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Parwani SR, Thakare KS, Kawadkar KP, Soni NJ, Parwani R, Dadlani H, Chaudhary DS, Pahuja D, Spagnuolo G, Armogida NG. Platelet-Rich Fibrin in Non-Surgical Periodontal Therapy: A Split-Mouth Randomized Controlled Clinical Trial. Dent J (Basel) 2024; 12:135. [PMID: 38786533 PMCID: PMC11120449 DOI: 10.3390/dj12050135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test group pockets alongside SRP, while control group pockets received SRP alone. Measurements at baseline and six weeks included probing pocket depths (PPDs), clinical attachment loss (CAL), gingival recession (GR), the plaque index, and the gingivitis index. The wound healing index was assessed at six weeks. The results show statistically significant improvements in the SRP+PRF group compared to SRP alone, demonstrating a better CAL gain (SRP+PRF group: 2.69 ± 0.63; SRP alone group: 4.15 ± 0.69-p-value: 0.001), PPD reduction (SRP+PRF group: 2.62 ± 0.65; SRP alone group: 3.85 ± 0.80-p-value: 0.001), and GR minimization (SRP+PRF group: 0.46 ± 0.62; SRP alone group: 0.81 ± 0.72-p-value: 0.21). The adjunctive use of PRF enhanced healing, reduced pocket depths, decreased tissue morbidity, and minimized gingival recession. This study concludes that PRF placement is effective in 5-6 mm pockets, potentially reducing the number of periodontal treatment sessions needed for pocket closure.
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Affiliation(s)
- Simran R. Parwani
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Kaustubh S. Thakare
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Kshipra P. Kawadkar
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Nishita Jaju Soni
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Rajkumar Parwani
- Department of Oral Pathology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India;
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Meerut 250103, India;
- Principal Consultant, Department of Dentistry, Max Hospital, Gurugram 122001, India
| | - Dhanashree S. Chaudhary
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Dipanshu Pahuja
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati 444602, India; (S.R.P.); (K.S.T.); (K.P.K.); (N.J.S.); (D.S.C.); (D.P.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy;
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow 119991, Russia
| | - Niccolò Giuseppe Armogida
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy;
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Ferrà-Cañellas MDM, Garcia-Sureda L. Exploring the Potential of Micro-Immunotherapy in the Treatment of Periodontitis. Life (Basel) 2024; 14:552. [PMID: 38792574 PMCID: PMC11122531 DOI: 10.3390/life14050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Periodontitis, characterized by the progressive destruction of dental support tissues due to altered immune responses, poses a significant concern for public health. This condition involves intricate interactions between the immune response and oral microbiome, where innate and adaptive immune responses, with their diverse cell populations and inflammatory mediators, play crucial roles in this immunopathology. Indeed, cytokines, chemokines, growth factors, and immune cells perform key functions in tissue remodeling. Focusing on periodontal therapies, our attention turns to micro-immunotherapy (MI), employing low doses (LDs) and ultra-low doses (ULDs) of immunological signaling molecules like cytokines, growth factors, and hormones. Existing studies across various fields lay the groundwork for the application of MI in periodontitis, highlighting its anti-inflammatory and regenerative potential in soft tissue models based on in vitro research. In summary, this review underscores the versatility and potential of MI in managing periodontal health, urging further investigations to solidify its clinical integration. MI supports an innovative approach by modulating immune responses at low doses to address periodontitis.
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Affiliation(s)
- Maria del Mar Ferrà-Cañellas
- Preclinical Research Department, Labo’Life España, 07330 Consell, Spain
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain
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Alasqah MN. Efficacy of methylene blue-mediated antimicrobial photodynamic therapy on clinical and radiographic outcomes among patients with periodontal diseases: A systematic review and meta-analysis of randomized controlled trials. Photodiagnosis Photodyn Ther 2024; 46:104000. [PMID: 38316339 DOI: 10.1016/j.pdpdt.2024.104000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This study aimed to assess the influence of methylene blue (MB)-mediated adjunctive antimicrobial photodynamic therapy (aPDT) when compared to conventional mechanical debridement (MD) alone on periodontal clinical and radiographic outcomes among periodontitis patients. METHODS Randomized clinical trials (RCTs) were incorporated by conducting an electronic search in Web of Science, Scopus, and PubMed for articles published in English up to August 2023 to address the following focused question based on the PICO format: "Whether the application of MB-mediated aPDT as an adjunctive to MD (Intervention) leads to improved periodontal clinical and/or radiographic outcomes (Outcome) among participants with and without periodontal diseases (Population) as compared to MD alone (Conparison)". The risk of bias (RoB) of the included studies was assessed using the modified Jadad scale. A meta-analysis was conducted, and it included the presentation of the standard mean difference (SMD) along with a 95 % confidence interval (CI). RESULTS In total, 11 studies were included in this systematic review and meta-analysis. The meta-analysis demonstrated statistically significant improvements in periodontal plaque index (SMD: -0.72 % [95 % CI: -0.99 % to -0.45 %]; p<0.00001), probing depth (SMD: -0.38 % [95 % CI: -0.57 % to -0.19 %; p<0.00001), and bleeding on probing (SMD: -0.44 % [95 % CI: -0.68 % to -0.20 %]; p = 0.0003) scores at the final follow-up visit after the application of MB-mediated aPDT in comparison with MD alone. Nevertheless, there was no statistically significant difference was observed in periodontal clinical attachment level values (SMD: -0.01 % [95 % CI: -0.21 % to 0.19 %]; p = 0.95) between the control group and the experimental group. Six studies achieved a low RoB, five were rated as having medium RoB, while no study received a high RoB. CONCLUSION MB-mediated aPDT, when used as an adjunct to conventional MD contributes to the improvement of periodontal clinical outcomes including PI, PD, and BOP in patients with periodontitis.
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Affiliation(s)
- Mohammed N Alasqah
- Department of Preventive Dental Sciences. College of Dentistry, Prince Sattam bin Abdulaziz University. Alkharj, Kingdom of Saudi Arabia.
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Li L, Hayashi-Okada Y, Falkner KL, Cervi S, Andrusz S, Shimizu Y, Zambon JJ, Kirkwood KL, Schifferle RE, Diaz PI. Randomized Trial to Test a Chemo-Mechanical Antiplaque Regimen as Adjunct to Periodontal Therapy. JDR Clin Trans Res 2024; 9:160-169. [PMID: 37148266 DOI: 10.1177/23800844231167065] [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: 05/08/2023] Open
Abstract
BACKGROUND The control of dental biofilm regrowth after nonsurgical periodontal therapy is associated with better clinical outcomes. However, many patients have difficulty achieving optimal plaque control. Subjects with diabetes, in which immune and wound-healing responses are typically impaired, may benefit from intensive antiplaque control regimens after scaling and root planing (SRP). OBJECTIVES This study aimed to evaluate the effects of an intensive, at-home, chemical, and mechanical antiplaque regimen as an adjunct to SRP for the treatment of moderate to severe periodontitis. A secondary objective was to compare responses in subjects with type 2 diabetes and nondiabetics. METHODS This was a 6-mo, single-center, parallel-group, randomized trial. The test group received SRP and oral hygiene instructions, and subjects were instructed to use a 0.12% chlorhexidine gluconate mouthrinse twice a day for 3 mo and utilize rubber interproximal bristle cleaners twice a day for 6 mo. The control group received SRP and oral hygiene instructions. The main outcome was change in mean probing depth (PD) from baseline to 6 mo. Secondary outcomes included change in sites with deep PDs, mean clinical attachment level, bleeding on probing, plaque index, hemoglobin A1C, fasting blood glucose, C-reactive protein, and taste assessment. This study was registered at ClinicalTrials.gov as NCT04830969. RESULTS In total, 114 subjects were randomized to either treatment. Eighty-six subjects completed the trial with no missing visits. Neither an intention-to-treat nor a per-protocol analysis showed statistically significant differences between treatment groups in mean PD at 6 mo. In a subgroup analysis, subjects with diabetes in the test group showed a statistically significant greater reduction in mean PD at 6 mo when compared to subjects with diabetes receiving the control treatment (Δ = 0.15, P = 0.04), while there were no differences within nondiabetics (Δ = 0.02, P = 0.75). CONCLUSION Outcomes in subjects with diabetes may be improved by chemo-mechanical antiplaque measures after nonsurgical periodontal therapy. KNOWLEDGE TRANSFER STATEMENT This study suggests diabetic subjects may benefit from an intensive, at-home, chemical, and mechanical antiplaque regimen to improve nonsurgical periodontal therapy outcomes.
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Affiliation(s)
- L Li
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - K L Falkner
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | - S Cervi
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | - S Andrusz
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - J J Zambon
- Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - K L Kirkwood
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - R E Schifferle
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - P I Diaz
- UB Microbiome Center, State University of New York at Buffalo, Buffalo, NY, USA
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
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Ma R, Liu Y, Xu Y, Duan D. Lipoxin A4 levels predict site-specific clinical improvements post scaling and root planing and correlate negatively with periodontal pathogens in severe periodontitis. BMC Oral Health 2024; 24:204. [PMID: 38331747 PMCID: PMC10851498 DOI: 10.1186/s12903-024-03948-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Serving as a stop signal of inflammation, the role of lipoxin A4 (LXA4) in periodontitis remains to be clarified. This study is aimed to examine the changes in LXA4 levels in gingival crevicular fluid (GCF) after scaling and root planing (SRP) and to determine the relationship between LXA4 levels and treatment outcomes and periodontal pathogens in severe periodontitis. METHODS A total of 74 GCF samples were collected from 21 severe periodontitis participants at the deepest affected sites. These sites were re-sampled at 1, 3, and 6 months after SRP. Besides, GCF samples were also collected from 25 periodontally healthy participants. Clinical parameters including probing depth (PD) and clinical attachment level (CAL) in periodontitis group were recorded. LXA4 levels and periodontal pathogens in the GCF were analyzed by ELISA and PCR, respectively. Correlations between GCF LXA4 levels and treatment effect and periodontal pathogens were assessed. RESULTS LXA4 levels in GCF significantly increased after SRP (p < 0.05), but remained lower than those observed in healthy individuals (p < 0.05). Sites with lower baseline LXA4 concentrations were more likely to experience greater improvements in PD at 6 months post-SRP (area under the curve [AUC] = 0.792), and the improvements were positively correlated with the increase of LXA4 at these sites post-treatment (p < 0.05). Furthermore, more elevated LXA4 levels were observed in sites that became negative for Prevotella intermedia or Tannerella forsythia after SRP. CONCLUSION Baseline LXA4 in GCF has the potential to predict the site-specific response of severe periodontal lesions to SRP. The increase of LXA4 levels after treatment was positively correlated with clinical improvements and negatively correlated with the presence of Prevotella intermedia or Tannerella forsythia.
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Affiliation(s)
- Rui Ma
- State Key Laboratory of Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yiying Liu
- State Key Laboratory of Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China
| | - Dingyu Duan
- State Key Laboratory of Oral Diseases, Department of Periodontics, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, 610041, China.
