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Rathod A, Jaiswal P, Kale B, Masurkar D. Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients. J Contemp Dent Pract 2023; 24:798-801. [PMID: 38152913 DOI: 10.5005/jp-journals-10024-3573] [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: 12/29/2023]
Abstract
AIM To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. MATERIALS AND METHODS A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. RESULTS The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. CONCLUSION Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. CLINICAL RELEVANCE Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.
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Affiliation(s)
- Aishwarya Rathod
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India, Phone: +91 9834240701, e-mail:
| | - Priyanka Jaiswal
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
| | - Bhairavi Kale
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
| | - Deepika Masurkar
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
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Dumitriu AS, Păunică S, Nicolae XA, Bodnar DC, Albu ȘD, Suciu I, Ciongaru DN, Giurgiu MC. The Effectiveness of the Association of Chlorhexidine with Mechanical Treatment of Peri-Implant Mucositis. Healthcare (Basel) 2023; 11:1918. [PMID: 37444752 DOI: 10.3390/healthcare11131918] [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: 05/22/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: The aim of the study was to evaluate the benefit of combining chlorhexidine with the mechanical treatment of peri-implant mucositis. (2) Methods: Articles from 2016 to 2021 included in the PubMed and Scopus databases were analyzed, following the PICOS criteria and the randomized controlled study model that used chlorhexidine in various forms in the treatment of peri-mucositis. According to the established criteria, a limited number of studies were selected. These studies had as their criteria of evaluation for the effectiveness of chlorhexidine, plaque indices, bleeding indices and depth probing indices. Chlorhexidine has been used after mechanical debridement as a solution, with different concentrations of 0.06%/0.12%/0.2% alone or in a concentration of 0.03%, in combination with 0.05% cetylpyridinium chloride, as well as in the form of a gel with a concentration of 0.2%. (3) Results: The results were assessed to a placebo or other substances, and showed a significant reduction in the indices with a follow-up period ranging from 3 months to 1 year. (4) Conclusions: The association of chlorhexidine with the mechanical treatment of peri-implant mucositis has a role in reducing inflammation, although a complete remission was not obtained in all cases, and the results were not statistically significantly different from the use of other antiseptics.
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Affiliation(s)
- Anca Silvia Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Stana Păunică
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ximena Anca Nicolae
- Doctoral School, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Dana Cristina Bodnar
- Department of Restorative Odontotherapy, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ștefan Dimitrie Albu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Ioana Suciu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Dragoș Nicolae Ciongaru
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Marina Cristina Giurgiu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu Street, 020021 Bucharest, Romania
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Adjunctive Nd:YAG laser irradiation in the treatment of stage III/IV periodontitis: a 12-month, randomized, controlled trial. Clin Oral Investig 2023:10.1007/s00784-023-04908-4. [PMID: 36795248 DOI: 10.1007/s00784-023-04908-4] [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: 08/10/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical efficacy of the adjunctive use of Nd:YAG laser (1064 nm) to full-mouth scaling and root planning (FMS), in stage III/IV periodontitis patients. MATERIALS AND METHODS Sixty stage III/IV periodontitis patients were randomly assigned to three groups. The control group received FMS, laser 1 group received combined FMS/single Nd:YAG laser irradiation (3 W, 150 mJ, 20 Hz,100 μs), and laser 2 group received combined FMS/double Nd:YAG laser irradiation with 1-week interval (2.0 W, 200 mJ, 10 Hz, 100 μs). PD, CAL, FMPS, GI, FMBS, and GR were evaluated at baseline, 6 weeks, 3, 6, and 12 months after treatment. Patient-reported outcomes were evaluated 1 week after treatment. RESULTS A significant improvement (p < 0.001) for all clinical parameters was observed during the entire study period, with the exception of mean CAL gain for the laser 2 group at 12 months. The percentage of pockets ≤ 4 mm was significantly higher compared to baseline for all groups throughout the study, with no inter-group differences at any time point. Patient-reported analgesic consumption was higher for laser 1 group. CONCLUSIONS The adjunctive use of Nd:YAG laser irradiation was similarly effective to FMS alone, during the entire study period. A slightly higher, though not statistically significant improvement was reported for PD at 6 and 12 months after a single post-FMS application of Nd:YAG laser for pocket epithelium removal and coagulation. CLINICAL RELEVANCE Additional Nd:YAG laser application for sulcular epithelium removal and coagulation may provide minor long-term improvements compared to FMS or laser irradiation for pocket disinfection and detoxification. TRIAL REGISTRATION ISRCTN26692900. Registration date: 09/06/2022.
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Morikawa S, Watanabe K, Otsuka R, Asoda S, Nakagawa T. Periodontal therapy for localized severe periodontitis in a patient receiving fixed orthodontic treatment: a case report. J Med Case Rep 2023; 17:19. [PMID: 36658639 PMCID: PMC9854180 DOI: 10.1186/s13256-023-03751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Orthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment. CASE PRESENTATION A 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved. CONCLUSIONS Orthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.
