting no differences between groups. CONCLUSIONS Nonsurgical periodontal therapy by mechanical subgingival instrumentation is an efficacious means to achieve infection control in periodontitis patients irrespective of the type of instrument or mode of delivery. Prospero ID: CRD42019124887.
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Affiliation(s)
- Jeanie Suvan
- Periodontology Unit and Department of Clinical Research, University College London Eastman Dental Institute, London, UK
| | - Yago Leira
- Periodontology Unit and Department of Clinical Research, University College London Eastman Dental Institute, London, UK
| | - Federico Manuel Moreno Sancho
- Periodontology Unit and Department of Clinical Research, University College London Eastman Dental Institute, London, UK
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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7
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The effects of repeated applications of antimicrobial photodynamic therapy in the treatment of residual periodontal pockets: a systematic review. Lasers Med Sci 2018; 34:855-863. [DOI: 10.1007/s10103-018-02703-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/03/2018] [Indexed: 01/12/2023]
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8
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Wang A, Swinford C, Zhao A, Ramos ED, Gregory RL, Srinivasan M. A Case-Control Study to Determine the Prognostic Features of Salivary Epithelial Cells in Periodontitis. JDR Clin Trans Res 2016; 1:256-265. [PMID: 30931739 DOI: 10.1177/2380084416653596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Periodontitis-a biofilm-induced immunoinflammatory pathology-often progresses gradually, exhibiting periodic bursts and resolution. Exfoliating oral epithelial cells act as reservoirs for key periodontal pathogens, facilitating reinfection or infection of new sites. Since saliva is a rich source of oral epithelial cells, we hypothesized that the microbial and functional profile of salivary epithelial cells (SECs) will reflect the in situ host response and disease severity. We used a case-control study design. Unstimulated whole saliva was collected from 20 chronic periodontitis patients and 20 healthy controls in accordance with the institutional review board. The isolated SECs were assessed for viability by trypan blue exclusion. Gram-stained SECs were analyzed by ImageJ, and Gram stain index (GSI) per SEC was calculated. Equal numbers of SECs from each sample were exposed to 2 periodontal pathogens- Porphyromonas gingivalis and Fusobacterium nucleatum-in biofilm or planktonic formulations at varying proportions. Cytokines in culture supernatants were assessed by ELISA (enzyme-linked immunosorbent assay). Additionally, soluble Toll-like receptor 2 (sTLR-2)-a pattern recognition receptor capable of binding microbial ligands associated with periodontitis-was measured in clarified saliva by ELISA. An increased number of SECs, a higher GSI/SEC, and a lower sTLR-2 were observed in periodontitis saliva as compared with healthy saliva. SECs from periodontitis saliva secreted higher amounts of interleukin 8 in response to P. gingivalis, and the presence of F. nucleatum dampened the response. Nonsurgical periodontal treatment improved clinical parameters, reduced the number of SECs, decreased GSI/SEC, and increased sTLR-2 in clarified saliva. In conclusion, our data suggest that SECs can provide a phenotypically distinct individualized resource for assessing epithelial response to pathogens in the course of periodontal disease. Furthermore, correlation between the sTLR-2 and GSI/SEC suggests that the expression profile of epithelial and soluble Toll-like receptor could provide an indirect measure of periodontal disease-associated dysbiosis. Knowledge Transfer Statement: The results of this study can be used for prognostic evaluation of chronic periodontitis in response to therapy and provide an opportunity for early identification of poor responders. A chip-based simple test incorporating the identified salivary epithelial cell characteristics can be developed and validated for future clinical applications, especially for monitoring patients with increased susceptibility for refractory and/or recurrent periodontitis.