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Torumtay Cin G, Lektemur Alpan A, Çevik Ö. Efficacy of injectable platelet-rich fibrin on clinical and biochemical parameters in non-surgical periodontal treatment: a split-mouth randomized controlled trial. Clin Oral Investig 2023; 28:46. [PMID: 38153510 DOI: 10.1007/s00784-023-05447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES The purpose of this clinical trial was to evaluate the potential clinical and biochemical effects of injectable platelet-rich fibrin (i-PRF) application adjunct to scaling and root planning (ScRp) in deep periodontal pockets. MATERIALS AND METHODS In this split-mouth-designed study, 17 patients with 34 deep periodontal pockets were randomly treated with ScRp + i-PRF (test group) and ScRp + saline (control group). Clinical periodontal measurements were recorded at baseline, 1st, 3rd, and 6th months after the treatments. The levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin (IL)-10 in gingival crevicular fluid (GCF) samples were analyzed using the ELISA method at baseline, 7th, and 14th days. RESULTS Clinical periodontal parameters showed significant improvements with both treatment modalities. Mean pocket reduction (PD) and clinical attachment (CAL) gain were significantly higher in the test group than in controls at follow-up visits (p < 0.05). In the test group, gingival recession (GR) values were significantly lower compared to the control group. VEGF and IL-10 levels in the test group were significantly higher than in controls at the 14th day, and TNF-α levels were found significantly lower in the test group at the 7th and 14th days. CONCLUSIONS Especially in the test group, the significant increase in VEGF and IL-10 expressions and the decrease in TNF-α levels may have accelerated the periodontal healing observed in the clinical parameters. CLINICAL RELEVANCE The result of the present study demonstrated the beneficial effects of adjunctive i-PRF administration during non-surgical periodontal treatment of deep periodontal pockets. CLINICAL TRIAL REGISTRATION NUMBER NCT05753631.
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Affiliation(s)
- Gizem Torumtay Cin
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey.
| | - Aysan Lektemur Alpan
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Özge Çevik
- Department of Medical Biochemistry, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
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Qasim SSB, Ahmed J, Karched M, Al-Asfour A. The potential of nano graphene oxide and chlorhexidine composite membranes for use as a surface layer in functionally graded membranes for periodontal lesions. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:63. [PMID: 38103062 PMCID: PMC10725336 DOI: 10.1007/s10856-023-06767-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
Membranes have been used for treating periodontal defects and play a crucial role in guided bone regeneration applications. Nano graphene oxide have been exploited in tissue engineering due to its biomechanical properties. Its composite formulations with hydroxyapatite and chitosan with controlled degradation could aid in becoming part of a surface layer in a functionally graded membrane. The aim of the study was to synthesize chitosan and composite formulations of nano graphene oxide, hydroxyapatite and chlorhexidine digluconate using solvent casting technique and to characterize the physiochemical, mechanical, water vapor transmission rate (barrier), degradation and antimicrobial potential of the membranes. Altogether four different membranes were prepared (CH, CCG, 3511 and 3322). Results revealed the chemical interactions of hydroxyapatite, chitosan and nanographene oxide due to inter and intra molecular hydrogen bonding. The tensile strength of 3322 (33.72 ± 6.3 MPa) and 3511 (32.06 ± 5.4 MPa) was higher than CH (27.46 ± 9.6 MPa). CCG showed the lowest water vapor transmission rate (0.23 ± 0.01 g/h.m2) but the highest weight loss at day 14 (76.6 %). 3511 showed a higher drug release after 72 h (55.6 %) Significant biofilm growth inhibition was observed for all membranes. 3511 showed complete inhibition against A. actinomycetemcomitans. Detailed characterization of the synthesized membranes revealed that 3511 composite membrane proved to be a promising candidate for use as a surface layer of membranes for guided bone regeneration of periodontal lesions.
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Affiliation(s)
- Syed Saad Bin Qasim
- Department of Bioclinical Sciences, College of Dentistry, Kuwait University, Kuwait, Kuwait.
| | - Jasim Ahmed
- Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - Maribasappa Karched
- Department of Biological Sciences, College of Dentistry, Kuwait University, Kuwait, Kuwait
| | - Adel Al-Asfour
- Department of Surgical Sciences, College of Dentistry, Kuwait University, Kuwait, Kuwait
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Mehrotra R, Gupta S, Siddiqui ZR, Chandra D, Ikbal SA. Clinical efficacy of ozonated water and photodynamic therapy in non-surgical management of chronic periodontitis: A clinico- microbial study. Photodiagnosis Photodyn Ther 2023; 44:103749. [PMID: 37625764 DOI: 10.1016/j.pdpdt.2023.103749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/26/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. Treatment of the periodontitis is a key challenge since the disease occurs due to microbial biofilm which is extremely resistant to host response and antimicrobials. Among non-surgical methods, scaling and root planning (SRP) is considered as the fundamental method and results in the utmost improvements. However, complete elimination of subgingival calculus is difficult. A substitute treatment in inhibition of subgingival microbiota can be attained by ozonated water at a concentration of 0.5-4 mg/L. Lately, laser light therapy has been proposed in periodontal therapy in an endeavor to improve the efficiency and effectiveness of bacterial elimination and root surface debridement. MATERIALS AND METHODS 26 patients with chronic periodontitis were selected. The selected arches were randomly divided into two groups: Group-A was subjected to SRP + Ozone-Therapy and Group-B to SRP + Photodynamic-Therapy. Clinical parameters were recorded at baseline, 1&2months. Microbial parameters were recorded at baseline and 2-months. RESULTS For both the groups significant decrease in clinical parameters were seen from baseline to 1 month and further in 2 months. On intergroup comparison of clinical parameters no significant result was found. Both the groups showed significant decrease in microbial parameters was seen from baseline to 2 months. On intergroup comparison of microbial parameters no significant result was found. CONCLUSION Clinically and microbiologically, there was significant difference in both the groups between all time periods (P < 0.001), however there was no significant difference between the two groups at all periods (P > 0.05).
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Affiliation(s)
- Roopanshi Mehrotra
- Department of Periodontology, Career PG Institute of Dental Sciences and Hospital, Lucknow 226013, India.
| | - Sanjay Gupta
- Department of Periodontology, Career PG Institute of Dental Sciences and Hospital, Lucknow 226013, India
| | - Zeba Rahman Siddiqui
- Department of Periodontology, Career PG Institute of Dental Sciences and Hospital, Lucknow 226013, India
| | - Deepti Chandra
- Department of Periodontology, Career PG Institute of Dental Sciences and Hospital, Lucknow 226013, India
| | - Sk Aziz Ikbal
- Department of Periodontology, Career PG Institute of Dental Sciences and Hospital, Lucknow 226013, India
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Kobayashi T, Bartold PM. Periodontitis and periodontopathic bacteria as risk factors for rheumatoid arthritis: A review of the last 10 years. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:263-272. [PMID: 37674898 PMCID: PMC10477376 DOI: 10.1016/j.jdsr.2023.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Rheumatoid arthritis (RA) is characterized by chronic inflammatory destruction of joint tissue and is caused by an abnormal autoimmune response triggered by interactions between genetics, environmental factors, and epigenetic and posttranslational modifications. RA has been suggested to be interrelated with periodontitis, a serious form or stage of chronic inflammatory periodontal disease associated with periodontopathic bacterial infections, genetic predisposition, environmental factors, and epigenetic influences. Over the last decade, a number of animal and clinical studies have been conducted to assess whether or not periodontitis and associated periodontopathic bacteria constitute risk factors for RA. The present review introduces recent accumulating evidence to support the associations of periodontitis and periodontopathic bacteria with the risk of RA or the outcome of RA pharmacological treatment with disease-modifying antirheumatic drugs. In addition, the results from intervention studies have suggested an improvement in RA clinical parameters after nonsurgical periodontal treatment. Furthermore, the potential causal mechanisms underlying the link between periodontitis and periodontopathic bacteria and RA are summarized.
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Affiliation(s)
- Tetsuo Kobayashi
- General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan
| | - Peter Mark Bartold
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia 5005, Australia
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Ferrarotti F, Baima G, Rendinelli M, Citterio F, Mariani GM, Mussano F, Romano F, Romandini M, Aimetti M. Pocket closure after repeated subgingival instrumentation: a stress test to the EFP guideline for stage III-IV periodontitis. Clin Oral Investig 2023; 27:6701-6708. [PMID: 37773418 PMCID: PMC10630226 DOI: 10.1007/s00784-023-05279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To study the effects of one or two repeated subgingival instrumentations (RSI) in achieving the endpoints of therapy (EoT) in open pockets [residual probing pocket depth (PPD) ≥ 6 mm and PPD 4-5 mm with bleeding on probing (BoP)] after steps I-II of therapy. MATERIALS AND METHODS Twenty-five patients (3,552 total sites; 1,450 open pockets) with stage III-IV periodontitis received steps I-II of periodontal therapy and were re-evaluated after 4-6 weeks (T1). Residual pockets received RSI at T1 and at 3 months (T2). EoT (PPD < 4 or PPD < 6 BoP-) rate at T1, T2 and 6 months (T3) was computed. The number of needed surgeries and treatment costs were calculated. RESULTS At T1, 67.6% of open pockets achieved EoT. At residual PPD ≥ 6 mm at T1 (n = 172), one and two RSI resulted in 33.1% and 45.9% of EoT at T2 and T3, respectively. At residual PPD 4-5 mm with BoP at T1 (n = 298), one and two RSI resulted in 66.8% and 72.1% of EoT at T2 and T3, respectively. PPD at T1 predicted EoT after RSI in both cases, while tooth type only in residual PPD 4-5 mm BoP + . At T1, mean number of surgeries per patient and associated costs were significantly higher than after one/two RSI. CONCLUSIONS RSI may achieve EoT in residual PPD 4-5 mm BoP + and PPD ≥ 6 mm in a considerable number of cases. CLINICAL RELEVANCE These findings may support the administration of one/two cycles of RSI prior to surgical approach. PROTOCOL REGISTRATION ClinicalTrials.gov identification number: NCT04826926.
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Affiliation(s)
- Francesco Ferrarotti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy.
- Politecnico di Torino, Turin, Italy.
| | - Martina Rendinelli
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Giulia Maria Mariani
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Federico Mussano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Geitmyrsveien, 69, 0455, Oslo, Norway.