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Affiliation(s)
- Satoru Morikawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Kazuya Watanabe
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan ,Watanabe Orthodontic Office, 1-11-26-2F Kichijoji-honcho, Musashino, Tokyo 180-0004 Japan
| | - Ryo Otsuka
- Familia Orthodontics, 1-7-5-12F Sakuragi-cho, Omiya-ku, Saitama, Saitama 330-0854 Japan
| | - Seiji Asoda
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
| | - Taneaki Nakagawa
- grid.26091.3c0000 0004 1936 9959Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan
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Kamata Y, Kessoku T, Shimizu T, Sato S, Kobayashi T, Kurihashi T, Morozumi T, Iwasaki T, Takashiba S, Hatanaka K, Hamada N, Kodama T, Higurashi T, Taguri M, Yoneda M, Usuda H, Wada K, Nakajima A, Minabe M. Periodontal Treatment and Usual Care for Nonalcoholic Fatty Liver Disease: A Multicenter, Randomized Controlled Trial. Clin Transl Gastroenterol 2022; 13:e00520. [PMID: 36000999 PMCID: PMC10476832 DOI: 10.14309/ctg.0000000000000520] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/06/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Periodontal disease is associated with nonalcoholic fatty liver disease (NAFLD). We evaluated periodontal treatment efficacy in patients with NAFLD and periodontal disease. METHODS This multicenter, 2-arm, randomized study recruited adult patients with NAFLD and periodontitis, alanine aminotransferase levels ≥40 U/L, and equivalent steatosis grade ≥1. Forty eligible patients (18 men and 22 women) were randomly assigned to 2 groups (scaling and root planning [SRP; n = 20] and tooth brushing [n = 20] groups) stratified by age and sex. The primary and secondary endpoints were changes in alanine aminotransferase levels and serum Porphyromonas gingivalis IgG antibody titers from baseline to 12 weeks, respectively. Efficacy analysis was performed using an intention-to-treat approach ( t test). This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000022079). RESULTS We observed a significantly higher decrease in absolute alanine aminotransferase levels and P. gingivalis IgG antibody titers in the SRP group than in the tooth brushing group (-12 vs 1 U/L; mean difference [δ], -12; 95% confidence interval [CI], -20 to -5; P = 0.002). The decrease in P. gingivalis IgG antibody titer was significantly higher in the SRP group than in the tooth brushing group (FDC381, -1.6 [2.5]; δ, -1.6; 95% CI, -2.7 to -0.4; P = 0.0092; SU63, -1.7 [2.0]; δ, -1.7; 95% CI, -2.7 to -0.7). No life-threatening events or treatment-related deaths occurred. DISCUSSION Periodontal treatment induced significant short-term and mid-term reductions in liver enzyme levels and antibody titers. Further research is warranted to clearly define SRP efficacy and tolerability in patients with NAFLD and periodontitis.
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Affiliation(s)
- Yohei Kamata
- Department of Highly Advanced Oral Stomatology, Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomoko Shimizu
- Department of Highly Advanced Oral Stomatology, Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| | - Satsuki Sato
- Department of Highly Advanced Oral Stomatology, Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| | - Takashi Kobayashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeo Kurihashi
- Department of Internal Medicine, Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| | - Toshiya Morozumi
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Tomoyuki Iwasaki
- Iwasaki Internal Medicine Clinic, Kamihoshikawa, Hodogaya-ku, Yokohama, Japan
| | - Shogo Takashiba
- Department of Pathophysiology—Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazu Hatanaka
- Department of Pathophysiology—Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobushiro Hamada
- Division of Microbiology, Department of Oral Science Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Toshiro Kodama
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masataka Taguri
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Haruki Usuda
- Department of Pharmacology, Shimane University School of Medicine, Shimane, Japan
| | - Koichiro Wada
- Department of Pharmacology, Shimane University School of Medicine, Shimane, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
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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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Di Stefano M, Polizzi A, Santonocito S, Romano A, Lombardi T, Isola G. Impact of Oral Microbiome in Periodontal Health and Periodontitis: A Critical Review on Prevention and Treatment. Int J Mol Sci 2022; 23:ijms23095142. [PMID: 35563531 PMCID: PMC9103139 DOI: 10.3390/ijms23095142] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/07/2023] Open
Abstract
The skin, oral cavity, digestive and reproductive tracts of the human body harbor symbiotic and commensal microorganisms living harmoniously with the host. The oral cavity houses one of the most heterogeneous microbial communities found in the human organism, ranking second in terms of species diversity and complexity only to the gastrointestinal microbiota and including bacteria, archaea, fungi, and viruses. The accumulation of microbial plaque in the oral cavity may lead, in susceptible individuals, to a complex host-mediated inflammatory and immune response representing the primary etiological factor of periodontal damage that occurs in periodontitis. Periodontal disease is a chronic inflammatory condition affecting about 20-50% of people worldwide and manifesting clinically through the detection of gingival inflammation, clinical attachment loss (CAL), radiographic assessed resorption of alveolar bone, periodontal pockets, gingival bleeding upon probing, teeth mobility and their potential loss in advanced stages. This review will evaluate the changes characterizing the oral microbiota in healthy periodontal tissues and those affected by periodontal disease through the evidence present in the literature. An important focus will be placed on the immediate and future impact of these changes on the modulation of the dysbiotic oral microbiome and clinical management of periodontal disease.
