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Feng Q, Zhang M, Zhang G, Mei H, Su C, Liu L, Wang X, Wan Z, Xu Z, Hu L, Nie Y, Li J. A whole-course-repair system based on ROS/glucose stimuli-responsive EGCG release and tunable mechanical property for efficient treatment of chronic periodontitis in diabetic rats. J Mater Chem B 2024; 12:3719-3740. [PMID: 38529844 DOI: 10.1039/d3tb02898d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Elevated glucose levels, multiple pro-inflammatory cytokines and the generation of excessive reactive oxygen species (ROS) are pivotal characteristics within the microenvironments of chronic periodontitis with diabetes mellitus (CPDM). Control of inflammation and modulation of immune system are required in the initial phase of CPDM treatment, while late severe periodontitis requires a suitable scaffold to promote osteogenesis, rebuild periodontal tissue and reduce alveolar bone resorption. Herein, a whole-course-repair system is introduced by an injectable hydrogel using phenylboronic acid functionalized oxidized sodium alginate (OSA-PBA) and carboxymethyl chitosan (CMC). Epigallocatechin-3-gallate (EGCG) was loaded to simultaneously adjust the mechanical property of the OSA-PBA/CMC + EGCG hydrogel (OPCE). This hydrogel has distinctive adaptability, injectability, and ROS/glucose-triggered release of EGCG, making it an ideal drug delivery carrier. As expected, OPCE hydrogel shows favourable antioxidant and anti-inflammatory properties, along with a regulatory influence on the phenotypic transition of macrophages, providing a favourable immune microenvironment. Apart from that, it provides a favourable mechanical support for osteoblast/osteoclast differentiation regulation at the late proliferation stage of periodontal regeneration. The practical therapeutic effects of OPCE hydrogels were also confirmed when applied for treating periodontitis in diabetic rats. In summary, OPCE hydrogel may be a promising whole-course-repair system for the treatment of CPDM.
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Affiliation(s)
- Qingchen Feng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Mei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Guanning Zhang
- Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Hongxiang Mei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Chongying Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Lisa Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Xiaoxia Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Ziqianhong Wan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Zhengyi Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
| | - Liangkui Hu
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Yu Nie
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, Sichuan, China.
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, no. 14, 3rd section, Renmin South Rd, Chengdu 610041, Sichuan, China.
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Xu X, Lu H, Huo P, Jin D, Zhu Y, Meng H. Effects of amoxicillin and metronidazole as an adjunct to scaling and root planing on glycemic control in patients with periodontitis and type 2 diabetes: A short-term randomized controlled trial. J Periodontal Res 2024; 59:249-258. [PMID: 38115631 DOI: 10.1111/jre.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To assess the effects of amoxicillin and metronidazole with scaling and root planing (SRP) on periodontal parameters and glycemic control in patients with severe periodontitis and diabetes mellitus. BACKGROUND Adjunctive antibiotics use is advantageous for treating periodontitis in patients with severe periodontitis and diabetes. However, the effects of adjunctive antibiotic use on hemoglobin A1c (HbA1c) levels remain unclear. METHODS This short-term, randomized controlled trial enrolled patients with severe periodontitis and type 2 diabetes. The patients were randomly allocated to SPR only (i.e., control) or SPR + antibiotics (500 mg of amoxicillin and 200 mg of metronidazole, three times daily for 7 days) groups. Periodontal and hematological parameters were assessed at baseline and 3 months after treatment. Inter- and intra-group analyses were performed using Student's t-tests, Mann-Whitney U tests, and the binary logistic regression models. p-values of <.05 were considered statistically significant. RESULTS This study enrolled 49 patients, with 23 and 26 patients in the SRP-only and SRP + antibiotics groups, respectively. The periodontal parameters improved significantly and similarly in both groups after treatment (p < .05). The SRP + antibiotics group had more sites of improvement than the SRP-only group when the initial probing depth was >6 mm. (698 [78.96%] vs. 545 [73.35%], p = .008). The HbA1c levels decreased in the SRP-only and SRP + antibiotics groups after treatment (0.39% and 0.53%, respectively). The multivariable binary logistic regression model demonstrated that antibiotics administration and a high baseline HbA1c level were associated with a greater reduction in the HbA1c level (odds ratio = 4.551, 95% confidence interval: 1.012-20.463; odds ratio = 7.162, 95% confidence interval: 1.359-37.753, respectively). CONCLUSIONS SRP and SRP plus systemic antibiotics were beneficial for glycemic control. Adjunctive antibiotic use slightly improved the outcome for patients with severe periodontitis and poorly controlled diabetes.