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, Turin, Italy
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11
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Yuan Z, Li J, Zou X, Liu C, Lu J, Ni C, Tang L, Wu X, Yan F. Knockdown of Bach1 protects periodontal bone regeneration from inflammatory damage. J Cell Mol Med 2023; 27:3465-3477. [PMID: 37602966 PMCID: PMC10660620 DOI: 10.1111/jcmm.17916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/17/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Abstract
Periodontal bone regeneration is a major challenge in the treatment of periodontitis. However, the regenerative vitality of periodontal ligament cells (PDLCs) declines in the environment of periodontitis and accompanying oxidative stress. This study aimed to investigate the functional mechanisms of Bach1, a transcriptional suppressor involved in oxidative stress response, and its regulation of PDLC osteogenesis under inflammatory conditions. We observed a significant elevation in Bach1 expression in periodontal tissues with periodontitis and PDLCs under inflammatory conditions. Knockdown of Bach1 alleviated the inflammation-induced oxidative stress level and partly offset the inhibitory effect of inflammatory conditions on osteogenesis, as well as the expression of osteogenic genes BMP6, OPG and RUNX2. Similarly, knockdown of Bach1 protects PDLCs from inflammatory damage to periodontal bone regeneration in vivo. Furthermore, we found that Bach1 could bind to the histone methyltransferase EZH2, and the binding increased under inflammatory conditions. Bach1 enhanced the ability of EZH2 to catalyse H3K27me3 on the promoter region of RUNX2 and BMP6, thus repressing the expression of osteoblastic genes. In conclusion, our study revealed that knockdown of Bach1 effectively rescued the osteogenesis and oxidative stress of PDLCs with inflammation. Bach1 could be a promising target for enhancing periodontal tissue regeneration under periodontitis conditions.
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Affiliation(s)
- Zhiyao Yuan
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Junjie Li
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life SciencesNanjing UniversityNanjingChina
| | - Xihong Zou
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Chaoyi Liu
- Hangzhou Stomatological HospitalHangzhouChina
| | - Jiangyue Lu
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Can Ni
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Lai Tang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Xudong Wu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life SciencesNanjing UniversityNanjingChina
| | - Fuhua Yan
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
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12
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Zhao X, Li M, Li M, Li W, Li A, Cheng Y, Pei D. Adhesive and biodegradable polymer mixture composed of high -biosafety pharmaceutical excipients as non-setting periodontal dressing. Biomater Sci 2023; 11:7067-7076. [PMID: 37724849 DOI: 10.1039/d3bm01314f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Periodontal dressing is a surgical dressing applied to oral wounds after periodontal surgery. Currently, all commercially available setting periodontal dressings are stiff, uncomfortable, with poor aesthetics, and need to be removed at the patient's follow-up visit, which may cause secondary damage. A periodontal dressing with soft texture, biodegradable properties, and that could balance both comfort and aesthetics is urgently desired. Hence, non-setting and degradable dressings were developed using sodium carboxymethyl cellulose, Eudragit S 100 and povidone K30, which were compared with the commercial degradable dressing Reso-pac®. The mucosal adhesion of the dressings was evaluated by lap shear tests, which indicated adequate adhesion. The in vitro swelling rates of the dressings were approximately half that of Reso-pac®, which led to less saliva adsorption and better dimensional stability. The dressings also exhibited satisfactory biocompatibility according to the results of CCK-8, Live/Dead staining, hemolysis, and subcutaneous implantation assays. Moreover, the dressing promoted the healing of full-thickness mucosal wounds in the palatal gingivae of SD rats and contributed to better therapeutic effect than Reso-pac®. Considering the multiple advantages and the pure pharmaceutical excipient formula, we anticipate that this dressing could be a promising product and may enter clinical practice in the near future.
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Affiliation(s)
- Xiaodan Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Meiwen Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Meng Li
- School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Wenbo Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Yilong Cheng
- School of Chemistry, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, China.
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13
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Aoki A, Mizutani K, Mikami R, Ohsugi Y, Kobayashi H, Akizuki T, Taniguchi Y, Takeuchi Y, Katagiri S, Sasaki Y, Komaki M, Meinzer W, Izumi Y, Iwata T. Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol 2023; 94:1187-1199. [PMID: 37015852 DOI: 10.1002/jper.22-0552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. METHODS Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12 months. RESULTS Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs. 1.89 mm on average; p = 0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs. 1.06 mm; p = 0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p = 0.031), compared with SRP alone. CONCLUSION The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Taniguchi Dental Clinic, Sapporo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiyuki Sasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University (KDU), Yokosuka, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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14
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Zhang L, Sheng M, Cao H, Zhang L, Shao W. Decoding the role of long non-coding RNAs in periodontitis: A comprehensive review. Biomed Pharmacother 2023; 166:115357. [PMID: 37619483 DOI: 10.1016/j.biopha.2023.115357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023] Open
Abstract
Periodontitis is an inflammatory disease characterized by the pathological loss of alveolar bone and the adjacent periodontal ligament. It is considered a disease that imposes a substantial health burden, with an incidence rate of 20-50%. The etiology of periodontitis is multifactorial, with genetic factors accounting for approximately half of severe cases. Studies have revealed that long non-coding RNAs (lncRNAs) play a pivotal role in periodontitis pathogenesis. Accumulating evidence suggests that lncRNAs have distinct regulatory mechanisms, enabling them to control numerous vital processes in periodontal cells, including osteogenic differentiation, inflammation, proliferation, apoptosis, and autophagy. In this review, we summarize the diverse roles of lncRNAs in the pathogenesis of periodontitis, shedding light on the underlying mechanisms of disease development. By highlighting the potential of lncRNAs as biomarkers and therapeutic targets, this review offers a new perspective on the diagnosis and treatment of periodontitis, paving the way for further investigation into the field of lncRNA-based therapeutics.
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Affiliation(s)
- Lizhi Zhang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Mengfei Sheng
- Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Pathogen Biology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, Anhui, China
| | - Huake Cao
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Lei Zhang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China.
| | - Wei Shao
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Pathogen Biology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, Anhui, China.
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15
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Ivanov AA, Kuznetsova AV, Popova OP, Danilova TI, Latyshev AV, Yanushevich OO. Influence of Extracellular Matrix Components on the Differentiation of Periodontal Ligament Stem Cells in Collagen I Hydrogel. Cells 2023; 12:2335. [PMID: 37830549 PMCID: PMC10571948 DOI: 10.3390/cells12192335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
Regeneration of periodontal tissues requires an integrated approach to the restoration of the periodontal ligament, cementum, and alveolar bone surrounding the teeth. Current strategies in endogenous regenerative dentistry widely use biomaterials, in particular the decellularized extracellular matrix (dECM), to facilitate the recruitment of populations of resident cells into damaged tissues and stimulate their proliferation and differentiation. The purpose of our study was to evaluate the effect of the exogenous components of the extracellular matrix (hyaluronic acid, laminin, fibronectin) on the differentiation of periodontal ligament stem cells (PDLSCs) cultured with dECM (combinations of decellularized tooth matrices and periodontal ligament) in a 3D collagen I hydrogel. The immunohistochemical expression of various markers in PDLSCs was assessed quantitatively and semi-quantitatively on paraffin sections. The results showed that PDLSCs cultured under these conditions for 14 days exhibited phenotypic characteristics consistent with osteoblast-like and odontoblast-like cells. This potential has been demonstrated by the expression of osteogenic differentiation markers (OC, OPN, ALP) and odontogenic markers (DSPP). This phenomenon corresponds to the in vivo state of the periodontal ligament, in which cells at the interface between bone and cementum tend to differentiate into osteoblasts or cementoblasts. The addition of fibronectin to the dECM most effectively induces the differentiation of PDLSCs into osteoblast-like and odontoblast-like cells under 3D culture conditions. Therefore, this bioengineered construct has a high potential for future use in periodontal tissue regeneration.
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Affiliation(s)
- Alexey A. Ivanov
- Laboratory of Molecular and Cellular Pathology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (A.V.K.); (O.P.P.); (T.I.D.); (A.V.L.)
| | - Alla V. Kuznetsova
- Laboratory of Molecular and Cellular Pathology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (A.V.K.); (O.P.P.); (T.I.D.); (A.V.L.)
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, 26 Vavilov Str., 119334 Moscow, Russia
| | - Olga P. Popova
- Laboratory of Molecular and Cellular Pathology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (A.V.K.); (O.P.P.); (T.I.D.); (A.V.L.)
| | - Tamara I. Danilova
- Laboratory of Molecular and Cellular Pathology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (A.V.K.); (O.P.P.); (T.I.D.); (A.V.L.)
| | - Andrey V. Latyshev
- Laboratory of Molecular and Cellular Pathology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (A.V.K.); (O.P.P.); (T.I.D.); (A.V.L.)
| | - Oleg O. Yanushevich
- Department of Periodontology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia;
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16
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Gousopoulou E, Bakopoulou A, Laskaris D, Gousopoulos E, Apatzidou DA. Characterization of the soft-tissue wall lining residual periodontal pockets and implications in periodontal wound healing. Clin Oral Investig 2023; 27:5031-5040. [PMID: 37486381 PMCID: PMC10492763 DOI: 10.1007/s00784-023-05122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/10/2023] [Indexed: 07/25/2023]
Abstract
AIM To characterize the soft-tissue wall of remaining periodontal pockets for wound healing-related parameters versus healthy gingival crevices in the same individuals. MATERIALS AND METHODS Gingival tissues collected from the diseased interface of pockets (GT biopsies) and from healthy gingival crevices (G biopsies) were subjected to RT2-profiler PCR Array for wound healing-related markers and network analysis of differentially expressed genes. Lymphangiogenesis-related gene expression was determined by qRT-PCR. The migration potential of mesenchymal stem cells isolated from GT biopsies (GT-MSCs) and G biopsies (G-MSCs) was evaluated by the scratch- and the transwell migration assays. The total collagen protein content was determined in GT-MSCs and G-MSCs homogenates. RESULTS Gene-ontology analysis on significantly upregulated genes expressed in GT biopsies revealed enrichment of several genes involved in processes related to matrix remodeling, collagen deposition, and integrin signaling. No significantly expressed genes were seen in G biopsies. Regarding lymphangiogenesis-related genes, GT biopsies demonstrated greater expression for PROX1 than G biopsies (p = 0.05). Lower migration potential (p < 0.001), yet greater production of collagen protein (p = 0.05), was found for GT-MSCs over G-MSCs. CONCLUSION Differential expression patterns of various molecular pathways in biopsies and cell cultures of diseased versus healthy gingival tissues indicate a potential of the former for tissue remodeling and repair. CLINICAL RELEVANCE In the course of periodontitis, granulation tissue is formed within a periodontal defect in an attempt to reconstruct the site. Following treatment procedures periodontal granulation tissue remains inflamed but appears to retain healing potential.
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Affiliation(s)
- Evangelia Gousopoulou
- Department of Preventive Dentistry, Periodontology & Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.T.H.), 54124, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.T.H.), 54124, Thessaloniki, Greece
| | - Dimitrios Laskaris
- Department of Molecular Pathology, Netherlands Cancer Institute, 1066CX, Amsterdam, Netherlands
| | - Epameinondas Gousopoulos
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Danae A Apatzidou
- Department of Preventive Dentistry, Periodontology & Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.T.H.), 54124, Thessaloniki, Greece.