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Affiliation(s)
- Mattia Di Stefano
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
- Correspondence: (A.P.); (S.S.); Tel.: +39-095-3782638 (A.P. & S.S.)
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
- Correspondence: (A.P.); (S.S.); Tel.: +39-095-3782638 (A.P. & S.S.)
| | - Alessandra Romano
- Department of General Surgery and Surgical-Medical Specialties, Unit of Hematology, University of Catania, 95124 Catania, Italy;
| | - Teresa Lombardi
- Department of Health Sciences, Magna Græcia University, 88100 Catanzaro, Italy;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (M.D.S.); (G.I.)
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Schulz S, Stein JM, Schumacher A, Kupietz D, Yekta-Michael SS, Schittenhelm F, Conrads G, Schaller HG, Reichert S. Nonsurgical Periodontal Treatment Options and Their Impact on Subgingival Microbiota. J Clin Med 2022; 11:jcm11051187. [PMID: 35268280 PMCID: PMC8911148 DOI: 10.3390/jcm11051187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different periodontal treatment methods (quadrant-wise debridement, scaling and root planing (Q-SRP), full-mouth scaling (FMS), full-mouth disinfection (FMD), and FMD with adjuvant erythritol air-polishing (FMDAP)) were applied in periodontitis patients (stage III/IV). The study objective (substudy of ClinicalTrials.gov Identifier: NCT03509233) was to compare the impact of treatments on subgingival colonization. METHODS Forty patients were randomized to the treatment groups. Periodontal parameters and subgingival colonization were evaluated at baseline and 3 and 6 months after treatment. RESULTS Positive changes in clinical parameters were recorded in every treatment group during the 3-month follow-up period, but did not always continue. In three groups, specific bacteria decreased after 3 months; however, this was associated with a renewed increase after 6 months (FMS: Porphyromonas gingivalis; FMD: Eubacterium nodatum, Prevotella dentalis; and FMDAP: uncultured Prevotella sp.). CONCLUSIONS The benefit of all clinical treatments measured after 3 months was associated with a decrease in pathogenic bacteria in the FMS, FMD, and FMDAP groups. However, after 6 months, we observed further improvement or some stagnation in clinical outcomes accompanied by deterioration of the microbiological profile. Investigating the subgingival microbiota might help appraise successful periodontal treatment and implement individualized therapy.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
- Correspondence:
| | - Jamal M. Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
- Private Practice, 52062 Aachen, Germany
| | - Anne Schumacher
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - David Kupietz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - Sareh S. Yekta-Michael
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
| | - Florian Schittenhelm
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
- Private Practice, 52062 Aachen, Germany
| | - Georg Conrads
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH) Aachen, 52074 Aachen, Germany; (J.M.S.); (S.S.Y.-M.); (F.S.); (G.C.)
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06108 Halle, Germany; (A.S.); (D.K.); (H.-G.S.); (S.R.)
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9
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Mamaklıoğlu D, Karched M, Kuru L, Kuru B, Asikainen S, Doğan B. Different Scaling And Root Planing Strategies In Turkish Patients With Aggressive Periodontitis: A Randomized Controlled Clinical Trial. Int J Dent Hyg 2022; 20:347-363. [PMID: 35143714 DOI: 10.1111/idh.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/06/2022] [Accepted: 02/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study is to compare clinical, cytokine and microbiological responses after quadrant-based scaling and root planing (Q-SRP), full-mouth SRP (FM-SRP) and full-mouth disinfection (FMD) in patients with generalized aggressive periodontitis (GAgP), which is currently termed as generalized stage III grade C periodontitis. METHODS Forty-two patients with GAgP were randomly assigned into groups as Q-SRP, FM-SRP or FMD with chlorhexidine. Clinical parameters were recorded and gingival crevicular fluid (GCF) and subgingival plaque samples collected at baseline, 3 and 6 months after treatment. GCF levels of interleukin (IL)-1β and IL-17 were analysed using ELISA. Quantities of six bacterial species were determined using qPCR. RESULTS Clinical parameters improved significantly in all groups at 3 and 6 months (p<0.05). Percentage of sites with probing depth >6 mm was lower in the FMD than Q-SRP group at 3 and 6 months (p<0.05). FMD showed significantly higher percentage of pocket closure compared to Q-SRP and FM-SRP at both 3 and 6 months after treatment (p<0.05). The IL-1β levels decreased only in the FMD group (p<0.05), whereas no changes were found in IL-17 levels in any group. The levels of five out of six bacterial species decreased at 3 and/or 6 months only in the FMD group (p<0.05). CONCLUSIONS The FMD treatment appears to offer superior outcome than Q-SRP and could be the first choice for patients with GAgP.
