Double-Masked Randomized Clinical Trial Evaluating the Effect of a Triclosan/Copolymer Dentifrice on Periodontal Healing After One-Stage Full-Mouth Debridement

Change in clinical parameters after subgingival instrumentation for the treatment of periodontitis and timing of periodontal re-evaluation: A systematic review and meta-analysis

AIM

To evaluate the changes in periodontal parameters (reduction in probing pocket depth [PPD], gain in clinical attachment level [CAL] and reduction in full-mouth bleeding on probing [BoP]) after subgingival instrumentation of periodontal pockets at different time points in systemically healthy patients suffering from periodontitis.

MATERIALS AND METHODS

Four databases were searched for RCTs that carried out subgingival instrumentation in periodontal pockets and evaluated PPD at a minimum of two consecutive time points other than baseline. The analysis was conducted for both all pocket depths and stratified for initially shallow (4-5 mm) and deep (≥6 mm) pockets and data were extracted for various time points, 1-2, 3-4 and 5-6 months. Weighted mean effects (WMEs) were calculated with 95% confidence interval (CI) and predictive intervals were calculated.

RESULTS

Twenty-nine RCTs were identified, and all of them were included in the meta-analysis. The results showed that for both shallow and deep pockets there was a small though clinically meaningful change between 1- to 2-month and 3- to 4-month time points and between these and 5-6 months.

CONCLUSIONS

In systemically healthy patients, the greater part of reduction in PPD and gain in CAL occurs within the first 1-2 months after subgingival instrumentation. However, additional benefits in terms of pocket depth reduction occur beyond these early time points.

Supra and subgingival application of antiseptics or antibiotics during periodontal therapy

Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral ecosystem. According to the current S3 level clinical practice guidelines, therapy of patients with periodontitis involves a stepwise approach that includes the control of the patient's risk factors and the debridement of supra and subgingival biofilm. This debridement can be performed with or without the use of some adjuvant therapies, including physical or chemical agents, host modulating agents, subgingivally locally delivered antimicrobials, or systemic antimicrobials. Therefore, the main aim of this article is to review in a narrative manner the existing literature regarding the adjuvant application of local agents, either subgingivally delivered antibiotics and antiseptics or supragingivally applied rinses and dentifrices, during the different steps in periodontal therapy performed in Europe.

Comparative study of the effect of Bluem active oxygen gel and coe-pack dressing on postoperative surgical depigmentation healing

Introduction

Black colored gingiva is an esthetic concern, especially when accompanied by a high lip line or gummy smile.

Surgical depigmentation with a scalpel is still considered the golden standard in gingival pigmentation management although it causes an area of open wound, which needs a special management with dressing.

This study aimed to comparatively evaluate the effectiveness of reactive oxygen gel species (BlueM gel) and the traditional Coe-Pack dressing on gingival healing and pain after surgical depigmentation.

Materials and Methods

This split-mouth randomized clinical trial was conducted on 20 nonsmoking individuals aged 20–38 years with maxillary physiologic gingival pigmentation classes (III) and (IV) according to the Dummett–Gupta Oral Pigmentation Index (40 treated sites) who had requested an esthetic treatment for gingival hyperpigmentation of the maxillary gingiva.

The maxilla was randomly divided into two symmetrical parts—from the right second premolar to the midline and from the midline to the left second premolar—to receive either BlueM gel or Coe-Pack as a dressing after surgical depigmentation with a scalpel. Various indices were assessed, such as pain and reepithelization index with toluidine blue, and the follow-up period was 1 month.

Results

A total of 20 patients were included in this study. There were statistically significant differences in the pain index after 1, 2, 3, 4, and 5 days. The BlueM gel group showed a higher significant difference after 1, 2, and 3 weeks in the reepithelization index.

Conclusion

Hence, BlueM gel can be considered as a good alternative for the Coe-Pack dressing after gingival depigmentation owing to its pain reduction properties, acceleration of wound healing, and postoperative reepithelization.

Triclosan toothpaste as an adjunct therapy to plaque control in children from periodontitis families: a crossover clinical trial

OBJECTIVES

Studies have demonstrated that children from aggressive periodontitis (AgP) parents presented precocious alterations in their periodontal condition, and the use of chemical agents in association to plaque control could be useful to control these alterations. This study aimed to evaluate the effect of Triclosan toothpaste to modulate the clinical and subgingival condition in children from AgP parents.

METHODS

Fifteen children from AgP parents and 15 from periodontally healthy parents were included in this crossover placebo study. Children were randomly allocated into triclosan or placebo therapy, using selected toothpaste for 45 days. After 15 days of wash-out, groups were crossed, changing the used toothpaste. Clinical examination and saliva, crevicular gingival fluid (GCF), and subgingival biofilm collection were performed at baseline and 45 days of each phase. GCF cytokines' levels were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens' levels by qPCR.

RESULTS

At baseline, AgP group presented higher plaque index (PI), gingival index (GI), and bleeding on probing (BoP), higher Aggregatibacter actinomycetemcomitans (Aa) abundance in saliva and subgingival biofilm, and lower levels of INF-ɣ, IL-4, and IL-17 in GCF. Placebo therapy only reduced PI in both groups. Triclosan toothpaste reduced PI and GI in both groups. Triclosan promoted reduction of BoP and probing depth (PD), Aa salivary, and IL-1β levels in AgP group. In health group, triclosan reduced INF-ɣ and IL-4 concentration.

CONCLUSION

Triclosan toothpaste demonstrated to be more effective than placebo toothpaste to control the periodontal condition in children from AgP parents, by reducing the BoP, PD, salivary Aa, and IL-1β.

CLINICAL RELEVANCE

Triclosan toothpaste can improve oral conditions in higher-risk population for AgP.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov with the identifier NCT03642353.