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17
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El Mobadder M, Nammour S, Grzech-Leśniak K. Photodynamic Therapy with Tolonium Chloride and a Diode Laser (635 nm) in the Non-Surgical Management of Periodontitis: A Clinical Study. J Clin Med 2023; 12:5270. [PMID: 37629310 PMCID: PMC10455230 DOI: 10.3390/jcm12165270] [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: 07/22/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to evaluate the efficacy of photodynamic therapy (PDT) using tolonium chloride and a 635 nm diode laser as an adjunct to non-surgical periodontitis treatment, specifically scaling and root planing (SRP) alone. A total of 32 patients with a pocket probing depth > 5 mm were included in the study. Among them, 16 patients underwent SRP alone (control group), and the remaining 16 patients received SRP along with PDT (study group). The PDT procedure utilized a 635 nm diode laser (Smart M, Lasotronix, Poland) and tolonium chloride. Clinical periodontal parameters, such as the plaque index (PI), bleeding on probing (BOP), gingival recession (GR), probing pocket depth (PPD), and clinical attachment loss (CAL), were assessed before treatment (T0) and at 3 months after treatment (T3). At T3, both groups demonstrated a significant reduction in the PI, BOP, PD, and CAL compared to T0. The SRP + PDT group displayed a significant reduction in PPD (3.79 mm ± 0.35) compared to the SRP alone group (4.85 mm ± 0.42) at T3. Furthermore, the SRP + PDT group exhibited a significant reduction in CAL (5.01 ± 0.81) compared to the SRP group (5.99 ± 1.08) at T3. Within the study's limitations, it was concluded that PDT, with tolonium chloride and a 635 nm diode laser, significantly contributed to the non-surgical treatment of periodontitis.
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Affiliation(s)
- Marwan El Mobadder
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland;
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium;
| | - Kinga Grzech-Leśniak
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland;
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298-0566, USA
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18
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Miroult C, Lasserre J, Toma S. Effects of Omega-3 as an adjuvant in the treatment of periodontal disease: A systematic review and meta-analysis. Clin Exp Dent Res 2023; 9:545-556. [PMID: 37345207 PMCID: PMC10441607 DOI: 10.1002/cre2.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/09/2023] [Accepted: 03/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES: Promoting resolution of inflammation using new classes of lipids mediators has been proposed for the management of inflammatory disease. This systematic review and meta-analysis aimed to evaluate the benefits of the use of omega-3 fatty acids as an adjuvant in the nonsurgical treatment of periodontitis. MATERIAL AND METHODS The data search was conducted into three main databases: PubMed, Embase, and Cochrane. The search equation was built around the PICO framework in which the population was constituted by human adults suffering from chronic periodontitis that had to be treated with conventional SRP with the adjunction of omega-3 fatty acids (I) or without the adjunction of omega-3 fatty acids (C), with, as a first outcome the probing pocket depth reduction (PPD) and as a second outcome the clinical attachment loss reduction (CAL). Risk of bias within studies was evaluated for each included study using the Cochrane collaboration tool for randomized studies (RoB Tool). A meta-analysis was performed using REVMAN 5.3. RESULTS After a global search, 117 studies were selected but only seven of them were eligible for the systematic review and meta-analysis. Six out of seven studies showed a significantly better PPD reduction in the omega-3 fatty acids group compared to the control group and five out of seven studies showed a significantly better CAL reduction in the omega-3 fatty acids group compared to the control group. The meta-analysis showed a statistically significant difference for PPD reduction (SMD: -0.78 [95% CI: -1.02, -0.54, p < .0001]) and CAL reduction (SMD: -0.80 [95% CI: -1.04, -0.56, p < .0001]) in favor of the test group. CONCLUSION After scaling and root planning, PPD reduction and CAL reduction were observed in both control and test groups, but with statistically significant better values for the omega-3 fatty acids group. Patients suffering from periodontitis could benefit from the use of omega-3 fatty acids to increase the effectiveness of a nonsurgical treatment.
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Affiliation(s)
- Clementine Miroult
- Department of Periodontology, Cliniques Universitaires Saint‐LucUniversité catholique de LouvainOttignies‐Louvain‐la‐NeuveBelgium
| | - Jerome Lasserre
- Department of Periodontology, Cliniques Universitaires Saint‐LucUniversité catholique de LouvainOttignies‐Louvain‐la‐NeuveBelgium
| | - Selena Toma
- Department of Periodontology, Cliniques Universitaires Saint‐LucUniversité catholique de LouvainOttignies‐Louvain‐la‐NeuveBelgium
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19
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Abu-Ta'a M, Marzouka D. Enamel Matrix Derivative (EMD) as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review. Cureus 2023; 15:e43530. [PMID: 37719602 PMCID: PMC10500965 DOI: 10.7759/cureus.43530] [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] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
If left untreated, periodontitis is a chronic, irreversible disease that can contribute to tooth loss. The primary objective of periodontal treatment is to arrest the progression of the disease and restore the supporting structures of the tooth. Scaling and root planing (SRP) is a common non-surgical periodontal therapy (NSPT) used to reduce inflammation, pocket depth, and clinical attachment loss. However, NSPT has limitations, notably in difficult-to-access deep pockets and molar furcations. Deep pockets (greater than 4 mm) frequently retain calculus following NSPT. To attain direct access, surgical periodontal therapy (SPT) is recommended, particularly for pockets deeper than 5 mm. Enamel matrix derivative (EMD) has emerged in recent years as a tool for periodontal regeneration when used in conjunction with NSP for infrabony defects. EMD may also have advantageous effects when combined with NSPT. The purpose of this review is to provide a thorough understanding of the effects of EMD as an adjunct to NSPT. The databases Scopus, PubMed/MEDLINE, Google Scholar, Cochrane, and Embase were systematically searched to identify relevant studies on the benefits of EMD and its use as an adjunct to NSPT. Incorporating EMD into NSPT reduces chair time, and 60% of studies demonstrated considerable benefits compared to SRP alone, according to the findings. On the basis of research, it can be concluded that EMD can be used as an adjunct to NSPT, thereby reducing the amount of time spent in the operating chair. In some cases, it can, therefore, be regarded as an alternative to surgical treatment.
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Affiliation(s)
| | - Dina Marzouka
- Dental Sciences, Arab American University, Ramallah, PSE
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20
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Gegout PY, Stutz C, Huck O. Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis. Heliyon 2023; 9:e17789. [PMID: 37455970 PMCID: PMC10345361 DOI: 10.1016/j.heliyon.2023.e17789] [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: 12/02/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This systematic review and meta-analysis evaluated the effect of the use of available drugs loaded gels used as adjunct to non-surgical periodontal therapy. Methods Systematic research on PubMed/MEDLINE, Cochrane Central register of Controlled Trials, and Embase databases up to December 2021 was performed. Randomized clinical trials (RCT) which compared the outcomes of scaling and root planing (SRP) + local adjuvant administration (gel) versus SRP + placebo or SRP alone in Humans were included. The primary outcome measures were PPD and CAL changes at 3 months. Results After articles screening, 77 articles were included and assessed for quality. Then, a meta-analysis was conducted in studies with at least 3 months of follow-up. Clinical improvements were found to be significant for tetracyclines (-0.51 [-0.71;-0.31] p < 0.001), macrolides (-0.71 [-1.04;-0.38] p < 0.001), statins (-0.84 [-0.98;-0.70] p < 0.001), metformin (-1.47 [-1.66;-1.29] p < 0.001) and hyaluronan (-1.61 [-2.28;-0.94] p < 0.001) loaded gels, but non-significant for chlorhexidine (-0.48 [-1.10; 0.14] p = 0.13), metronidazole (-0.50 [-1.20; 0.20] p = 0.16) and bisphosphonates (-0.42 [-1.39; 0.54] p = 0.539) gels. Conclusion Adjunctive use of drugs loaded gels to non-surgical periodondal treatment could improve PPD reduction at 3 months. However, huge disparities remain when comparing the outcomes of the differents drugs used. Future comparative studies should be considered to determine precisely short and long term benefits of such treatments.
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Affiliation(s)
- Pierre-Yves Gegout
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Céline Stutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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21
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Poormoradi B, Dehghani S, Zare H, Alikhani MY, Haghgoo JM, Farmany A. Enhanced antibacterial activity of cadmium telluride nanocrystals in combination with 940-nm laser diode on anaerobic bacteria P. gingivalis: an in vitro study. Lasers Med Sci 2023; 38:112. [PMID: 37103664 DOI: 10.1007/s10103-023-03773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/10/2023] [Indexed: 04/28/2023]
Abstract
Periodontal disease is one of the most common chronic diseases in the oral cavity that causes tooth loss. Root scaling and leveling cannot eliminate all periodontal pathogens, and the use of antibacterial agents or lasers can increase the efficiency of mechanical methods. The aim of this study was to evaluate and compare the antibacterial activity of cadmium telluride nanocrystals in combination with 940-nm laser diode. Cadmium telluride nanocrystals were prepared by a green route of synthesis in aqueous medium. The results of this study showed that cadmium telluride nanocrystals significantly inhibit the growth of P. gingivalis. The antibacterial property of this nanocrystal increases with increasing its concentration, laser diode 940-nm irradiation and with increasing the time. It was shown that the antibacterial activity of combination of 940-nm laser diode and cadmium telluride nanocrystals is greater than the effect of either alone and can have a similar effect with its long-term presence of microorganisms. This is very important because it is not possible to use these nanocrystals in the mouth and in the periodontal bag for a long time.
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Affiliation(s)
- Banafsheh Poormoradi
- Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Safoora Dehghani
- Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Mohammad Yousef Alikhani
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Janet Moradi Haghgoo
- Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Farmany
- Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
- Dental Implant Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
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22
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Puthalath S, Santhosh VC, Nath SG, Viswanathan R. Rehabilitation and follow up of a Case of Periodontitis - Generalized, Stage IV, Grade B, Progressive, and with no Risk Factors. Contemp Clin Dent 2023; 14:166-170. [PMID: 37547433 PMCID: PMC10399796 DOI: 10.4103/ccd.ccd_733_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/03/2023] [Accepted: 01/20/2023] [Indexed: 08/08/2023] Open
Abstract
Periodontitis results in loss of periodontal attachment. This case report focuses on diagnosing a special case of periodontitis that required extreme care and maintenance. The peculiarities of this case are that based on 1999 American Academy of Periodontology classification this is a case of generalized aggressive periodontitis, but as per the recent 2017 classification, this is a case of periodontitis - generalized, Stage IV, Grade B, progressive and with no risk factors. Although this case is ideal for surgical management using regenerative techniques, it has been limited to mechanical therapy and laser due to patient-related economical factors. Within the limitations, this case has been successfully managed by dental laser and strategic implants. Despite all the limitations, 1-year follow-up shows periodontal stability and bone regeneration as evidenced through series of panoramic radiographs (OPG).