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Affiliation(s)
- Xinran Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - He Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Pengcheng Huo
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dongsiqi Jin
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunxuan Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chen Q, Zhao Y, Xie C, Wu S, Ji W, Xiao X, Zheng X. Therapeutic Effect of a Novel M1 Macrophage-Targeted Nanodrug in Chronic Periodontitis Mice. Mol Pharm 2024; 21:1677-1690. [PMID: 38478716 DOI: 10.1021/acs.molpharmaceut.3c00954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Chronic periodontitis is a chronic, progressive, and destructive disease. Especially, the large accumulation of advanced glycation end products (AGEs) in a diseased body will aggravate the periodontal tissue damage, and AGEs induce M1 macrophages. In this project, the novel nanodrugs, glucose-PEG-PLGA@MCC950 (GLU@MCC), are designed to achieve active targeting with the help of glucose transporter 1 (GLUT1) which is highly expressed in M1 macrophages induced by AGEs. Then, the nanodrugs release MCC950, which is a kind of NLRP3 inhibitor. These nanodrugs not only can improve the water solubility of MCC950 but also exhibit superior characteristics, such as small size, stability, innocuity, etc. In vivo experiments showed that GLU@MCC could reduce periodontal tissue damage and inhibit cell apoptosis in periodontitis model mice. In vitro experiments verified that its mechanism of action might be closely related to the inhibition of the NLRP3 inflammatory factor in M1 macrophages. GLU@MCC could effectively reduce the damage to H400 cells caused by AGEs, decrease the expression of NLRP3, and also obviously reduce the M1-type macrophage pro-inflammatory factors such as IL-18, IL-1β, caspase-1, and TNF-α. Meanwhile, the expression of anti-inflammatory factor Arg-1 in the M2 macrophage was increased. In brief, GLU@MCC would inhibit the expression of inflammatory factor NLRP3 and exert antiperiodontal tissue damage in chronic periodontitis via GLUT1 in the M1 macrophage as the gating target. This study provides a novel nanodrug for chronic periodontitis treatment.
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Affiliation(s)
- Qiuye Chen
- Department of Stomatology, Cancer Hospital Affiliated to Hainan Medical University, Haikou 570311, Hainan, China
| | - Yunshan Zhao
- School of Stomatology, Hainan Medical University, Haikou 571199, Hainan, China
- Integrated Department, Hainan Stomatological Hospital, Haikou 570105, Hainan, China
| | - Chen Xie
- School of Stomatology, Hainan Medical University, Haikou 571199, Hainan, China
| | - Shiwang Wu
- School of Stomatology, Hainan Medical University, Haikou 571199, Hainan, China
| | - Weizhen Ji
- Integrated Department, Hainan Stomatological Hospital, Haikou 570105, Hainan, China
| | - Xu Xiao
- Department of Stomatology, the First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan, China
| | - Xu Zheng
- Department of Stomatology, the First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan, China
- School of Stomatology, Hainan Medical University, Haikou 571199, Hainan, China
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Zhang B, Wang L, Liu C. Expression of TNF-α, omentin-1, and IL-6 before and after adjunctive treatment with a bioactive antimicrobial peptide periodontal gel. J Oral Pathol Med 2024; 53:201-207. [PMID: 38402639 DOI: 10.1111/jop.13518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/31/2023] [Accepted: 02/04/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND The objective of this study was to evaluate and compare the expression levels of TNF-α, omentin-1, and IL-6 in periodontitis patients before and after treatment with biological antimicrobial peptide (AMP) periodontal gel. METHODS There involved 86 periodontitis patients admitted to our hospital from January 2020 to March 2021. They were equally and randomly distributed into the study group and the control group. The efficacy and adverse reactions were compared between the two groups after treatment, Additionally, the sulcus bleeding index (SBI), plaque index (PLI), gingival index (GI), periodontal probing depth (PD), and levels of TNF-α, omentin-1, and IL-6 were measured before and after treatment. RESULTS After treatment, the total effective rate of the study group was significantly higher than that of the control group (p < 0.05), while the scores of four indicators (SBI, PLI, GI, and PD) and the levels of TNF-α, omentin-1, and IL-6 in the study group were evidently lower than the control group (p < 0.05). The study group had 1 case of mild irritant reaction, with an adverse reaction rate of 2.33% (1/43). And the control group had 1 case of nausea and 1 case of allergy, with an adverse reaction rate of 4.65% (2/43). The adverse reactions demonstrated no statistical difference between the two groups (χ2 = 0.345, p = 0.557). CONCLUSIONS The levels of TNF-α and IL-6 were highly expressed before the auxiliary therapy of biological AMP periodontal gel for periodontitis, alongside low expression of omentin-1. Subsequently, the biological antibacterial polypeptide periodontal gel demonstrated efficacy in the treatment of periodontitis.
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Affiliation(s)
- Bo Zhang
- Department of Stomatology, Wuhan No. 1 Hospital (Wuhan Hospital of Traditional Chinese & Western Medicine), Wuhan, China
| | - Lulu Wang
- Department of Stomatology, Wuhan No. 1 Hospital (Wuhan Hospital of Traditional Chinese & Western Medicine), Wuhan, China
| | - Chang Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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V V, Sk B, Krishnakumar D, Kumar D, Lavu V. Assessment of clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in the management of periodontitis - a split mouth randomized clinical trial. Lasers Med Sci 2024; 39:82. [PMID: 38418665 DOI: 10.1007/s10103-024-04032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
Aim of this study is to assess the clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in management of periodontitis. Type of study is a Split mouth clinical trial in which a total of 13 patients were recruited based on specific inclusion and exclusion criteria. In each participant, random allocation of selected sites into test and control in contralateral quadrants was done. Clinical parameters such as probing depth and clinical attachment loss was measured in control and test sites using occlusal stents. Flap surgery was carried out 6 weeks after phase I therapy and the selected contralateral sites with a probing depth of > 5mm were subjected to surgical therapy. In a test quadrant, 445 nm diode laser with a power of 0.8 W, CW mode, 320 µm fiber, in non-contact mode was used as an adjunct to flap surgery. Primary outcome variable assessed was change in PPD between baseline, pre-operative, 1-, 3- and 6-months post-surgery. Secondary outcomes variables assessed were Clinical attachment loss at baseline, pre-operative, 1, 3 and 6 months, visual analog scale at days 3 and 7 and patient satisfaction index at day 7 post surgery. Surgery for the second site (Test/control) in the contralateral quadrants was performed 1 week after the first surgery. A higher reduction in probing depth and gain in CAL was observed in test site at 1, 3 and 6 months follow up amongst all the included participants. VAS score was lower at the test site as compared to the control sites. PSI scores were similar in both the sites. The adjunctive use of 445nm diode laser to surgical periodontal therapy contributed to improved short term clinical outcomes as assessed at the end of 6 months post- surgery. VAS score indicative of post -surgical discomfort were also lower for the laser treated sites. Hence adjunctive use of laser (445 nm wavelength) can be recommended for achieving more predictable clinical outcomes.