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Affiliation(s)
- Dilek Mamaklıoğlu
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Maribasappa Karched
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Sirkka Asikainen
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait.,Oral Microbiology, Umea University, Umea, Sweden
| | - Başak Doğan
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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10
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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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11
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The effect of drug dose and duration of adjuvant Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:5671-5685. [PMID: 33751238 DOI: 10.1007/s00784-021-03869-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/01/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim is to explore the optimal drug dose and duration of adjunctive Amoxicillin-plus-Metronidazole (AMX/MET) to full-mouth scaling and planing (FMSRP) in periodontitis. METHODS An electronic search in four databases and manual search in four journals were conducted for randomised clinical trials comparing AMX/MET adjunct to FMSRP with FMSRP alone for at least 3 months. RESULTS Eleven studies were eligible and included. The primary outcome was clinical attachment level (CAL) gain, the secondary outcomes were periodontal pocket depth (PPD) reduction and adverse events. Our results showed a beneficial effect of adjunctive AMX/MET with higher drug dose to FMSRP for CAL gain and PPD reduction at 3 months, and the benefit remained stable at 6 months. However, minimal difference among three-seven-and ten-day drug duration was observed. In addition, the risk difference of adverse events was minimal between two groups. CONCLUSION FMSRP adjunct to a high drug dose of 500/500 mg of AMX/MET showed a significant and stable improvement on 6-month follow-up period. No decision for drug duration could be made due to limited evidence. CLINICAL RELEVANCE On 6-month follow-up, higher dose of AMX/MET adjunct to FMSRP could provide a stable clinical effect. No recommendation for drug duration could be made.
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12
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Theodoro LH, da Rocha TE, Wainwright M, Nuernberg MAA, Ervolino E, Souza EQM, Brandini DA, Garcia VG. Comparative effects of different phenothiazine photosensitizers on experimental periodontitis treatment. Photodiagnosis Photodyn Ther 2021; 34:102198. [PMID: 33578028 DOI: 10.1016/j.pdpdt.2021.102198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022]
Abstract
AIM The aim of the present study was to compare the effects of the phenothiazine photosensitizers methylene blue (MB), toluidine blue-O (TBO) and butyl toluidine blue (BuTB) in antimicrobial photodynamic therapy (aPDT), as adjuvant therapy to scaling and root planing (SRP) in the treatment of experimental periodontitis (EP) in rats. MATERIAL AND METHODS 120 Wistar rats underwent ligation around the lower left molar. After seven days, the ligature was removed. The animals were separated into the following groups (n = 15): EP, no treatment; SRP, SRP and irrigation with saline solution; MB, SRP and deposition of MB; TBO, SRP and deposition of TBO; BuTB, SRP and deposition of BuTB; MB-aPDT, SRP and aPDT with MB; TBO-aPDT, SRP and aPDT with TBO and; BuTB-aPDT, SRP and aPDT with BuTB. The aPDT session was performed after SRP, with deposition of the photosensitizer and irradiation with a diode laser (DL; InGaAlP, 660 nm, 40 mW, 60 s, 2.4 J). Histological and histometric analysis was performed. RESULTS BuTB-aPDT group had a lesser extent of the inflammatory process compared to the EP, SRP, MB and TBO at all experimental periods (p < 0.05). At 15 days, the aPDT treated groups had a greater bone tissue structure than groups EP and SRP (p < 0.05) The BuTB showed lower Alveolar Bone Loss (ABL) compared to the TBO-aPDT group at 30 days (p < 0.05). CONCLUSION aPDT using the photosensitizer BuTB proved to be the adjuvant therapy that most favored the reduction of inflammatory infiltrate in the furcation area and ABL.
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Affiliation(s)
- Letícia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Tiago Esgalha da Rocha
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Mark Wainwright
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
| | | | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Eduardo Quintão Manhanini Souza
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Daniela Atili Brandini
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Valdir Gouveia Garcia
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil; Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, PR, Brazil.