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Affiliation(s)
- A Wang
- 1 Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - C Swinford
- 1 Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - A Zhao
- 1 Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - E D Ramos
- 2 Department of Periodontics and Allied Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - R L Gregory
- 3 Department of Biomedical and Applied Sciences, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - M Srinivasan
- 1 Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
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9
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de Freitas LM, Calixto GMF, Chorilli M, Giusti JSM, Bagnato VS, Soukos NS, Amiji MM, Fontana CR. Polymeric Nanoparticle-Based Photodynamic Therapy for Chronic Periodontitis in Vivo. Int J Mol Sci 2016; 17:ijms17050769. [PMID: 27213356 PMCID: PMC4881588 DOI: 10.3390/ijms17050769] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/25/2016] [Accepted: 05/04/2016] [Indexed: 12/31/2022] Open
Abstract
Antimicrobial photodynamic therapy (aPDT) is increasingly being explored for treatment of periodontitis. Here, we investigated the effect of aPDT on human dental plaque bacteria in suspensions and biofilms in vitro using methylene blue (MB)-loaded poly(lactic-co-glycolic) (PLGA) nanoparticles (MB-NP) and red light at 660 nm. The effect of MB-NP-based aPDT was also evaluated in a clinical pilot study with 10 adult human subjects with chronic periodontitis. Dental plaque samples from human subjects were exposed to aPDT—in planktonic and biofilm phases—with MB or MB-NP (25 µg/mL) at 20 J/cm2in vitro. Patients were treated either with ultrasonic scaling and scaling and root planing (US + SRP) or ultrasonic scaling + SRP + aPDT with MB-NP (25 µg/mL and 20 J/cm2) in a split-mouth design. In biofilms, MB-NP eliminated approximately 25% more bacteria than free MB. The clinical study demonstrated the safety of aPDT. Both groups showed similar improvements of clinical parameters one month following treatments. However, at three months ultrasonic SRP + aPDT showed a greater effect (28.82%) on gingival bleeding index (GBI) compared to ultrasonic SRP. The utilization of PLGA nanoparticles encapsulated with MB may be a promising adjunct in antimicrobial periodontal treatment.
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Affiliation(s)
- Laura Marise de Freitas
- Faculdade de Ciencias Farmaceuticas, UNESP-Univ Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Araraquara, SP 14800-903, Brazil.
| | - Giovana Maria Fioramonti Calixto
- Faculdade de Ciencias Farmaceuticas, UNESP-Univ Estadual Paulista, Campus Araraquara, Departamento de Farmacos e Medicamentos, Araraquara, SP 14800-903, Brazil.
| | - Marlus Chorilli
- Faculdade de Ciencias Farmaceuticas, UNESP-Univ Estadual Paulista, Campus Araraquara, Departamento de Farmacos e Medicamentos, Araraquara, SP 14800-903, Brazil.
| | - Juçaíra Stella M Giusti
- Instituto de Fisica de Sao Carlos, Universidade de Sao Paulo, Caixa Postal 369, Sao Carlos, SP 15980-900, Brazil.
| | - Vanderlei Salvador Bagnato
- Instituto de Fisica de Sao Carlos, Universidade de Sao Paulo, Caixa Postal 369, Sao Carlos, SP 15980-900, Brazil.
| | - Nikolaos S Soukos
- Applied Molecular Photomedicine Laboratory, the Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA.
| | - Mansoor M Amiji
- Department of PharmaceuticalSciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, 140 The Fenway, Room 156, 360 Huntington Avenue Boston, MA 02115, USA.
| | - Carla Raquel Fontana
- Faculdade de Ciencias Farmaceuticas, UNESP-Univ Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Araraquara, SP 14800-903, Brazil.
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10
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Martelli FS, Fanti E, Rosati C, Martelli M, Bacci G, Martelli ML, Medico E. Long-term efficacy of microbiology-driven periodontal laser-assisted therapy. Eur J Clin Microbiol Infect Dis 2016; 35:423-31. [DOI: 10.1007/s10096-015-2555-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/10/2015] [Indexed: 12/23/2022]
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11
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Canabarro A, Marcantonio É, De-Deus G. Use of the Strength of Recommendation Taxonomy (SORT) to assess full-mouth treatments of chronic periodontitis. J Oral Sci 2015; 57:345-53. [PMID: 26666858 DOI: 10.2334/josnusd.57.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Previous studies have not resolved whether scaling and root planing with a full-mouth (with or without antiseptics) or quadrant approach is better for treatment of chronic periodontitis. We identified relevant studies and used Strength of Recommendation Taxonomy (SORT) criteria to critically interpret the results of all relevant studies. A literature search was performed using the PubMed, EMBASE, and Cochrane databases up to July 2015. Selected studies were stratified according to their quality, quantity, and consistency. In total, 377 studies were identified, and 36 articles selected for retrieval were stratified according SORT criteria, as follows: no level 1 studies, 15 level 2 studies, and 21 level 3 studies (which were excluded from subsequent analysis). Among the selected level 2 studies, including seven randomized clinical trials and three systematic reviews, 67% showed no significant difference between scaling and root planing with a full-mouth or quadrant approach. In conclusion, on the basis of the best available data, the strength of evidence is grade B (consistent, low-quality evidence) for full-mouth (with or without antiseptics) and quadrant scaling and root planing for treatment of chronic periodontitis.