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Affiliation(s)
- Vineet V
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Balaji Sk
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Dhanadivya Krishnakumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Divya Kumar
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India
| | - Vamsi Lavu
- Department of Periodontology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600 116, Tamil Nadu, India.
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Bertl K, Vlachou S, Pandis N, Zampelis A, Stavropoulos A. Repeated local delivery of hyaluronic acid gel as adjunctive treatment of residual pockets in periodontitis patients undergoing supportive periodontal care. A randomized controlled clinical trial. Clin Oral Investig 2024; 28:158. [PMID: 38376596 PMCID: PMC10879318 DOI: 10.1007/s00784-024-05505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES To assess the effect of hyaluronic acid (HyA) application as adjunct to re-instrumentation of residual pockets in patients undergoing regular supportive periodontal care (SPC). METHODS Chronic periodontitis patients (stage III and IV, grade B and C) with 4 interproximal residual pockets were randomly assigned to the test (HyA gel) or control (saline) group. After subgingival instrumentation, test or control substance was applied subgingivally, then daily supragingivally for 3 months, and if required a second time after subgingival re-instrumentation after 3 months. Clinical and patient reported outcome parameters were recorded every 3 months for 12 months. Pocket closure [probing pocket depth (PPD) ≤ 4mm with absence of bleeding on probing (BoP) at PPD = 4mm] was the main outcome parameter. RESULTS Fifty-six patients (221 experimental sites) were analysed. Pocket closure was achieved in 56.8 and 46.6% of the experimental sites in the test and control group, respectively (p > 0.05), while median PPD and PPD distribution (< 5mm/5mm/ > 5mm) differed significantly between groups in favour of the test group, at 12 months. Further, significantly fewer sites in the HyA group required re-instrumentation at 3 months, and sites in the HyA group showed a tendency for lower odds to remain diseased compared to the control group (OR 0.48, 95%CI 0.22-1.06). The odds for a site to remain diseased after 12 months increased significantly in the presence of plaque (OR 7.94, 95%CI 4.12-15.28), but in general, decreased significantly over time (OR 0.48, 95%CI 0.28-0.81). CONCLUSION Re-instrumentation of residual pockets in SPC patients, per se, leads to a significant increase in pocket closure over time; this was impeded by poor plaque control. Repeated local application of HyA results in fewer sites requiring re-instrumentation and might slightly improve the rate of pocket closure. (clinicaltrials.gov registration nr. NCT04792541). CLINICAL RELEVANCE HyA gel is easy to apply, well accepted by patients, and may have some positive effect in terms of fewer sites requiring re-instrumentation at 3 months and higher pocket closure rate at 12 months.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University Vienna, Freudplatz 3, 1020, Vienna, Austria
- Department of Periodontology, Blekinge Hospital, Hälsovägen, Byggnad 13, 371 41, Karlskrona, Sweden
| | - Stefania Vlachou
- Division of Regenerative Dental Medicine and Periodontology, CUMD, University of Geneva, Rue Michel-Servet 1, 1211, Genève 4, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Antonios Zampelis
- Private Practice, Drottninggatan 27, 652 25, Karlstad, Sweden
- Specialist Clinic for Endodontics and Periodontology, Public Dental Service, Värmland, Hagagatan 6, 652 20, Karlstad, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Blekinge Hospital, Hälsovägen, Byggnad 13, 371 41, Karlskrona, Sweden.
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 205 06, Malmö, Sweden.
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland.
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Yuan Y, Xu J. Application analysis of minocycline hydrochloride ointment combined with tinidazole in the treatment of chronic periodontitis. Minerva Surg 2024; 79:123-125. [PMID: 35023707 DOI: 10.23736/s2724-5691.21.09427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ying Yuan
- Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Junfeng Xu
- Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, China -
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Govindharajulu R, Syed NK, Sukumaran B, Seshadri PR, Mathivanan S, Ramkumar N. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024; 25:114-117. [PMID: 38514407 DOI: 10.5005/jp-journals-10024-3642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM The study aims is to evaluate the antibacterial effect of vitamin D3 against the red complex bacteria, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia in chronic periodontitis patients. MATERIALS AND METHODS The study comprised 98 participants with chronic periodontitis. All clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and a microbiological assay of P. gingivalis, T. denticola, T. forsythia were assessed at the baseline. All study participants who underwent scaling and root planning were divided into two groups, A and B, each with 49 patients and only group B patients were advised to take vitamin D supplementation of 60,000 IU granules, once daily for 2 months. All the patients of both the groups were recalled at the end of 2nd month and all the clinical and microbiological parameters were reassessed. RESULTS After two months, there was a reduction in all the clinical markers in both groups, but the group B patients showed more improvement following non-surgical treatment vitamin D intake. There was also a statistical reduction in P. gingivalis, T. denticola, and T. forsythia following administration of vitamin D in group B patients compared to group A. CONCLUSION These discoveries proposed that vitamin D has a superb antimicrobial impact against red complex periodontal microbes and might be considered a promising compound in the counteraction of periodontal disease. CLINICAL SIGNIFICANCE Vitamin D is considered to possess anti-inflammatory and antimicrobial activity, which may help to delay the progression of periodontitis. So, vitamin D3 can be used as a potential supplement that could be employed to stop the advancement of periodontal disease. How to cite this article: Govindharajulu R, Syed NK, Sukumaran B, et al. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024;25(2):114-117.