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Affiliation(s)
- Sreekanth Puthalath
- Department of Periodontics, Educare Institute of Dental Sciences, Malappuram, Kerala University of Health Sciences, Kerala, India
| | - V. C. Santhosh
- Department of Periodontics, KMCT Dental College, Kozhikode, Kerala University of Health Sciences, Kerala, India
| | - Sameera G. Nath
- Department of Periodontics, Government Dental College, Kozhikode, Kerala University of Health Sciences, Kerala, India
| | - Reshmi Viswanathan
- V Care Dental Clinic, Dental Laser and Implantology Centre, Kozhikode, Kerala, India
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23
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Agudio G, Buti J, Bonaccini D, Pini Prato G, Cortellini P. Longevity of teeth in patients susceptible to periodontitis: Clinical outcomes and risk factors associated with tooth loss after active therapy and 30 years of supportive periodontal care. J Clin Periodontol 2023; 50:520-532. [PMID: 36631984 DOI: 10.1111/jcpe.13770] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
AIM (i) To evaluate the efficacy of active periodontal therapy supplemented by supportive periodontal care (SPC) in retaining dentition during a 30-year follow-up period in patients susceptible to periodontitis, and (ii) to assess the prognostic factors associated with tooth loss. MATERIALS AND METHODS One-hundred and fifty-four patients with periodontitis, retrospectively classified as stage I-IV and grade B-C periodontitis, treated between 1984 and 1986 in a private practice, were enrolled in this study. After periodontal assessment, patients received non-surgical treatment followed by surgical periodontal therapy, orthodontic treatment, and tooth-splinting, where appropriate. SPC consisted of a strict recall programme every 3-6 months over a 30-year period. Recurrences were treated either with subgingival root planing or flap surgery. Dental and periodontal variables were measured at baseline (T0), end of active therapy (T1), and after 25 (T2) and 30 (T3) years. Generalized mixed models were analysed to assess the prognostic factors associated with and survival analyses for tooth loss. RESULTS Data on 154 patients (4083 teeth) were available at baseline (T0). Teeth considered unworthy of treatment were extracted during active therapy (160, 3.9%) and at re-assessment (13, 0.3%; T1). After 25 years of SPC, 140 teeth out of 3910 in 154 patients (3.6%) were lost (24 in 18 patients for periodontal reasons). Between 25 and 30 years, 20 patients (482 teeth) dropped out, and 61 teeth (2%) were lost (15 in 14 patients for periodontal reasons). Overall, 201 teeth (5.1%) were lost (39 for periodontal reasons) in 30 years of SPC. Generalized mixed models showed that stage III or stage IV periodontitis was associated with greater tooth loss during SPC compared to stage I or stage II (OR = 2.10; p = .048). Generalized periodontitis showed a statistically significant OR = 3.24 (p = .016) compared to the localized one. In SPC (T1-T3), age (p = .011), gender (male; p = .038), molar teeth (p = < .001), T0 and T1 pocket depth (p = < .001), tooth mobility grades 2 (p = .018) and 3 (p = .050), T0 and T1 bone loss (p = < .001), and presence of a root canal treatment (p = < .001) and a crown (p = .009) were statistically significantly associated with tooth loss. CONCLUSION (i) Periodontal therapy and a stringent SPC are effective in maintaining most of the teeth in patients with moderate/advanced periodontitis for 30 years, and (ii) age, gender, molar teeth, pocket depth, bone loss, and the presence of a root canal treatment and a crown are prognostic factors associated with tooth loss.
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Affiliation(s)
| | - Jacopo Buti
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | | | - Giovanpaolo Pini Prato
- Private Practice, Florence, Italy
- Accademia Toscana di Ricerca Odontostomatologica (ATRO), Florence, Italy
| | - Pierpaolo Cortellini
- Private Practice, Florence, Italy
- Accademia Toscana di Ricerca Odontostomatologica (ATRO), Florence, Italy
- European Research Group on Periodontology (ERGOPERIO), Bern, Switzerland
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Huang X, Wang H, Wang C, Cao Z. The Applications and Potentials of Extracellular Vesicles from Different Cell Sources in Periodontal Regeneration. Int J Mol Sci 2023; 24:ijms24065790. [PMID: 36982864 PMCID: PMC10058679 DOI: 10.3390/ijms24065790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Periodontitis is a chronic infectious disease worldwide that can cause damage to periodontal supporting tissues including gingiva, bone, cementum and periodontal ligament (PDL). The principle for the treatment of periodontitis is to control the inflammatory process. Achieving structural and functional regeneration of periodontal tissues is also essential and remains a major challenge. Though many technologies, products, and ingredients were applied in periodontal regeneration, most of the strategies have limited outcomes. Extracellular vesicles (EVs) are membranous particles with a lipid structure secreted by cells, containing a large number of biomolecules for the communication between cells. Numerous studies have demonstrated the beneficial effects of stem cell-derived EVs (SCEVs) and immune cell-derived EVs (ICEVs) on periodontal regeneration, which may be an alternative strategy for cell-based periodontal regeneration. The production of EVs is highly conserved among humans, bacteria and plants. In addition to eukaryocyte-derived EVs (CEVs), a growing body of literature suggests that bacterial/plant-derived EVs (BEVs/PEVs) also play an important role in periodontal homeostasis and regeneration. The purpose of this review is to introduce and summarize the potential therapeutic values of BEVs, CEVs and PEVs in periodontal regeneration, and discuss the current challenges and prospects for EV-based periodontal regeneration.
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Affiliation(s)
- Xin Huang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Huiyi Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Chuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zhengguo Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
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Al-Hamoudi N, Ahmed Y, Al Rifaiy MQ, Alwithanani N, Vohra F, Abduljabbar T. Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels. Photodiagnosis Photodyn Ther 2023; 42:103494. [PMID: 36871808 DOI: 10.1016/j.pdpdt.2023.103494] [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: 12/09/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
AIM To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n=32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1β and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.
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Affiliation(s)
- Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Yassir Ahmed
- Department of General Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Q Al Rifaiy
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Taif University, Taif, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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27
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Saha A, Kamble P, Mangalekar SB. Comparative Evaluation of Conventional Therapy With and Without Use of Diode Laser (DL) in the Treatment of Chronic Generalized Periodontitis: A Clinico-Microbiological Study. Cureus 2023; 15:e35720. [PMID: 37016638 PMCID: PMC10066870 DOI: 10.7759/cureus.35720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Chronic periodontitis is caused by a persistent and expanding interaction between a subgingival pathogenic microbial biofilm and the host immune system. The host's reaction to local factors directly influences the inflammation and bone loss that result from these interactions. Depending on variables like the severity of soft tissue damage and bone loss, treatment options can range from nonsurgical to surgical. Nonsurgical treatments are frequently used as the first-line therapy for inflammatory periodontal disease. In fact, careful scaling and root planing (SRP), a nonsurgical treatment, has been extensively studied and shown to be a highly predictable and effective therapy. According to recent research, using a diode laser (DL) in addition to standard SRP may reduce bacterial count and reinfection significantly. Laser therapy could be helpful in treating periodontal disease because of its antibacterial and detoxifying effects. The goal of this study is to investigate whether using a DL in addition to conventional flap surgery enhances patient outcomes for those with chronic generalized periodontitis. MATERIALS AND METHODS The 12 participants in this split-mouth trial with chronic generalized periodontitis were the main subject of the study. All of them had probing pocket depths (PPDs) of at least 5 mm after the initial phase of treatment. Each patient in the control group (Group A) and test group (Group B) received a conventional flap after being randomly assigned to one of the groups. Group B underwent a conventional flap with a 980 nm DL, whereas those in Group A did not receive any DL therapy. Periodontal pockets in both groups were evaluated at baseline, 45 days, and 90 days after a sub-gingival plaque test. Quantitative real-time polymerase chain reactions were used to examine the presence of red complex organisms in the plaque sample. RESULTS From baseline to 45 days and then to 90 days, clinical attachment loss (CAL), plaque index (PI), and gingival index (GI) all significantly decreased. However, results from 45 days to 90 days were statistically non-significant, with the exception of the GI, where Group B results were significantly different from Group A results from 45 days to 90 days. On the other hand, when a DL was combined with conventional flap surgery in the test group, the quantity of red complex bacteria was significantly decreased. CONCLUSION When DL was used in conjunction with conventional flap surgery, the results showed that CAL, PI, and GI were all significantly reduced while the quantity of red complex bacteria was also significantly decreased.
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28
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Chen H, Feng X, Yang Q, Yang K, Man S. Expression Pattern and Value of Brain-Derived Neurotrophic Factor in Periodontitis. Int Dent J 2023:S0020-6539(23)00055-2. [PMID: 36997422 PMCID: PMC10390664 DOI: 10.1016/j.identj.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/14/2022] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Periodontitis is a common human disease with an increasing incidence. Brain-derived neurotrophic factor (BDNF) is known to play a crucial role in the regeneration of periodontal tissue; however, the expression, methylation level, molecular function, and clinical value of BDNF in periodontitis require further investigation. This study aimed to investigate the expression and potential functions of BDNF in periodontitis. METHODS RNA expression and methylation data were obtained from the Gene Expression Omnibus (GEO) database, and the expression and methylation levels of BDNF were compared between periodontitis and normal tissues. In addition, bioinformatics analysis was performed to investigate the downstream molecular functions of BDNF. Finally, Reverse transcription Quantitative real-time polymerase chain reaction was performed to determine the level of BDNF expression in periodontitis and normal tissues. RESULTS GEO database analysis revealed that BDNF was hypermethylated in periodontitis tissues and that its expression was downregulated. Reverse transcription Quantitative real-time polymerase chain reaction confirmed that BDNF expression was downregulated in periodontitis tissues. Several genes that interact with BDNF were determined using a protein-protein interaction network. Functional analysis of BDNF revealed that it was enriched in the Gene Ontology terms cytoplasmic dynein complex, glutathione transferase activity, and glycoside metabolic process. Kyoto Encyclopedia of Genes and Genomes analysis suggested that BDNF was associated with the mechanistic target of rapamycin signaling pathway, fatty acid metabolism, the Janus kinase-signal transducer and activator of transcription signaling pathway, glutathione metabolism, and others. Furthermore, the level of BDNF expression was correlated with the immune infiltration degree of B cells and CD4+ T cells. CONCLUSIONS This study shown that BDNF was hypermethylated and downregulated in periodontitis tissues, which could be a biomarker and treatment target of periodontitis.
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Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21:41-58. [PMID: 36300683 DOI: 10.1111/idh.12635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/14/2022] [Accepted: 10/24/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this review was to compare air polishing devices with conventional periodontal therapy (hand instrumentation and/or ultrasonic debridement), in terms of their clinical, microbiological and patient-related outcomes in patients undergoing periodontal maintenance therapy. METHODS An online database search was performed to identify randomized controlled trials (RCTs) published between January 1987 and March 2021. Selection, data extraction and assessment risk of individual bias were conducted by two independent reviewers. The PICO method was employed to formulate the question: "In patients undergoing periodontal maintenance therapy/supportive periodontal therapy, do air polishing systems result in better clinical, microbiological and patient related outcomes than ultrasonic instrumentation or hand instrumentation?" Primary outcomes were bleeding on probing, gingival index and/or bleeding index. Secondary outcomes were probing depth, clinical attachment level, plaque index, microbiological counts and/or patient tolerance. The risk of bias was evaluated and the systematic review protocol was registered in PROSPERO. RESULTS The electronic search yielded 501 references of which 14 were included in this review. A meta-analysis was not performed due to great heterogeneity within the studies. Air polishing devices and conventional periodontal therapy presented identical results in the 14 studies analysed; however, air polishing devices presented better antimicrobial behaviour and better patient-related outcomes. CONCLUSIONS Both air polishing devices and conventional techniques demonstrated no difference in terms of clinical efficacy; however, air polishing devices seem to present improved antimicrobial results. In addition, they are also a safer, faster and more comfortable option for patients undergoing supportive periodontal therapy.