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Affiliation(s)
- Antonio Canabarro
- Department of Periodontology, School of Dentistry, Veiga de Almeida University
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12
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Fang H, Han M, Li QL, Cao CY, Xia R, Zhang ZH. Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 2015; 51:417-30. [PMID: 26477533 DOI: 10.1111/jre.12326] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2015] [Indexed: 11/28/2022]
Abstract
Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p < 0.05) for FMD vs. Q-SRP in single-rooted teeth with moderate pockets, and clinical attachment level gain in single- and multirooted teeth with moderate pockets was 0.33 mm (p < 0.05) for FMD vs. Q-SRP. Except for those, no statistically significant differences were found in the other subanalyses of FMD vs. Q-SRP, FMS vs. Q-SRP and FMD vs. FMS. Therefore, the meta-analysis results showed that FMD was better than Q-SRP for achieving probing pocket depth reduction and clinical attachment level gain in moderate pockets. Additionally, regardless of the treatment, no serious complications were observed. FMD, FMS and Q-SRP are all effective for the treatment of adult chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis.
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Affiliation(s)
- H Fang
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - M Han
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Q-L Li
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - C Y Cao
- College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - R Xia
- The 2nd Hospital affiliated to Anhui Medical University, Hefei, China
| | - Z-H Zhang
- Hospital of Anhui Province, Hefei, China
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Eberhard J, Jepsen S, Jervøe‐Storm P, Needleman I, Worthington HV. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev 2015; 2015:CD004622. [PMID: 25884249 PMCID: PMC8687876 DOI: 10.1002/14651858.cd004622.pub3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Periodontitis is chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Mild to moderate periodontitis affects up to 50% of adults. Conventional treatment is quadrant scaling and root planing. In an attempt to enhance treatment outcomes, alternative protocols for anti-infective periodontal therapy have been introduced: full-mouth scaling (FMS) and full-mouth disinfection (FMD), which is scaling plus use of an antiseptic. This review updates our previous review of full-mouth treatment modalities, which was published in 2008. OBJECTIVES To evaluate the clinical effects of 1) full-mouth scaling (over 24 hours) or 2) full-mouth disinfection (over 24 hours) for the treatment of chronic periodontitis compared to conventional quadrant scaling and root planing (over a series of visits at least one week apart). A secondary objective was to evaluate whether there was a difference in clinical effect between full-mouth disinfection and full-mouth scaling. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 26 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2015, Issue 2), MEDLINE via OVID (1946 to 26 March 2015), EMBASE via OVID (1980 to 26 March 2015) and CINAHL via EBSCO (1937 to 26 March 2015). We searched the US National Institutes of Health Trials Register (ClinicalTrials.gov) and the WHO International Clinical Trials Registry Platform for ongoing studies. There were no restrictions regarding language or date of publication in the searches of the electronic databases. We scanned reference lists from relevant articles and contacted the authors of eligible studies to identify trials and obtain additional information. SELECTION CRITERIA We included randomised controlled trials (RCTs) with at least three months of follow-up that evaluated full-mouth scaling and root planing within 24 hours with adjunctive use of an antiseptic such as chlorhexidine (FMD) or without the use of antiseptic (FMS), compared to conventional quadrant scaling and root planing (control). Participants had a clinical diagnosis of chronic periodontitis according to the International Classification of Periodontal Diseases. We excluded studies of people with aggressive periodontitis, systemic disorders or who were taking antibiotics. DATA COLLECTION AND ANALYSIS Several review authors independently conducted data extraction and risk of bias assessment (which focused on method of randomisation, allocation concealment, blinding of examiners and completeness of follow-up). Our primary outcome was tooth loss and secondary outcomes were change in probing pocket depth (PPD), bleeding on probing (BOP) and probing attachment (i.e. clinical attachment level; CAL), and adverse events. We followed the methodological guidelines of The Cochrane Collaboration. MAIN RESULTS We included 12 trials, which recruited 389 participants. No studies assessed the primary outcome tooth loss.Ten trials compared FMS and control; three of these were assessed as being at high risk of bias, three as unclear risk and four as low risk. There was no evidence for a benefit for FMS over the control for change in probing pocket depth (PPD), gain in probing attachment (i.e. clinical attachment level; CAL) or bleeding on probing (BOP). The difference in changes between FMS and control for whole mouth PPD at three to four months was 0.01 mm higher (95% CI -0.17 to 0.19, three trials, 82 participants). There was no evidence of heterogeneity. The difference in changes for CAL was 0.02 mm lower (95% CI -0.26 to 0.22, three trials, 82 participants), and the difference in change in BOP was 2.86 per cent of sites lower (95% CI -7.65 to 1.93, four trials, 120 participants).We included six trials in the meta-analyses comparing FMD and control, with two trials assessed as being at high risk of bias, one as low and three as unclear. The analyses did not indicate a benefit for FMD over the control for PPD, CAL or BOP. The difference in changes for whole-mouth PPD between FMD and control at three to four months was 0.13 mm higher (95% CI -0.09 to 0.34, two trials, 44 participants). There was no evidence of heterogeneity. The difference in changes for CAL was 0.04mm higher (95% CI -0.25 to 0.33, two trials, 44 participants) and the difference in change in BOP being 12.59 higher for FMD (95% CI -8.58 to 33.77, three trials, 68 participants).Three trials were included in the analyses comparing FMS and FMD. The mean difference in PPD change at three to four months was 0.11 mm lower (-0.34 to 0.12, two trials, 45 participants) indicating no evidence of a difference between the two interventions. There was a difference in the gain in CAL at three to four months (-0.25 mm, 95% CI -0.42 to -0.07, two trials, 45 participants), favouring FMD but this was not found at six to eight months. There was no evidence for a difference between FMS and FMD for BOP (-1.59, 95% CI -9.97 to 6.80, two trials, 45 participants).Analyses were conducted for different teeth types (single- or multi-rooted) and for teeth with different levels of probing depth at baseline, for PPD, CAL and BOP. There was insufficient evidence of a benefit for either FMS or FMD.Harms and adverse events were reported in eight studies. The most important harm identified was an increased body temperature after FMS or FMD treatments.We assessed the quality of the evidence for each comparison and outcome as 'low' because of design limitations leading to risk of bias and because of the small number of trials and participants, which led to imprecision in the effect estimates. AUTHORS' CONCLUSIONS The inclusion of five additional RCTs in this updated review comparing the clinical effects of conventional mechanical treatment with FMS and FMD approaches for the treatment of chronic periodontitis has not changed the conclusions of the original review. From the twelve included trials there is no clear evidence that FMS or FMD provide additional benefit compared to conventional scaling and root planing. In practice, the decision to select one approach to non-surgical periodontal therapy over another should include patient preference and the convenience of the treatment schedule.
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Affiliation(s)
- Joerg Eberhard
- Hannover Medical SchoolProsthetic Dentistry and Biomaterials ScienceCarl‐Neuberg‐Straße 1HannoverGermany30625
| | - Sören Jepsen
- University Hospital BonnDepartment of Periodontology, Operative and Preventive DentistryWelschnonnenstr. 16BonnGermany53113
| | - Pia‐Merete Jervøe‐Storm
- University Hospital BonnDepartment of Periodontology, Operative and Preventive DentistryWelschnonnenstr. 16BonnGermany53113
| | - Ian Needleman
- UCL Eastman Dental InstituteUnit of Periodontology and International Centre for Evidence‐Based Oral Healthcare256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupCoupland III Building, Oxford RoadManchesterUKM13 9PL
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Clinical and microbiological effects of quadrant versus full-mouth root planing—A randomized study. J Dent Sci 2014. [DOI: 10.1016/j.jds.2013.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Figueiredo LC, Souza DC, Santos VR, Miranda TS, Feres M, Faveri M, Duarte PM. Full-mouth scaling and root planing in type 2 diabetic subjects: one-year microbiological outcomes. Aust Dent J 2014; 59:490-6. [DOI: 10.1111/adj.12221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/27/2022]
Affiliation(s)
- LC Figueiredo
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - DC Souza
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - VR Santos
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - TS Miranda
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - M Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - M Faveri
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
| | - PM Duarte
- Department of Periodontology; Dental Research Division; Guarulhos University; São Paulo Brazil
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Eick S, Renatus A, Heinicke M, Pfister W, Stratul SI, Jentsch H. Hyaluronic Acid as an Adjunct After Scaling and Root Planing: A Prospective Randomized Clinical Trial. J Periodontol 2013; 84:941-9. [DOI: 10.1902/jop.2012.120269] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lauenstein M, Kaufmann M, Persson GR. Clinical and microbiological results following nonsurgical periodontal therapy with or without local administration of piperacillin/tazobactam. Clin Oral Investig 2013; 17:1645-60. [DOI: 10.1007/s00784-012-0856-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 09/27/2012] [Indexed: 10/27/2022]
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Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical Treatment of Periodontitis. J Evid Based Dent Pract 2012; 12:76-86. [DOI: 10.1016/s1532-3382(12)70019-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Santos VR, Ribeiro FV, Lima JA, Miranda TS, Feres M, Bastos MF, Duarte PM. Partial- and full-mouth scaling and root planing in type 2 diabetic subjects: a 12-mo follow-up of clinical parameters and levels of cytokines and osteoclastogenesis-related factors. J Periodontal Res 2011; 47:45-54. [DOI: 10.1111/j.1600-0765.2011.01403.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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