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Affiliation(s)
- Ramaprabha Govindharajulu
- Department of Periodontology, GRS Dental Clinic, Mayiladuthurai, Tamil Nadu, India, Phone: +91 9245196777, e-mail:
| | - Nubesh K Syed
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Al-Qassim, Kingdom of Saudi Arabia
| | - Binsu Sukumaran
- Department of Prosthetic Dental Sciences, Benser Dental Clinic, Kerala, India
| | - Pavithra R Seshadri
- Department of Periodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Narayane Ramkumar
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
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Souza DAS, de Lima Dantas JB, Souto CS, Mendonça DM, Oliveira TJS, Dos Santos Vianna Néri J. Photodynamic therapy adjuvant to non-surgical periodontal therapy: Systematic review of randomized clinical trials. Int J Dent Hyg 2024; 22:45-55. [PMID: 37752814 DOI: 10.1111/idh.12759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES To systematically evaluate randomised controlled trials (RCTs) on whether adjuvant application of antimicrobial photodynamic therapy (aPDT) through the technique of irradiation in the external region of the periodontal pocket with optic-fibre tip offers benefits to scaling and root planning (SRP). METHODS Five databases were searched by two independent reviewers according to pre-specified eligibility criteria up to April 2023. No restrictions regarding date of publication, language and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and Grading of Recommendations, Assessment, Development and Evaluation for assessing the certainty of evidence. RESULTS A total of 1388 publications were identified and reviewed for eligibility. Four of them fulfilled the inclusion criteria. The sample consisted of a total of 83 patients with periodontitis. In these, 330 periodontal sites were evaluated. The clinical findings of the majority of the included studies demonstrated that patients who received the association of aPDT + RAR with the protocol evaluated here, obtained clinical results similar to patients who received only the SRP alone. In none of the evaluated RCTs, clinical advantages were observed that would categorise this aPDT protocol as superior to conventional treatment. CONCLUSION Applying aPDT after SRP with external irradiation of the periodontal pocket does not seem to result in any clinical benefit compared to the use of SRP alone in patients with periodontitis.
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Affiliation(s)
- Daniel Adrian Silva Souza
- Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
| | - Juliana Borges de Lima Dantas
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
- Federal University of Bahia, Institute of Health Sciences, Stricto Sensu Graduate Program in Interactive Process of Organs and Systems, Salvador, Bahia, Brazil
- School of Medicine and Public Health, Salvador, Bahia, Brazil
| | | | | | - Tiago José Silva Oliveira
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
- São Leopoldo Mandic Dental Research Center, Stricto Sensu Graduate Program in Dental Sciences (Implantology), São Paulo, Brazil
| | - Júlia Dos Santos Vianna Néri
- Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
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Abdullah AN, Al-Habib OAM, Mohammed SA. Changes in the level of cytokines in the saliva of hypertensive patients with chronic periodontitis after scaling and root planning. Prostaglandins Other Lipid Mediat 2023; 169:106765. [PMID: 37451535 DOI: 10.1016/j.prostaglandins.2023.106765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Cytokines have a key role in the pathogenesis of both hypertension and periodontitis. Salivary diagnosis is a promising field with numerous clinical applications. Since limited studies have been carried out on how salivary inflammatory cytokines can be determined and how well periodontal disease and hypertension might react to scaling and root planning (SRP). The goal of this study was to identify the pattern of changes in salivary inflammatory cytokines in chronic periodontitis subjects with hypertension after nonsurgical periodontal therapy. METHODS It included observational trial recruited 94 chronic periodontitis patients, 44 of whom had hypertension. All subjects have undergone non- surgical periodontal treatment. The clinical periodontal parameters included gingival index (GI), plaque index (PI), and probing of pocket depth (PPD). Unstimulated saliva was collected to determine the inflammatory biomarkers (using a commercial Elisa kit) both before and after SRP RESULTS: In comparison to non-hypertensive participants, the periodontal PPD was significantly higher in hypertensive subjects. All clinical parameters in the first examination, except for PI, were significantly higher in hypertensive than in non-hypertensive subjects. Plaque Index, GI, and PPD parameters at first visit and after finishing treatment positively correlated with salivary IL-1β, excluding pretreatment GI. The current results demonstrate the presence of a positive correlation between diastolic blood pressure and TNF (r = 0.330 and P = 0.029). All patients enrolled in this study showed a significant increase in the salivary levels of IL-4 after SRP. CONCLUSIONS The current study offer important and valuable information concerning the practical application of pro-inflammatory and anti-inflammatory cytokines as useful biomarkers and indicators for determining the outcome of SRP and progression of chronic periodontitis in patients with hypertension.