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Affiliation(s)
- Orlando Martins
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Costa
- DDM, Private Practice, Vila Real, Portugal
| | - Daniela Silva
- Institute of Periodontology, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Oral Medicine and Surgery, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Al‐Rihaymee S, Sh. Mahmood M. The efficacy of non-surgical platelet-rich fibrin application on clinical periodontal parameters and periostin level in periodontitis: Clinical trial. J Cell Mol Med 2023; 27:529-537. [PMID: 36691719 PMCID: PMC9930425 DOI: 10.1111/jcmm.17675] [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: 10/13/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/25/2023] Open
Abstract
Platelet-rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1- and 3-month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4-6 mm in depth in each patient were selected. The sites in every participant were randomly allocated into control sites or test sites. In control sites, only conventional scaling and root planing was carried out. In test sites, however, scaling and root planing method and PRF were applied. Periostin level in GCF and clinical periodontal parameters were measured. The test sites revealed greater relative attachment gain (2.614 ± 0.606 mm and 3.321 ± 0.668 mm) than control sites (1.285 ± 0.671 mm and 1.839 ± 0.632 mm) and a significant pocket reduction (2.535 ± 0.664 mm and 3.321 ± 0.668 mm) than the control sites (1.21 ± 0.508 mm and 1.892 ± 0.655 mm) at 1- and 3-month recall visits respectively. In the test sites, level of periostin (48.83 ± 9.3 ng/μl and 98.90 ± 24.94 ng/μl) were greater than periostin levels in the control sites (42.65 ± 7.03 ng/μl and 49.29 ± 15.14 ng/μl) at 1- and 3-month recall visits respectively. In conclusion, the non-surgical application of PRF as an adjunct to scaling and root planing significantly improved the clinical periodontal parameters through raising periostin level in GCF.
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Affiliation(s)
- Sarah Al‐Rihaymee
- Department of PeriodonticsCollege of dentistry, University of BaghdadBaghdadIraq
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Ribeiro FV, Mehta JJ, Monteiro MF, Moore J, Casati MZ, Nibali L. Minimal invasiveness in nonsurgical periodontal therapy. Periodontol 2000 2023; 91:7-19. [PMID: 36661203 DOI: 10.1111/prd.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/21/2023]
Abstract
Periodontal treatment is quickly moving towards a philosophy consisting of a less invasive approach. In this context, minimally invasive nonsurgical therapy (MINST) is a promising option. This paper reviews the concepts behind minimal invasiveness in nonsurgical periodontology and reports the state-of the art evidence for this topic. Instruments used and protocols suggested for these applications are introduced and discussed. The original papers reviewed show probing pocket depth (PPD) reductions and clinical attachment level (CAL) gains ranging from 2 to 4 mm between baseline and 6 months to 5 years posttreatment for intrabony defects and from 1.5 to 3 mm between baseline and 2-6 months of follow-up for full-mouth results. These clinical outcomes are accompanied by statistically significant reductions in radiographic bone defect depth and increases in intrabony defect angles posttreatment. Wound healing mechanisms following MINST are presented, and clinical applications and directions for future research are suggested.
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Affiliation(s)
- Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - Jaimini J Mehta
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Mabelle F Monteiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Jatinder Moore
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marcio Z Casati
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil.,Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Kwoen MJ, Park JH, Kim KS, Lee JR, Kim JW, Lee H, Lee HJ. Association between periodontal disease, tooth extraction, and medication-related osteonecrosis of the jaw in women receiving bisphosphonates: A national cohort-based study. J Periodontol 2023; 94:98-107. [PMID: 35856336 DOI: 10.1002/jper.21-0611] [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: 10/24/2021] [Revised: 03/31/2022] [Accepted: 05/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND We investigated whether periodontal diseases contribute to the development of medication-related osteonecrosis of the jaw (MRONJ) in addition to tooth extraction, which is a major risk factor for MRONJ occurrence. METHODS This retrospective, nationwide cohort study was performed using South Korea's National Health Insurance Service database on women aged > 50 years who took bisphosphonates for at least 1 year between 2010 and 2015. MRONJ, periodontal disease, and tooth extraction were defined using the claims data. RESULTS Among the 27,168 patients analyzed, the incidence of confirmed MRONJ was significantly higher in the periodontal disease group (0.58%) than in the nonperiodontal disease group (0.31%). While extraction alone showed an increased risk of MRONJ development (hazard ratio [HR] = 1.61, 95% confidence interval [CI]: 0.74-3.52), periodontal disease without tooth extraction also indicated a similar risk (HR = 1.68, 95% CI: 0.86-3.28); when a history of both periodontal disease and tooth extraction was present, the HR significantly increased to 2.55 (95% CI: 1.41-4.64). CONCLUSIONS The risk of MRONJ increased significantly when tooth extraction was performed in patients diagnosed with periodontal disease; therefore, periodontal diseases should be proactively managed in patients taking bisphosphonates.
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Affiliation(s)
- Min-Jeong Kwoen
- Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Ewha Womans University College of Medicine and Graduate School of Medicine, Seoul, Republic of Korea
| | - Keun-Suh Kim
- Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University College of Medicine and Graduate School of Medicine, Seoul, Republic of Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Takedachi M, Kawasaki K, Sawada K, Sakura K, Murata M, Shimomura J, Kawakami K, Morimoto C, Miki K, Takeshita N, Iwayama T, Okura H, Matsuyama A, Saito M, Kitamura M, Murakami S. Periodontal Tissue Regeneration by Transplantation of Autologous Adipose Tissue-Derived Multi-Lineage Progenitor Cells With Carbonate Apatite. Cell Transplant 2023; 32:9636897231198296. [PMID: 37710973 PMCID: PMC10503283 DOI: 10.1177/09636897231198296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 09/16/2023] Open
Abstract
We have developed an autologous transplantation method using adipose tissue-derived multi-lineage progenitor cells (ADMPCs) as a method of periodontal tissue regeneration that can be adapted to severe periodontal disease. Our previous clinical study confirmed the safety of autologous transplantation of ADMPCs and demonstrated its usefulness in the treatment of severe periodontal disease. However, in the same clinical study, we found that the fibrin gel used as the scaffold material might have caused gingival recession and impaired tissue regeneration in some patients. Carbonate apatite has a high space-making capacity and has been approved in Japan for periodontal tissue regeneration. In this study, we selected carbonate apatite as a candidate scaffold material for ADMPCs and conducted an in vitro examination of its effect on the cellular function of ADMPCs. We further performed autologous ADMPC transplantation with carbonate apatite as the scaffold material in a model of one-wall bone defects in beagles and then analyzed the effect on periodontal tissue regeneration. The findings showed that carbonate apatite did not affect the cell morphology of ADMPCs and that it promoted proliferation. Moreover, no effect on secretor factor transcription was found. The results of the in vivo analysis confirmed the space-making capacity of carbonate apatite, and the acquisition of significant new attachment was observed in the group involving ADMPC transplantation with carbonate apatite compared with the group involving carbonate apatite application alone. Our results demonstrate the usefulness of carbonate apatite as a scaffold material for ADMPC transplantation.
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Affiliation(s)
- Masahide Takedachi
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kohsuke Kawasaki
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Keigo Sawada
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kazuma Sakura
- Department of Medical Innovation, Osaka University Hospital, Suita, Japan
| | - Mari Murata
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Junpei Shimomura
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kazuma Kawakami
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Chiaki Morimoto
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Koji Miki
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Noboru Takeshita
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tomoaki Iwayama
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hanayuki Okura
- Center for Reverse Translational Research, Osaka Habikino Medical Center, Osaka Prefectural Hospital Organization, Habikino, Japan
- Adipo Medical Technology, Osaka, Japan
- Institute of Innovative Medical Technology, Osaka. Japan
| | - Akifumi Matsuyama
- Center for Reverse Translational Research, Osaka Habikino Medical Center, Osaka Prefectural Hospital Organization, Habikino, Japan
| | - Masahiro Saito
- Department of Restorative Dentistry, Division of Operative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masahiro Kitamura
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shinya Murakami
- Department of Periodontology and Regenerative Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
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Aghayan S, Yazdanfar A, Seyedjafari E, Noroozian M, Ioana Bordea R, Chiniforush N. Evaluation of indocyanine-mediated photodynamic therapy cytotoxicity in human osteoblast-like cells: an in vitro study. Folia Med (Plovdiv) 2022; 64:932-937. [PMID: 36876572 DOI: 10.3897/folmed.64.e67475] [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: 04/17/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Antimicrobial photodynamic therapy (aPDT) is an adjunctive non-invasive procedure for the management of periodontal tissue infection and deep periodontal pocket decontamination. However, the effects of this procedure on periodontal cells like osteoblasts that play a role in periodontal tissue repair and regeneration is not yet clear.
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Equisetum arvense Inhibits Alveolar Bone Destruction in a Rat Model with Lipopolysaccharide (LPS)-Induced Periodontitis. Int J Dent 2022; 2022:7398924. [PMID: 36794024 PMCID: PMC9925265 DOI: 10.1155/2022/7398924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/31/2022] Open
Abstract
Background and Aims Equisetum arvense extract (EA) exerts various biological effects, including anti-inflammatory activity. The effect of EA on alveolar bone destruction has not been reported; therefore, we aimed to determine whether EA could inhibit alveolar bone destruction associated with periodontitis in a rat model in which periodontitis was induced using lipopolysaccharide from Escherichia coli (E. coli-LPS). Methods Physiological saline or E. coli-LPS or E. coli-LPS/EA mixture was topically administered into the gingival sulcus of the upper molar region of the rats. After 3 days, periodontal tissues of the molar region were collected. Immunohistochemistry was performed for cathepsin K, receptor activator of NF-κB ligand (RANKL), and osteoprotegerin (OPG). The cathepsin K-positive osteoclasts along the alveolar bone margin were counted. EA effects on the expression of the factors regulating osteoclastogenesis in osteoblasts with E. coli-LPS-stimulation were also examined in vitro. Results Treatment with EA significantly reduced the number of osteoclasts by decreasing the RANKL-expression and increasing OPG-expression in the periodontal ligament in the treatment group compared to the E. coli-LPS group. The in vitro study showed that the upregulation of p-IκB kinase α and β (p-IKKα/β), p-NF-κB p65, TNF-α, interleukin-6, and RANKL and downregulation of semaphorin 3A (Sema3A), β-catenin, and OPG in the osteoblasts with E. coli-LPS-stimulation improved with EA-treatment. Conclusion These findings demonstrated that topical EA suppressed alveolar bone resorption in the rat model with E. coli-LPS-induced periodontitis by maintaining a balance in RANKL/OPG ratio via the pathways of NF-κB, Wnt/β-catenin, and Sema3A/Neuropilin-1. Therefore, EA possesses the potential to prevent bone destruction through inhibiting osteoclastogenesis attributed to cytokine burst under plaque accumulation.