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13
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Nuernberg MAA, Wainwright M, Miessi DMJ, Scalet V, Olivo MB, Ervolino E, Garcia VG, Theodoro LH. Effects of butyl toluidine blue photosensitizer on antimicrobial photodynamic therapy for experimental periodontitis treatment in rats. Photodiagnosis Photodyn Ther 2020; 31:101868. [DOI: 10.1016/j.pdpdt.2020.101868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/16/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022]
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14
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Engel Naves Freire A, Macedo Iunes Carrera T, de Oliveira GJPL, Pigossi SC, Vital Ribeiro Júnior N. Comparison between Antimicrobial Photodynamic Therapy and Low-level laser therapy on non-surgical periodontal treatment: A Clinical Study. Photodiagnosis Photodyn Ther 2020; 31:101756. [PMID: 32302705 DOI: 10.1016/j.pdpdt.2020.101756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/11/2020] [Accepted: 03/20/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Alternative antibacterial therapeutic modalities, such as antimicrobial photodynamic therapy (aPDT) and low-level laser therapy (LLLT), have been proposed to improve the effectiveness of periodontal treatment. However, clinical studies evaluating the efficiency of these treatments have been inconclusive, partly due to contradictory results regarding their clinical and microbiological effects. The aim of this study was to evaluate the clinical effects of aPDT and LLLT after a one-stage full-mouth disinfection (OSFMD) protocol during periodontitis treatment. METHODS A split-mouth clinical trial was conducted in 20 patients presenting at least two contralateral teeth with a probing pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) on both sides of the mouth. All patients were submitted to an OSFMD protocol. The selected sites randomly received either (1) aPDT (methylene blue as a photosensitizer activated by red and infrared diode laser) or (2) LLLT (red and infrared diode laser). Clinical parameters were assessed at baseline and at 4 and 12 weeks post-treatment. RESULTS Both treatment protocols promoted significant reductions in PD, number of deep pockets and BOP and an increase in clinical attachment level (CAL) after 4 and 12 weeks, but there were no differences between the two groups. There was no change in the gingival level (GL) of either group for all periods of analysis. A decrease in the number of moderate pockets (4-5 mm) was found in the LLLT group (5.15 ± 4.20) when compared to the aPDT group (7.10 ± 5.24), but only after 4 weeks. CONCLUSIONS In conclusion, both the aPDT and LLLT therapies promoted improvements in periodontal clinical parameters after the OSFMD protocol; however, in general, there were no distinct differences between the two treatment modalities evaluated in this study.
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Affiliation(s)
- Alice Engel Naves Freire
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
| | - Thaisa Macedo Iunes Carrera
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
| | | | - Suzane Cristina Pigossi
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil.
| | - Noé Vital Ribeiro Júnior
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
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15
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Afacan B, Çınarcık S, Gürkan A, Özdemir G, İlhan HA, Vural C, Köse T, Emingil G. Full-mouth disinfection effects on gingival fluid calprotectin, osteocalcin, and N-telopeptide of Type I collagen in severe periodontitis. J Periodontol 2020; 91:638-650. [PMID: 32023661 DOI: 10.1002/jper.19-0445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/08/2019] [Accepted: 12/29/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND To compare the effects of full-mouth disinfection (FMD) and full-mouth ultrasonic debridement (FMUD) on clinical, microbiological and biochemical parameters with conventional quadrant-wise scaling and root planning (Q-SRP) in severe chronic periodontitis. METHODS In the present prospective randomized controlled clinical trial with three parallel arms (#NCT04038801), 60 chronic periodontitis patients were randomly assigned to three study groups by a consecutive number in ascending order: FMD (n = 20), FMUD (n = 20), and Q-SRP (n = 20). All measurements and treatments were performed by the same investigator. At baseline, gingival crevicular fluid (GCF) and subgingival plaque were collected and clinical periodontal parameters were recorded. Ultrasonic debridement was completed within 24 hours in FMD and FMUD groups. Chlorhexidine gluconate was used for FMD. Q-SRP was performed by hand instruments per quadrant at 1-week-intervals. Clinical measurements and sampling were repeated at 1, 3, and 6 months after treatment. Real-time PCR was used for quantitative analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, and total bacteria count. GCF Calprotectin, osteocalcin, and N-telopeptide of type I collagen (NTx) levels were analyzed by ELISA. The changes of GCF biomarker levels after treatment between groups were the primary outcomes. RESULTS No harm was observed. All treatment strategies resulted in significant improvements in all clinical parameters (P < 0.05), with no significant differences between study groups at all time-points (P ˃ 0.05). Aggregatibacter actinomycetemcomitans was significantly decreased in FMD compared to FMUD and Q-SRP at 6 months (P < 0.05). Although GCF NTx total amounts increased in all groups during the study period, this increase was less prominent in full-mouth groups at three time points after treatment (P < 0.05). CONCLUSIONS Present results represent the short-term effects. Full-mouth treatment approaches offered limited beneficial effects on microbiological and biochemical parameters over quadrant-wise approach. All three treatment strategies can be recommended in the management of severe chronic periodontitis.