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Affiliation(s)
- Ahed Najimelddin Abdullah
- Department of Dental Basic Sciences, College of Dentistry, University of Duhok, Duhok, Kurdistan Region, Iraq.
| | | | - Saeed Ali Mohammed
- Periodontics Department, College of Dentistry, University of Duhok, Duhok, Kurdistan Region, Iraq
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Ojha M, Rao DPC, Gowda V. Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial. J Contemp Dent Pract 2023; 24:921-927. [PMID: 38317387 DOI: 10.5005/jp-journals-10024-3605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM This study aims to evaluate the efficacy of calcium phosphate-poly(lactide-co-glycolide) composite graft in the regeneration of intrabony defects in chronic periodontitis patients over a period of 12 months. MATERIALS AND METHODS A total of 11 systemically healthy chronic periodontitis patients with 22 graftable sites were treated with calcium phosphate cement (CPC) bone graft (control group) and CPC-poly(lactic-co-glycolic acid)(PLGA) composite (test group) after flap reflection and debridement. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 3, 6, 9, and 12 months. Bone probing depth (BPD) and radiographic parameters such as defect depth (DD), changes in alveolar crest level (ALR), defect depth reduction (DDR), and percentage in defect depth reduction (PDDR) were calculated at baseline, and 6 and 12 months. The data were recorded and statistically analyzed. RESULTS On intragroup comparison, there was a significant improvement in all the parameters over a period of 1 year (clinically and radiographically). However, there was no statistically significant difference between the two groups in any of the parameters though there was a slightly higher bone fill noted in the test group. CONCLUSION Even though the CPC-PLGA composite bone graft showed a slight improvement in clinical and radiographic parameters as compared to the CPC graft, it was not statistically significant. CLINICAL SIGNIFICANCE A major drawback of Calcium Phosphate cements as bone grafts is their poor degradability. The PLGA microspheres degrade to expose macropores and interconnected pores in the graft substrate which in turn would promote the ingrowth of osteoblasts. Also, this composite graft is mouldable, and resorbable and has been shown to snugly fit into the defects making them a suitable scaffold material. How to cite this article: Ojha M, Pawar Chandrashekara Rao D, Gowda V. Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial. J Contemp Dent Pract 2023;24(12):921-927.
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Affiliation(s)
- Moitri Ojha
- Department of Periodontology, JSS Dental College & Hospital, Mysuru, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Deepika Pawar Chandrashekara Rao
- Department of Periodontology, JSS Dental College & Hospital, Mysuru, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India, Phone: +91 9902066073, e-mail:
| | - Vishakante Gowda
- Department of Pharmaceutics, JSS College of Pharmacy, Mysuru, Karnataka, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Khan M, Sharma A, Sharma A, Singh G, Khan S, Ahmad S, Alrashidi AAM, Sherwani S, Mishra H, Alsulimani A. The effect of non-surgical periodontal therapy on salivary IL-6 levels in patients with moderate to severe generalized chronic periodontitis. Ir J Med Sci 2023; 192:2981-2986. [PMID: 36869249 DOI: 10.1007/s11845-023-03325-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Gene regulation of IL-6 is characterized by the presence of inflammatory cytokines, bacterial products, viral infection, and activation of the diacylglycerol-, cyclic AMP-, or Ca + + -activated signal transduction pathways. AIM Scaling and root planning (SRP), a non-surgical periodontal therapy, was studied in connection to several clinical parameters for its effect on salivary IL-6 levels in patients with generalized chronic periodontitis. METHODS For this study, a total of 60 GCP patients were included. Plaque index (PI), gingival index (GI), pocket probing depth (PPD), bleeding on probing percentage (BOP%), and clinical attachment loss were among the clinical indicators covered (CAL). RESULTS Following SRP, mean IL-6 levels in patients with GCP were significantly higher in the pre-treatment group (2.93 5.17 pg/ml; p 0.05) than in the posttreatment group (5.78 8.26 pg/ml; baseline). Pre- and post-treatment IL-6 levels for PI (pre), BOP percent (pre/post), GI (post), and PPD were found to be positively correlated (post). In patients with GCP, the study showed a statistically significant correlation between periodontal metrics and salivary IL-6. CONCLUSIONS Changes in periodontal indices and IL-6 levels that are statistically significant over time indicate that non-surgical treatment is effective, and IL-6 can be regarded as a potent disease activity marker.
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Affiliation(s)
- Mahvish Khan
- Department of Biology, College of Science, Ha'il University, Ha'il, 2440, Saudi Arabia
| | - Anamika Sharma
- Department of Dentistry, LLRM Medical College, CCS University Meerut, Uttar Pradesh, India.
| | - Ananya Sharma
- Department of Dentistry, LLRM Medical College, CCS University Meerut, Uttar Pradesh, India
| | - Ganesh Singh
- Department of Community Medicine, LLRM Medical College, CCS University Meerut, Uttar Pradesh, India
| | - Saif Khan
- Department of Basic Dental and Medical sciences, College of Dentistry, Ha'il University, Ha'il, 2440, Saudi Arabia
| | - Saheem Ahmad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of , Hail, Saudi Arabia
| | | | - Subuhi Sherwani
- Department of Biology, College of Science, Ha'il University, Ha'il, 2440, Saudi Arabia
| | - Hemlata Mishra
- Kailash Hospital, Sector-27, Noida, Uttar Pradesh, India
| | - Ahmad Alsulimani
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
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Rodrigues RD, Araujo NS, Filho JMP, Vieira CLZ, Ribeiro DA, Dos Santos JN, Cury PR. Photodynamic therapy as adjunctive treatment of single-rooted teeth in patients with grade C periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2023; 44:103776. [PMID: 37657680 DOI: 10.1016/j.pdpdt.2023.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND The present study aimed to evaluate the adjunctive effect of an antimicrobial photodynamic therapy (aPDT) protocol on single-rooted teeth of patients with grade C periodontitis. METHODS Sixty-four single-rooted teeth (14 patients) were included in each group of this double-blinded split-mouth randomized clinical trial. The teeth were randomly divided into scaling and root planing + aPDT (test group) and scaling and root planing+sham aPDT (control group). The aPDT protocol consisted of incubation with 1% methylene blue for 5 min, rinsing, and application of a diode laser (wavelength of 660 nm, power of 100 mW) for 10 s. aPDT was repeated after 7 days. Bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) were recorded before and 3 months after treatment. A 5% significance level was adopted for statistical analysis. RESULTS Final PD was significantly (P = 0.02) lower in the test group (2.87 ± 1.40 mm) compared to control (3.12 ± 1.69 mm). The test group showed a significantly higher percentage of sites with PD≤4 mm and concomitant BoP compared to control (91%x86%;P < 0.001). At sites with baseline PD>4 mm, final PD and CAL were significantly (P = 0.01) lower in the test group (4.11 ± 1.66 and 4.89 ± 2.49 mm, respectively) compared to control (4.88 ± 1.99 and 5.89 ± 2.74 mm, respectively). CONCLUSIONS aPDT combined with scaling and root planning provided slightly better periodontal clinical results than the latter procedure alone, exerting a superior effect at sites with greater baseline PD. aPDT might be used as adjunctive treatment in grade C periodontitis affecting single-rooted teeth since it improves the response to conventional periodontal treatment.