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Jolivet G, Huck O, Petit C. Evaluation of furcation involvement with diagnostic imaging methods: a systematic review. Dentomaxillofac Radiol 2022; 51:20210529. [PMID: 35787071 PMCID: PMC9717400 DOI: 10.1259/dmfr.20210529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/09/2022] [Accepted: 07/01/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Multirooted teeth respond less favorably to non-surgical periodontal treatment and long-term tooth prognosis is influenced by the degree of furcation involvement (FI). Therapeutic strategy for multirooted teeth is essentially based on accurate diagnosis of the FI. The aim of this systematic review is to evaluate the accuracy of the different furcation assessment methods and to determine if radiographic help is needed to determine early stage of FI. METHODS Electronic databases were searched up to March 2021. Comparative studies describing the reliability of different clinical and/or radiological furcation assessment methods were identified. RESULTS A total of 22 studies comparing at least 2 furcation assessment methods, among which 15 retrospective studies, 5 prospective studies, 1 randomized controlled trial and 1 case series, were included in this review. The reliability of cone beam CT (CBCT), intraoral radiographs (IOs), orthopantomograms (OPGs) and MRI to identify FI was evaluated. Using OFS as a reference for FI detection and diagnosis, agreement ranged from 43.3 to 63% for OPG, 38.7 to 83.1% for IO and 82.4 to 84% for CBCT. The validity of the measurements was mainly influenced by the location of the furcation entrance. For radiological diagnosis, CBCT displayed the closest agreement with OFS while the accuracy of IO and OPG showed modest agreement and were influenced by the examiner's experience. CONCLUSION Altogether, it appears that the use of IO, OPG or CBCT allows detection of FI but could not be considered as gold-standard techniques.
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Chatzopoulos GS, Doufexi AE, Zarenti S, Anastasopoulos M, Kouvatsi A. Periodontal disease progression and gene polymorphisms: results after 3 years of active periodontal treatment. Minerva Dent Oral Sci 2022; 71:329-338. [PMID: 35686958 DOI: 10.23736/s2724-6329.22.04709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although non-surgical periodontal treatment is considered the gold standard, a subgroup of patients displays recurrence/progression of periodontitis after treatment. The aim of the present prospective study was to assess the effect of IL-6 -572 G/C and IL-10 -592 C/A gene polymorphisms on the risk of disease recurrence/progression at 3 years following non-surgical periodontal treatment. METHODS Thirty-seven patients diagnosed with chronic periodontitis received oral hygiene instructions and non-surgical periodontal treatment and were monitored for 3 years. All individuals were clinically evaluated for PPD, CAL and BOP at baseline and 3 years. Based on the clinical findings at 3 years, all subjects were considered either "at risk" or "not at risk" of periodontal disease progression based on specific criteria. Blood samples were collected at baseline and genotyping of the polymorphisms in IL-6 (rs1800796) and IL-10 (rs1800872) genes were performed by PCR. RESULTS Following DNA separation and genotyping, 70.3% of the patients were homozygous carriers of the IL-6 -572G and 45.9% were carriers of the IL-10 -592A allele. Individuals at risk of disease progression ranged from 16.2% to 56.8% based on the criteria used. IL-6 -572 G/C and IL-10 -592 C/A polymorphisms were not associated with an increased risk of further disease progression (P>0.05) when the three criteria were examined. All examined periodontal clinical measures were significantly improved (P<0.05) after treatment. Males showed a significantly higher risk of disease progression than females when full-mouth BOP ≥30% was considered (P=0.008). CONCLUSIONS Within the limitations of this 3-year prospective study, individuals susceptible to periodontal disease as determined by the presence of the IL-6 -572GG genotype or the IL-10 -592A allele were not associated with an increased risk of further disease progression and the potential need for further treatment following non-surgical periodontal treatment. Males were more prone to be at risk of disease progression than females.
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Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, MN, USA - .,Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece -
| | - Aikaterini-Elisavet Doufexi
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Private practitioner, Thessaloniki, Greece
| | - Sofia Zarenti
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Menelaos Anastasopoulos
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Kouvatsi
- Department of Genetics, Development and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Swanson WB, Yao Y, Mishina Y. Novel approaches for periodontal tissue engineering. Genesis 2022; 60:e23499. [PMID: 36086991 PMCID: PMC9787372 DOI: 10.1002/dvg.23499] [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: 06/10/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
The periodontal complex involves the hard and soft tissues which support dentition, comprised of cementum, bone, and the periodontal ligament (PDL). Periodontitis, a prevalent infectious disease of the periodontium, threatens the integrity of these tissues and causes irreversible damage. Periodontal therapy aims to repair and ultimately regenerate these tissues toward preserving native dentition and improving the physiologic integration of dental implants. The PDL contains multipotent stem cells, which have a robust capacity to differentiate into various types of cells to form the PDL, cementum, and alveolar bone. Selection of appropriate growth factors and biomaterial matrices to facilitate periodontal regeneration are critical to recapitulate the physiologic organization and function of the periodontal complex. Herein, we discuss the current state of clinical periodontal regeneration including a review of FDA-approved growth factors. We will highlight advances in preclinical research toward identifying additional growth factors capable of robust repair and biomaterial matrices to augment regeneration similarly and synergistically, ultimately improving periodontal regeneration's predictability and long-term efficacy. This review should improve the readers' understanding of the molecular and cellular processes involving periodontal regeneration essential for designing comprehensive therapeutic approaches.
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Affiliation(s)
- W. Benton Swanson
- Department of Biologic and Materials Science, Division of ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Yao Yao
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Biointerfaces InstituteUniversity of MichiganAnn ArborMichiganUSA
| | - Yuji Mishina
- Department of Biologic and Materials Science, Division of ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
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Clinical and radiographic evaluation of low-speed platelet-rich fibrin (PRF) for the treatment of intra-osseous defects of stage-III periodontitis patients: a randomized controlled clinical trial. Clin Oral Investig 2022; 26:6671-6680. [PMID: 35876893 PMCID: PMC9643252 DOI: 10.1007/s00784-022-04627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 12/04/2022]
Abstract
Aim The current randomized controlled trial assessed for the first time the effect of a low-speed platelet-rich fibrin (PRF) with open flap debridement (OFD) versus OFD alone in the treatment of periodontal intra-osseous defects of stage-III periodontitis patients. Methods Twenty-two periodontitis patients with ≥ 6 mm probing depth (PD) and ≥ 3 mm intra-osseous defects were randomized into test (PRF + OFD; n = 11) and control (OFD; n = 11) groups. Clinical attachment level (CAL)–gain (primary outcome), PD-reduction, gingival recession depth (GRD), full-mouth bleeding scores (FMBS), full-mouth plaque scores (FMPS), radiographic linear defect depth (RLDD), and radiographic bone fill (secondary-outcomes) were examined over 9 months post-surgically. Results Low-speed PRF + OFD and OFD demonstrated significant intra-group CAL-gain and PD- and RLDD-reduction at 3, 6, and 9 months (p < 0.01). Low-speed PRF + OFD exhibited a significant CAL-gain of 3.36 ± 1.12 mm at 6 months (2.36 ± 0.81 mm for the control group; p < 0.05), and a significantly greater PD-reduction of 3.36 ± 1.12 mm at 3 months, of 3.64 ± 1.12 mm at 6 months and of 3.73 ± 1.19 mm at 9 months (2.00 ± 0.89 mm, 2.09 ± 1.04 mm, and 2.18 ± 1.17 mm in the control group respectively; p < 0.05). No significant differences were notable regarding GRD, FMPS, FMBS, RLDD, or bone fill between both groups (p > 0.05). Conclusions Within the current clinical trial’s limitations, the use of low-speed PRF in conjunction with OFD improved CAL and PD post-surgically, and could provide a cost-effective modality to augment surgical periodontal therapy of intra-osseous defects of stage-III periodontitis patients. Clinical relevance Low-speed PRF could provide a cost-effective modality to improve clinical attachment gain and periodontal probing depth reduction with open flap debridement approaches.
Supplementary Information The online version contains supplementary material available at 10.1007/s00784-022-04627-2.
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Patila T, Y SS, Vivekanandan G, Shetty RM, Rahman B, Al Shehadat S, Shetty SR. Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure-a randomised controlled split-mouth clinical trial. Lasers Med Sci 2022; 37:3213-3220. [PMID: 35867285 DOI: 10.1007/s10103-022-03605-0] [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: 10/06/2021] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Abstract
Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study's limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.
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Affiliation(s)
- Thaneshwar Patila
- Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, India
| | - Sunaina Shetty Y
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
| | - Gopinath Vivekanandan
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| | - Raghavendra M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.,Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE.,Adjunct Faculty, Dept. of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India
| | - Betul Rahman
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Saaid Al Shehadat
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Clinical Benefits of Minimally Invasive Non-Surgical Periodontal Therapy as an Alternative of Conventional Non-Surgical Periodontal Therapy-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127456. [PMID: 35742702 PMCID: PMC9223734 DOI: 10.3390/ijerph19127456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 02/01/2023]
Abstract
Minimally invasive procedures were introduced in periodontics, which could enhance clinical outcomes and reduce post-operative discomfort. However, minimally invasive non-surgical periodontal therapy (MINST) as an alternative modality of conventional non-surgical root surface debridement has not been clearly evaluated by randomized controlled clinical trial. The present study aimed to investigate clinical outcomes and patients’ comfort feedback of MINST compared to conventional non-surgical periodontal therapy (CNST). Patients with moderate to severe periodontitis were included. Nine out of ten patients were recruited and completed the post-treatment re-evaluation in this study. Randomized split-mouth design, CNST and MINST on each side, was performed. Clinical parameters, including periodontal probing depth (PD), gingival recession (REC), clinical attachment level (CAL), and gingival bleeding on probing (BOP), were recorded on baseline, 1 month and 3 months post-treatment. Non-parametric statistics were used for analysis. PD, REC, CAL, and BOP were improved after treatment in both CNST and MINST groups. Comfort feedback and gingival recession showed better outcomes in the MINST group than in the CNST group. No statistical significance of parameters was found between CNST and MINST. Within the limitations, minimally invasive non-surgical periodontal therapy could be an alternative modality of conventional non-surgical periodontal therapy. Further studies are required to establish clinical protocol and evidence of MINST.