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Affiliation(s)
- Beral Afacan
- Department of Periodontology, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Serhat Çınarcık
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Ali Gürkan
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
| | - Güven Özdemir
- Department of Biology, Basic and Industrial Microbiology Section, Faculty of Science, Ege University, Izmir, Turkey
| | - Harika Atmaca İlhan
- Department of Biology, Section of Molecular Biology, Faculty of Science and Letters, Celal Bayar University, Manisa, Turkey
| | - Caner Vural
- Department of Biology, Basic and Industrial Microbiology Section, Faculty of Science, Ege University, Izmir, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Turkey
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16
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Oliveira AMSD, Costa FO, Nogueira LMR, Cortelli SC, Oliveira PAD, Aquino DR, Miranda TB, Cortelli JR. Azithromycin and Full-Mouth Scaling For the Treatment of Generalized Stage III and IV Periodontitis: A 6-Month Randomized Comparative Clinical Trial. Braz Dent J 2019; 30:429-436. [DOI: 10.1590/0103-6440201902111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022] Open
Abstract
Abstract The effectiveness of azithromycin combined with full-mouth scaling procedures was compared to quadrant-wise scaling combined with the same dosage of azithromycin when treating periodontitis patients over a 6-month period. In this randomized clinical trial study, thirty-four individuals diagnosed with generalized stage III and IV periodontitis underwent baseline, 3-month, and 6-month post-treatment examinations. The study population was randomly assigned to either full-mouth scaling (FMS) or quadrant-wise scaling and root planning (QSRP) in addition to their taking of systemic azithromycin (500 mg/day) for three consecutive days. Periodontal probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) were monitored along with the quantification of total bacterial load and red complex bacterial species (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) in subgingival samples by real time polymerase chain reaction. The volume of gingival crevicular fluid (GCF) was also monitored over time. The primary outcomes included improvements of PD and CAL. Data was statistically analyzed through a repeated-measures analysis of variance (ANOVA) test, multiple least significant difference (LSD) comparisons, Kruskal-Wallis, Friedman, and paired Student t-tests (p<0.05). FMS and QSRP provided similar PD, CAL, GI, PI, and GCF improvements. After treatment, the FMS group displayed lower mean values of total bacterial load and red complex bacterial species in comparison to the QSRP group. FMS and QSRP in conjunction with systemic azithromycin appeared to be an effective and reliable short-term therapeutic approach for the treatment of generalized stage III and IV periodontitis. However, FMD demonstrated superiority in regard to the 6-month antibacterial effects when compared to QSRP.
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17
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Gaudilliere DK, Culos A, Djebali K, Tsai AS, Ganio EA, Choi WM, Han X, Maghaireh A, Choisy B, Baca Q, Einhaus JF, Hedou JJ, Bertrand B, Ando K, Fallahzadeh R, Ghaemi MS, Okada R, Stanley N, Tanada A, Tingle M, Alpagot T, Helms JA, Angst MS, Aghaeepour N, Gaudilliere B. Systemic Immunologic Consequences of Chronic Periodontitis. J Dent Res 2019; 98:985-993. [PMID: 31226001 DOI: 10.1177/0022034519857714] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Chronic periodontitis (ChP) is a prevalent inflammatory disease affecting 46% of the US population. ChP produces a profound local inflammatory response to dysbiotic oral microbiota that leads to destruction of alveolar bone and tooth loss. ChP is also associated with systemic illnesses, including cardiovascular diseases, malignancies, and adverse pregnancy outcomes. However, the mechanisms underlying these adverse health outcomes are poorly understood. In this prospective cohort study, we used a highly multiplex mass cytometry immunoassay to perform an in-depth analysis of the systemic consequences of ChP in patients before (n = 28) and after (n = 16) periodontal treatment. A high-dimensional analysis of intracellular signaling networks revealed immune system-wide dysfunctions differentiating patients with ChP from healthy controls. Notably, we observed exaggerated proinflammatory responses to Porphyromonas gingivalis-derived lipopolysaccharide in circulating neutrophils and monocytes from patients with ChP. Simultaneously, natural killer cell responses to inflammatory cytokines were attenuated. Importantly, the immune alterations associated with ChP were no longer detectable 3 wk after periodontal treatment. Our findings demarcate systemic and cell-specific immune dysfunctions in patients with ChP, which can be temporarily reversed by the local treatment of ChP. Future studies in larger cohorts are needed to test the boundaries of generalizability of our results.
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Affiliation(s)
- D K Gaudilliere
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - A Culos
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - K Djebali
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - A S Tsai
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - E A Ganio
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - W M Choi
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - X Han
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - A Maghaireh
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - B Choisy
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Q Baca
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - J F Einhaus
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - J J Hedou
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - B Bertrand
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - K Ando
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - R Fallahzadeh
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - M S Ghaemi
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - R Okada
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - N Stanley
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - A Tanada
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - M Tingle
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - T Alpagot
- 3 Department of Periodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - J A Helms
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - M S Angst
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - N Aghaeepour
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - B Gaudilliere
- 2 Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA
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18
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Almeida ML, Duarte PM, Figueira EA, Lemos JC, Nobre CMG, Miranda TS, de Vasconcelos Gurgel BC. Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes. Clin Oral Investig 2019; 24:333-341. [PMID: 31102044 DOI: 10.1007/s00784-019-02927-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 04/30/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and non-diabetic subjects for up to 1 year. Secondary aim was to evaluate the effects of this therapy on the salivary levels of periodontal pathogens between diabetics and non-diabetics. MATERIAL AND METHODS Twenty-six type 2 diabetic subjects and 28 non-diabetic subjects with mild-to-moderate periodontitis received full-mouth scaling and root planing within 24 h, application of chlorhexidine digluconate (CHX) gel in pockets and tongue plus CHX rinses for 14 days. Clinical monitoring was performed at baseline, 3, 6, and 12 months post-therapy. Salivary levels of red complex bacterial species were evaluated at baseline, 6, and 12 months post-therapy by qPCR. RESULTS Intention-to-treat analyses were performed for seven diabetics and three non-diabetics that did not return for the 12-month evaluation. Most clinical parameters improved significantly at 3, 6, and 12 months post-therapies for both groups (p < 0.05). Overall, there were no significant differences in clinical parameters between groups after therapy (p > 0.05). At 1 year, 39.3% and 50.0% of the non-diabetic and diabetic subjects, respectively, achieved the desired clinical endpoint for treatment (≤ 4 sites with probing depth ≥ 5 mm) (primary outcome variable) (p > 0.05). FMD did not promote changes in the salivary levels of pathogens in either of the groups (p > 0.05). Levels of T. forsythia were lower in diabetic than in non-diabetic subjects at 6 months post-therapy (p < 0.05). CONCLUSIONS Type 2 diabetic subjects and systemically healthy subjects with mild-to-moderate periodontitis responded similarly to the proposed FMD protocol for up to 1 year. CLINICAL RELEVANCE There is a general thought that diabetics do not answer as well as non-diabetics to periodontal treatments. However, this study showed that diabetics and non-diabetics respond equally to the FMD protocol. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02643771.