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Affiliation(s)
- Rafael Drummond Rodrigues
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Nara Santos Araujo
- Postgraduate Program in Biotechnology, Northeast Biotechnology Network (RENORBIO), Federal University of Bahia, Av. Araujo Pinho, 62, CEP 4110-160, Salvador, Bahia, Brazil
| | - Jorge Moreira Pinto Filho
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Carolina Letícia Zilli Vieira
- Department of Environmental Health, School of Public Health, Harvard T.H. Chan, 401 Park Dr Landmark Center West 420 Room, Boston, MA 02215, USA
| | - Daniel Araki Ribeiro
- Department of Biosciences, Federal University of São Paulo, Av. Ana Costa, 95 - Vila Mathias, CEP: 11060-001, Santos, São Paulo, Brazil
| | - Jean Nunes Dos Santos
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Patricia Ramos Cury
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil.
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Abdel-Fatah R, Mowafey B, Baiomy A, Elmeadawy S. Efficacy of curcumin gel as an adjunct to scaling and root planing on salivary procalcitonin level in the treatment of patients with chronic periodontitis: a randomized controlled clinical trial. BMC Oral Health 2023; 23:883. [PMID: 37981665 PMCID: PMC10658924 DOI: 10.1186/s12903-023-03512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 11/21/2023] Open
Abstract
THE AIM OF THE STUDY To evaluate the effect of curcumin gel combined with scaling and root planing (SRP) on salivary procalcitonin in periodontitis treatment. MATERIALS AND METHODS seventy patients were selected from the Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, and sixteen patients were excluded. Patients in groups II and III included stage II grade A periodontitis. The participants were classified into three groups: group I as a negative control group (individuals with healthy gingiva), group II (SRP) were treated with SRP, and group III (curcumin gel) which was applied weekly for four weeks after SRP. Clinical indices (plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing depth (PD)) and saliva samples for procalcitonin (PCT) assessment using an enzyme-linked immunosorbent assay (ELISA) test were collected and measured at both baselines and after six weeks. RESULTS This randomized controlled clinical trial registered on ClinicalTrials.gov (NCT05667376) and first posted at 28/12/2022 included Fifty-four patients (20 male; 34 female). Regarding the age and sex distribution, there was no statistically significant difference between the three studied groups (p > 0.05). There was no significant statistical difference regarding PI, GI, PPD, and CAL between group II and group III at baseline p (> 0.05). However, there was a significant statistical difference regarding the clinical parameters at baseline of both group II and group III as compared to group I (p ≤ 0.05). At six weeks after treatment, group III showed greater improvement in the PI, PD, and CAL as opposed to group II (p ≤ 0.05). Regarding PCT values, at baseline, there wasn't a statistically significant difference between group II and group III (p > 0.05). However, there was a significant statistical difference between group II, group III, and group I (p ≤ 0.05). At six weeks after treatment, there was a statistically significant decrease in PCT levels of both group II and III (p ≤ 0.05). CONCLUSION The application of curcumin gel was found to have a significant effect on all clinical indices as opposed to SRP.
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Affiliation(s)
- Reham Abdel-Fatah
- Oral Medicine, Periodontology, Diagnosis, and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Bassant Mowafey
- Oral Medicine, Periodontology, Diagnosis, and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Azza Baiomy
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samah Elmeadawy
- Oral Medicine, Periodontology, Diagnosis, and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
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Rathod A, Jaiswal P, Kale B, Masurkar D. Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients. J Contemp Dent Pract 2023; 24:798-801. [PMID: 38152913 DOI: 10.5005/jp-journals-10024-3573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. MATERIALS AND METHODS A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. RESULTS The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. CONCLUSION Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. CLINICAL RELEVANCE Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.