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Shen KL, Huang CL, Lin YC, Du JK, Chen FL, Kabasawa Y, Chen CC, Huang HL. Effects of Artificial Intelligence (AI)-Assisted Dental Monitoring Intervention in Patients with Periodontitis: A Randomized Controlled Trial. J Clin Periodontol 2022; 49:988-998. [PMID: 35713224 DOI: 10.1111/jcpe.13675] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the effects of an at-home AI-assisted dental monitoring application on treatment outcomes in patients with periodontitis. MATERIALS AND METHODS Participants with periodontitis were recruited and randomly assigned into an AI (AI; n = 16), AI and human counseling (AIHC; n = 17), or control (CG; n = 20) group. All participants received nonsurgical periodontal treatment. We employed an AI-assisted tool called DENTAL MONITORING® (DM) intervention, a new technological AI monitoring product that utilizes smartphone cameras for intraoral scanning and assessment. Patients in the AI and AIHC groups respectively received additional (a) DM or (b) DM with real-person counseling over three months. Periodontal parameters were collected at baseline and follow-ups. A mixed-design model analyzed the follow-up effects over time. RESULTS The AI and AIHC groups respectively exhibited greater improvement in probing pocket depth [Mean diff = -0.9±0.4 and -1.4±0.3, effect size (ES) = 0.76 and 1.98], clinical attachment level (Mean diff = -0.8±0.3 and -1.4±0.3, ES = 0.84 and 1.77) and plaque index (Mean diff = -0.5±0.2 and -0.7±0.2, ES = 0.93 and 1.81) at 3-month follow-up than the CG did. The AIHC group had a greater reduction in probing pocket depth (ES = 0.46) and clinical attachment level (ES = 0.64) at the 3-month follow-up compared with the AI group. CONCLUSION Using AI monitoring at home had a positive effect on treatment outcomes for patients with periodontitis. Patients with AI-assisted health counseling exhibited better treatment outcomes than did patients who used AI monitoring alone. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kang-Ling Shen
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chiung-Lin Huang
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Je-Kang Du
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Fu-Li Chen
- Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yuji Kabasawa
- Oral Care for Systemic Health Support, Faculty of Dentistry, School of Oral Health Care Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chih-Chang Chen
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Estrin NE, Lesniewski A, McClain S, Hou W, Romanos GE. Thermal Penetration Depth of Pulsed Lasers in Gingival Tissues: An In Vitro Study. Photobiomodul Photomed Laser Surg 2022; 40:410-416. [DOI: 10.1089/photob.2021.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nathan E. Estrin
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Agata Lesniewski
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Steve McClain
- Department of Dermatology, School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Georgios E. Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (La-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
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Divnic-Resnik T, Pradhan H, Spahr A. The efficacy of the adjunct use of subgingival air-polishing therapy with erythritol powder compared to conventional debridement alone during initial non-surgical periodontal therapy. J Clin Periodontol 2022; 49:547-555. [PMID: 35373340 PMCID: PMC9321595 DOI: 10.1111/jcpe.13623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/19/2022] [Accepted: 03/24/2022] [Indexed: 01/12/2023]
Abstract
Aim To assess the efficacy of the adjunct use of a subgingival erythritol powder air‐polishing device (EPAP) in comparison to conventional subgingival instrumentation alone during initial non‐surgical periodontal therapy. Materials and Methods Twenty‐one patients with generalized Stages 2 and 3 grade B periodontitis were included in this single centre, single blinded, split‐mouth, randomized clinical trial. Teeth on the control side were treated with conventional hand and ultrasonic instrumentation, while those on the contralateral test side was treated using EPAP as adjunct to conventional subgingival instrumentation with hand and ultrasonic instruments. Three months after initial instrumentation, persisting pockets of ≥4 mm were re‐treated, in both control and test sides, again with the respective treatment approach—subgingival instrumentation alone on control, and subgingival instrumentation + EPAP on test side. Clinical parameters such as probing pocket depth (PPD), bleeding on probing, and relative attachment level were recorded at baseline and 3 and 6 months following the initial instrumentation. Subgingival plaque samples were collected at baseline, immediately post surgery, as well as at 1 week, 1 month, 3 months, and 6 months after initial instrumentation. Results In the test group after 6 months, a significantly larger number of initially deep pockets (PPD ≥ 5.5 mm) were reduced to shallow (PPD ≤ 3.4 mm), and a larger attachment gain was observed. No statistically significant microbiological differences could be found between test and control group. Conclusions The results of the present study indicate that the adjunct use of subgingival airflow therapy with EPAP during initial non‐surgical periodontal therapy might be beneficial in initially deep pockets (PPD ≥ 5.5 mm).
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Affiliation(s)
- Tihana Divnic-Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Harold Pradhan
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Hussain B, Karaca EO, Kuru BE, Gursoy H, Haugen HJ, Wohlfahrt JC. Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone-A randomized, feasibility parallel-arm clinical trial. J Periodontol 2022; 93:780-789. [PMID: 34710240 DOI: 10.1002/jper.21-0496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND A brush made of chitosan has shown to be an effective and harmless device for non-surgical treatment of mild to moderate peri-implantitis. To date, no study has evaluated the use of a chitosan brush in the non-surgical treatment of residual pockets in periodontal treatment. METHODS Seventy-eight patients with periodontitis were included in this multicenter, randomized, examiner-blind clinical trial of 6 months duration. Patients with residual probing pocket depth (PPD) of ≥5 mm and ≤7 mm following previous active periodontal treatment were included. Patients were assigned either subgingival treatment with curettes (control) or an oscillating chitosan brush (test). Changes in bleeding on probing (BoP) and PPD between baseline and terminal evaluation at 6 months were evaluated. RESULTS A significant reduction in both PPD and BoP was seen within both groups. There was no significant difference in BoP between test and control groups after 6 months, but the reduction in PPD was significantly improved in the test group (P ≤ 0.01). The combined outcome of no BOP and PPD ≤4 mm was significantly better in the test group (P ≤ 0.01). No adverse reactions were seen. CONCLUSION Treatment of residual periodontal pockets (PPD = 5 to 7 mm) with a chitosan brush disclosed equal or better clinical results as compared to regular curettes. This study supports that a chitosan brush can be used for subgingival biofilm removal and soft tissue curretage in the treatment of periodontitis.
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Affiliation(s)
- Badra Hussain
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Ebru Ozkan Karaca
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Bahar Eren Kuru
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Hare Gursoy
- Department of Periodontology, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.,Bjerke Tannmedisin, Oslo, Norway
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Dortaj D, Bassir SH, Hakimiha N, Hong H, Aslroosta H, Fekrazad R, Moslemi N. Efficacy of Nd:YAG laser-assisted periodontal therapy for the management of periodontitis: A double-blind split-mouth randomized controlled clinical trial. J Periodontol 2022; 93:662-672. [PMID: 34411291 DOI: 10.1002/jper.21-0242] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study aimed to explore the efficacy of Nd:YAG laser-assisted periodontal therapy for management of patients with stage II-IV periodontitis. METHODS Patients who presented with residual periodontal pockets were enrolled. After non-surgical periodontal therapy (NSPT), test sites received Nd:YAG laser (first entrance to pocket: 3 W, 100 μs, 20 Hz; second entrance: 4 W, 600 μs, 20 Hz) and control sites received placebo (laser off). Periodontal probing depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 1, 2, 3, 4 and 6-month visits. RESULTS Twenty patients completed the 6-month period. Significant reductions in PPD, CAL, BOP, and PI values and a significant increase in GR at all follow-up visits compared to the baseline (all P < 0.001) were revealed in both groups. Test sites showed significantly greater improvement in PPD (P = 0.0002) and greater increase in GR (P < 0.0001) compared to the control sites at 6-month visit. There was no difference between two groups regarding CAL gain through the study period (P = 0.23). CONCLUSION NSPT+Nd:YAG laser with the current protocol results in greater PPD reduction compared to NSPT alone. However, this reduction is likely because of greater GR rather than attachment gain. Therefore, the adjunction of Nd:YAG laser (with the current setting) to the NSPT for the treatment of residual periodontal pockets did not ameliorate the clinical outcomes (ClinicalTrials.gov ID: NCT03365167).
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Affiliation(s)
- Dorara Dortaj
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Operative Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Bassir
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Neda Hakimiha
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Houlin Hong
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Hoori Aslroosta
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, School of Dentistry, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Neda Moslemi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Influence on the patient's oral hygiene depending on the treatment performed by either one or different pre-graduate practitioners - a randomized, controlled, clinical short-term trial. Clin Oral Investig 2022; 26:5339-5350. [PMID: 35486196 PMCID: PMC9381624 DOI: 10.1007/s00784-022-04501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
Objectives Plaque control by improved domestic oral hygiene is essential in periodontal treatment. However, changing treatment providers may interfere with building a dentist-patient relationship and in turn affect treatment success. The aim of this randomized, controlled, prospective short-term study was to determine the influence of either one or four different pre-graduate practitioners on patients’ oral hygiene parameters during active periodontal therapy. Material and Methods A total of 55 patients with periodontitis were allocated to two groups. Within the group “continuous treatment” (CT, n = 27), each patient was treated by one individual practitioner over the treatment period. For patients of the group “discontinuous treatment” (DT, n = 28), treatment in each session was performed by a different practitioner. Periodontal parameters (BOP, PBI, and PCR) were assessed at two timepoints: T1 (baseline) and T2 (end of active therapy). Results With CT, the PBI improved in 93% of the patients, compared to 71% with DT (p = 0.048). T1-T2 intragroup analysis showed a statistically significant improvement of all observed clinical parameters with no differences in ∆PBI, ∆BOP, and ∆PCR. Spearman’s correlation analysis revealed a weak correlation between PCR and BOP of CT only. Conclusions In the present study, improvement of all parameters was comparable between the groups. PBI, as a parameter displaying patient’s domestic plaque control compliance, improved in more patients from CT than DT. This is possibly indicating an advantage of continuous treatment by one single practitioner. Clinical relevance Treatment by either a single practitioner or by multiple, constantly changing practitioners might influence patients’ compliance to modify their behaviour when medically necessary.
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Skipina TM, Elhawary MM, Soliman EZ. Periodontal disease is associated with elevated atherosclerotic cardiovascular disease risk score. Am J Med Sci 2022; 364:327-332. [DOI: 10.1016/j.amjms.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
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49
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Wang J, Liu Y, Wang W, Ma J, Zhang M, Lu X, Liu J, Kou Y. The rationale and potential for using Lactobacillus in the management of periodontitis. JOURNAL OF MICROBIOLOGY (SEOUL, KOREA) 2022; 60:355-363. [PMID: 35344188 DOI: 10.1007/s12275-022-1514-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 01/13/2023]
Abstract
Periodontitis refers to a wide range of the inflammatory conditions of supporting dental structures. For some patients with periodontitis, antibacterial agents are needed as an adjuvant to mechanical debridement treatments and oral hygiene maintenance. However, the widespread use of broad-spectrum antibiotics for the prophylaxis and treatment of periodontal infections results in the emergence of resistant pathogens. Therefore, probiotics have become markedly interesting to researchers as a potentially safe alternative to periodontal treatment and maintenance. Probiotics have been used in medicine for decades and extensively applied to the treatment of inflammatory diseases through the modulation of microbial synergy and other mechanisms. A growing amount of evidence has shown that using Lactobacillus strains for oral cavity maintenance could improve periodontal health. In this study, we reviewed studies showing proof of the inhibitory effects of Lactobacillus species on periodontal inflammation. We also explored the rationale and potential for using Lactobacillus species in the management of periodontitis.
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Affiliation(s)
- Jiaqi Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Yingman Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Weiru Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jiaojiao Ma
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Manman Zhang
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Xiaoying Lu
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jie Liu
- Science Experiment Center, China Medical University, Shenyang, 110122, P. R. China
| | - Yurong Kou
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China. .,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China.
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The circular RNA circ_0099630/miR-940/receptor-associated factor 6 regulation cascade modulates the pathogenesis of periodontitis. J Dent Sci 2022; 17:1566-1576. [PMID: 36299308 PMCID: PMC9588814 DOI: 10.1016/j.jds.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
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