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Affiliation(s)
- Mariana Linhares Almeida
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil.,Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - Eduardo Aleixo Figueira
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil
| | - Janaína Cavalcante Lemos
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil
| | - Cintia Mirela Guimarães Nobre
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil
| | | | - Bruno César de Vasconcelos Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil.
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19
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Reinhardt B, Klocke A, Neering SH, Selbach S, Peters U, Flemmig TF, Beikler T. Microbiological dynamics of red complex bacteria following full-mouth air polishing in periodontally healthy subjects-a randomized clinical pilot study. Clin Oral Investig 2019; 23:3905-3914. [PMID: 30729346 DOI: 10.1007/s00784-019-02821-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Suppression of periodontal pathogens in the oral cavity of periodontally healthy individuals may lower the risk for periodontal or periimplant diseases. Therefore, the present study aimed to analyze the effect of supragingival debridement (SD) with adjunctive full mouth glycine powder air polishing (FM-GPAP) on the prevalence of periodontal pathogens in periodontally healthy individuals. MATERIALS AND METHODS Eighty-seven systemically and periodontally healthy intraoral carriers of red complex bacteria, i.e., Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola or other periodontal pathogens including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Eikenella corrodens were enrolled into the study and randomly assigned to receive SD with adjunctive FM-GPAP (test, n = 42) or SD alone (control, n = 45). In the first observation period, microbiological samples were obtained prior to, and 2, 5, and 9 days following intervention. If one of these periodontal pathogens could still not be identified, additional microbial sampling was performed after 6 and 12 weeks. RESULTS The prevalence of red complex bacteria was significantly reduced in the test compared to the control group following treatment (p = 0.004) and at day 9 (p = 0.031). Intragroup comparison showed a significant (test, p < 0.001; control, p ≤ 0.01) reduction in the mean prevalence in both groups from BL through day 9 with an additional significant intergroup difference (p = 0.048) at day 9. However, the initial strong reduction returned to baseline values after 6 and 12 weeks. CONCLUSION In periodontally healthy carriers of periodontal pathogens, FM-GPAP as an adjunct to SD transiently enhances the suppression of red complex bacteria. CLINICAL RELEVANCE Whether the enhanced suppression of red complex bacteria by adjunctive FM-GPAP prevents the development of periodontitis in periodontally healthy carriers requires further investigations.
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Affiliation(s)
| | | | | | | | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center of Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
| | | | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center of Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany.
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20
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Tasdemir Z, Özsarı Tasdemir F, Gürgan C, Eroglu E, Gunturk I, kocyigit I. The effect of periodontal disease treatment in patients with continuous ambulatory peritoneal dialysis. Int Urol Nephrol 2018; 50:1519-1528. [DOI: 10.1007/s11255-018-1913-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/07/2018] [Indexed: 02/02/2023]
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21
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Bishwokarma Ghimire R. Clinical Outcome and Safety Profile of Patients Underwent Hair Transplantation Surgery by Follicular Unit Extraction. JNMA J Nepal Med Assoc 2018; 56:540-543. [PMID: 30058640 PMCID: PMC8997317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Hair transplant surgery is a minimally invasive surgery, where hair follicle is transplanted from donor area of patient's own body to the desired area. METHODS Patient with hair transplant surgery from a clinic were followed up for one year. The patients were asked for their complications within 2 days, 7 days, one month, 2 to 6 months and one year for assessment of results, side effects. At the end of one-year, subjective evaluation was done with patient's satisfaction to growth as- poor growth, satisfactory and good growth. RESULTS Out of 152 patients, maximum patients 74 (48.6%) were in age group 21-30, followed by 61 (40.01%) in age group 31-40, mean age was 31.79, youngest being 21 years and oldest being 70 years of age. Among the complications, swelling of forehead was in more than two- thirds of the patients 106 (69.74%), followed by temporary hair fall noted in 65 (42.76%) of patients. Clients' remarks noted at the end on one-year revealed 86.18% as excellent results, 11.84% as satisfactory and 1.97% as poor results. CONCLUSIONS Hair transplant sugary by FUE is a relatively safe surgery with optimum results and minimum complications, which can be useful to patients with androgenetic alopecia.