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Affiliation(s)
- Aishwarya Rathod
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India, Phone: +91 9834240701, e-mail:
| | - Priyanka Jaiswal
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
| | - Bhairavi Kale
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
| | - Deepika Masurkar
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
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Costa FO, Esteves Lima RP, Costa AM, Costa AA, Mattos Pereira GH, Cortelli SC, Cortelli JR, Magalhães Cyrino R, Aparecida Silva T, Miranda Cota LO. Adjunctive effects of photodynamic therapy using indocyanine green in residual pockets during periodontal maintenance therapy: A split-mouth randomized controlled trial. J Periodontol 2023; 94:1100-1111. [PMID: 37051740 DOI: 10.1002/jper.22-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Prospective studies have reported conflicting results regarding the adjunctive effect of antimicrobial photodynamic therapy (aPDT) on clinical and microbiological parameters in individuals under periodontal maintenance therapy (PMT). This study aimed to evaluate the clinical and microbiological adjunctive effects of aPDT using indocyanine green (ICG) in residual sites with probing depth (PD) ≥5 mm during PMT in comparison with scaling and root planing (SRP) alone. METHODS A split-mouth randomized controlled clinical trial was conducted with 24 individuals in a PMT program. Contralateral quadrants with eligible residual sites were randomly assigned to either SRP + aPDT (test group) or SRP alone (control). aPDT included ICG dye and diode laser (909 nm) performed together with SRP and repeated 15 days after. Periodontal clinical parameters, periodontal inflamed surface area (PISA) index, and subgingival biofilm samples were collected at baseline (T1), 3 (T2), and 6 months later (T3). Microbiological analyses were performed by quantitative real-time polymerase chain reaction. RESULTS Significant improvements were observed in all clinical and microbiological parameters in both groups from T1 to T3. However, no significant differences were observed regarding plaque index, PD, and clinical attachment level. Test group showed significantly greater reductions in bleeding on probing (BOP), PISA index, and Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans levels, when compared with controls. CONCLUSIONS Both treatments resulted in significant clinical periodontal improvements, but with no significant differences between groups except from inflammation parameters. aPDT using ICG resulted in significant reductions in BOP and PISA index, as well as in P. gingivalis and A. actinomycetemcomitans levels.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Adriana Moreira Costa
- Department of Periodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Renata Magalhães Cyrino
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Al-Kheraif AA, Javed R, Al-Momani MM, Wasi A, Mohamed BA, Khan AA. Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis. Photodiagnosis Photodyn Ther 2023; 43:103690. [PMID: 37422202 DOI: 10.1016/j.pdpdt.2023.103690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
AIMS To evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. METHODOLOGY Individuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro‑aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. RESULTS The mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). CONCLUSION Combined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ravish Javed
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Mahmoud Al-Momani
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aisha Wasi
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Badreldin A Mohamed
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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Liu K, Ahemaiti A, Tuernisaguli K, Gulinuer A. [Effect of metformin combined with DPP-4 inhibitor on alveolar bone density in patients with type 2 diabetes mellitus and chronic periodontitis]. Shanghai Kou Qiang Yi Xue 2023; 32:410-416. [PMID: 38044737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
PURPOSE To investigate the effect of metformin combined with DPP-4 inhibitor on alveolar bone density in patients with type 2 diabetes mellitus and chronic periodontitis. METHODS A total of 80 patients with type 2 diabetes mellitus and chronic periodontitis were selected and randomly divided into group A and group B by random number table, with 40 patients in each group. Group A (medication alone group): oral metformin and basic periodontal treatment; Group B (combination group): DPP-4 inhibitor (sitagliptin) was taken orally in addition to group A. Before treatment (T0) and 3 months (T1) and 6 months (T2) after treatment, alveolar bone mineral density (BDM), periodontal probing depth (PD), clinical attachment loss(CAL), probing bleeding (BOP), glycated hemoglobin (HbA1c),serum phosphorus, serum calcium, adiponectin (ADP), leptin (LEP), interleukin-6 (IL-6), C-reactive protein (HS-CRP), tumor necrosis factor (TNF-α) were detected. SPSS 23.0 software package was used for data analysis. RESULTS Three and 6 months after treatment, PD, CAL, BOP and HbAlc in group B were significantly lower than those in group A(P<0.05). BDM in group B was significantly higher than that in group A (P<0.05). Compared with group A, the levels of inflammatory cytokines (IL-6, Hs-CRP, TNF-α) and leptin in group B were significantly decreased, while the level of adiponectin was significantly increased (P<0.05). CONCLUSIONS Metformin combined with DPP-4 inhibitor can increase alveolar bone density in patients with type 2 diabetes mellitus and chronic periodontitis, effectively improve periodontal clinical and serum biochemical indicators, and reduce periodontal inflammation.
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Affiliation(s)
- Ke Liu
- Department of Stomatology, Peking University Third Hospital Yanqing Hospital. Beijing 102100, China. E-mail:
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22
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Annunziata M, Donnarumma G, Guida A, Nastri L, Persico G, Fusco A, Sanz-Sánchez I, Guida L. Clinical and microbiological efficacy of indocyanine green-based antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2023; 27:2385-2394. [PMID: 36719506 PMCID: PMC10159973 DOI: 10.1007/s00784-023-04875-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The aim of the present randomized clinical trial (RCT) with a parallel arm design was to evaluate the clinical and microbiological efficacy of repeated ICG-aPDT as an adjunct to full-mouth subgingival debridement in the treatment of periodontitis. MATERIALS AND METHODS Twenty-four periodontitis patients were treated with full-mouth ultrasonic subgingival debridement (FMUD). Initial sites with probing depth (PD) > 4 mm were randomly assigned to receive the test (ICG-aPDT with an 810 nm diode laser) or the control treatment (off-mode aPDT) one and four weeks after FMUD. Clinical parameters were registered after 3 and 6 months. The presence of the main periodontal pathogens in subgingival samples was assessed with real-time PCR. RESULTS Both treatment modalities resulted in significant clinical improvements at 3 and 6 months. The only significant differences in favour of the test group were found at 6 months for a higher PD reduction in initial deep pockets (PD ≥ 6 mm) and a higher percentage of closed pockets (PD ≤ 4 mm/no bleeding on probing). Limited microbiological changes were observed in both groups after treatment with no inter-group difference, except for a more significant reduction in Aggregatibacter actinomycetemcomitans and Parvimonas micra levels in the test group at 3 months. CONCLUSION The combination of repeated ICG-aPDT and FMUD provided no benefits except for selective clinical and microbiological improvements compared to FMUD alone. CLINICAL RELEVANCE Based on the obtained results, only limited adjunctive effects could be found for the combined use of ICG-aPDT and FMUD. Further, well-designed RCT with larger sample sizes are required to confirm these findings. TRIAL REGISTRATION ClinicalTrials.gov NCT04671394.