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Affiliation(s)
- Rupak Bishwokarma Ghimire
- Department of Dermatology, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal,Correspondence: Dr. Rupak Bishwokarma Ghimire, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal. , Phone: +977-9802900007
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22
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Goel K. Supracrestal Non-Surgical Therapy in Periodontal Diseases. JNMA J Nepal Med Assoc 2018; 56:544-546. [PMID: 30058641 PMCID: PMC8997323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periodontal diseases are the complex disease with a dynamic relationship between biofilm and the host immunoinflammatory response. The goal of periodontal therapy is to preserve the natural dentition and increase their longevity by creation of a favorable environment around the teeth. The mainstay to achieve this is by the non-surgical periodontal therapy, followed by surgical and other recent treatment modalities. However, there seems no sure indication to choose amongst them that are clinically significant and offer long term predictability. We report here two cases that had supracrestal defects and were treated with less invasive instrumentation and repeated full mouth scaling and root planing. This avoided a surgical intervention and was more cost-effective in treating moderate to severe young chronic periodontitis patients. The decision for the type of treatment needs to be critically assessed with a better understanding of the outcome, morphology of the defects, and type of teeth involved. Fundamentals like positive reinforcements, compliance and self-performed plaque control will always remain an integral component regardless of nonsurgical or surgical periodontal therapy.
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Affiliation(s)
- Khushboo Goel
- Department of Periodontology and Oral Implantology, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal,Correspondence: Dr. Khushboo Goel, Department of Periodontology and Oral Implantology, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal. , Phone +977-9842638286
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23
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Martinez-Herrera M, Silvestre FJ, Silvestre-Rangil J, López-Domènech S, Bañuls C, Rocha M. Levels of serum retinol-binding protein 4 before and after non-surgical periodontal treatment in lean and obese subjects: An interventional study. J Clin Periodontol 2017; 45:336-344. [DOI: 10.1111/jcpe.12840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Mayte Martinez-Herrera
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | - Francisco Javier Silvestre
- Service of Stomatology; University Hospital Doctor Peset-FISABIO; Valencia Spain
- Department of Stomatology; University of Valencia; Valencia Spain
| | | | - Sandra López-Domènech
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
| | - Celia Bañuls
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
| | - Milagros Rocha
- Service of Endocrinology and Nutrition; University Hospital Doctor Peset-FISABIO; Valencia Spain
- CIBER CB06/04/0071 Research Group; CIBER Hepatic and Digestive Diseases; University of Valencia; Valencia Spain
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24
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Preus HR, Gjermo P, Baelum V. A double-masked Randomized Clinical Trial (RCT) comparing four periodontitis treatment strategies: 5-year clinical results. J Clin Periodontol 2017; 44:1029-1038. [DOI: 10.1111/jcpe.12793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Hans R. Preus
- Department of Periodontology; Institute of Clinical Odontology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Per Gjermo
- Department of Periodontology; Institute of Clinical Odontology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Vibeke Baelum
- Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
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25
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Kurgan Ş, Önder C, Balcı N, Fentoğlu Ö, Eser F, Balseven M, Serdar MA, Tatakis DN, Günhan M. Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy. J Periodontal Res 2016; 52:574-581. [DOI: 10.1111/jre.12425] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Ş. Kurgan
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
| | - C. Önder
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
| | - N. Balcı
- Department of Periodontology; Faculty of Dentistry; Istanbul Medipol University; İstanbul Turkey
| | - Ö. Fentoğlu
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - F. Eser
- Department of Physical Medicine and Rehabilitation; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - M. Balseven
- Department of Periodontology; Faculty of Dentistry; Pamukkale University; Denizli Turkey
| | - M. A. Serdar
- Department of Medical Biochemistry; School of Medicine; Acıbadem University; Ankara Turkey
| | - D. N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - M. Günhan
- Department of Periodontology; Faculty of Dentistry; Ankara University; Ankara Turkey
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26
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Effect of non-surgical periodontal treatment by full-mouth disinfection or scaling and root planing per quadrant in halitosis—a randomized controlled clinical trial. Clin Oral Investig 2016; 21:1545-1552. [DOI: 10.1007/s00784-016-1959-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/05/2016] [Indexed: 11/26/2022]
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27
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Taşdemir Z, Özsarı Taşdemir F, Koçyiğit İ, Yazıcı C, Gürgan CA. The clinical and systemic effects of periodontal treatment in diabetic and non-diabetic obese patients. J Oral Sci 2016; 58:523-531. [DOI: 10.2334/josnusd.16-0163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Zekeriya Taşdemir
- Department of Periodontology, Faculty of Dentistry, Erciyes University
| | | | - İsmail Koçyiğit
- Deparment of Nephrology, Internal Medicine, Faculty of Medicine, Erciyes University
| | - Cevat Yazıcı
- Department of Biochemistry, Faculty of Medicine, Erciyes University
| | - Cem A. Gürgan
- Department of Periodontology, Faculty of Dentistry, Erciyes University
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