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Affiliation(s)
- Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanna Donnarumma
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Agostino Guida
- U.O.C. Odontostomatologia, A.O.R.N. "A. Cardarelli", Naples, Italy
| | - Livia Nastri
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gerardo Persico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Fusco
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ignacio Sanz-Sánchez
- Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - Luigi Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Luque-Bracho A, Rosales Y, Vergara-Buenaventura A. The benefits of propolis in periodontal therapy. A scoping review of preclinical and clinical studies. J Ethnopharmacol 2023; 303:115926. [PMID: 36400346 DOI: 10.1016/j.jep.2022.115926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/24/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The treatment of periodontal disease (PD) is aimed at adequate control of bacterial plaque. In many patients mechanical methods are unable to eliminate this plaque leading to the need for adjuvant chemical products. Propolis is a natural product that has demonstrated therapeutic properties and has shown to be effective as an anti-inflammatory and antibacterial agent in dentistry. AIM OF THE STUDY Considering the beneficial effects of propolis on various oral conditions, this study aimed to review, update and summarize the available evidence on the benefits of propolis in in vitro studies, animal models, and human clinical trials on non-surgical periodontal therapy. MATERIALS AND METHODS An electronic search in three databases was performed up to December 2021. The search strategy included the terms "propolis" and "periodontal disease" to identify relevant studies on the potential advantages of propolis in periodontal therapy in in vitro studies, animal models, and human clinical trials. RESULTS The search yielded 538 results, discarding 459 studies that did not clearly meet the inclusion criteria. A total of 42 studies were included: 18 in vitro, one animal, and 23 randomized clinical trials. In vitro studies have demonstrated that propolis has antimicrobial activity against periodontal pathogens and clinical studies have reported its use as an adjunct to non-surgical periodontal therapy. The clinical effects of propolis have been reported in conjunction with prophylaxis, polishing, and scaling and root planing (SRP). It has shown to have anti-plaque activity and improve gingival health. Propolis was found to be more effective in improving clinical parameters than conventional treatment (SRP alone) and demonstrated similar efficacy in treating chronic periodontitis compared to positive controls. Only one study reported an allergic reaction. CONCLUSION The evidence available on the benefits of propolis in in vitro studies, animal models, and clinical trials suggests that propolis could be a promising adjunct to conventional therapy of gingivitis and periodontitis. However, further studies are needed to determine its superiority to other therapies in the treatment of PD.
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Affiliation(s)
- Angel Luque-Bracho
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima, Peru.
| | - Yasmin Rosales
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima, Peru.
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Kaipa VRK, Asif SM, Assiri KI, Saquib SA, Arem SA, Sree S, Yassin SM, Ibrahim M, Shariff M, Shamsudeen SM, Kaleem SM, Ghaffar Khan AA. Antioxidant effect of spirulina in chronic periodontitis. Medicine (Baltimore) 2022; 101:e31521. [PMID: 36550811 PMCID: PMC9771209 DOI: 10.1097/md.0000000000031521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Production of reactive oxygen species (ROS) by polymorpho nuclear neutrophils occurs in chronic periodontitis. These ROS are mainly involved in bacterial destruction. However, extracellular release of same results in destruction of surrounding tissue. Spirulina, a potent antioxidant when administered sub gingivally in pockets can offer improved results in chronic periodontitis patients. This study was conducted to evaluate the effect of Spirulina when delivered sub gingivally in patients with chronic periodontitis. METHODS Sixty chronic periodontitis patients were divided into 2 groups. Group I (n = 30) were treated with Scaling and Root planning (SRP) followed by placement of placebo (SRP-P) and in Group II (n = 30) Spirulina microspheres were placed sub gingivally (SRP-S) following SRP. Clinical parameters like bleeding on probing (BOP), clinical attachment level (CAL), gingival index (GI) and probing pocket depth (PPD) were evaluated. Levels of salivary and serum Malondialdehyde (MDA) were estimated using ultra violet spectrophotometer. RESULTS At baseline, in both groups there was no statistically significant difference in clinical and biochemical parameters. Intra group comparisons of parameters from baseline to 90 days were statistically significant in both groups. After 90 days difference in clinical parameters and salivary MDA levels were statistically significant in SRP-S compared to SRP-P group. Though serum MDA levels were reduced in both groups, they were not significant statistically. CONCLUSIONS Our study concluded that, local drug delivery of Spirulina adjunctive to SRP has potent antioxidant effect in treatment of chronic periodontitis.
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Affiliation(s)
| | - Shaik Mohammed Asif
- Department of Diagnostic Science and Oral Biology, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
- *Correspondence: Shaik Mohammed Asif, Department of Diagnostic Sciences & Oral Biology, College of Dentistry, King Khalid University, Abha 61421, Kingdom of Saudi Arabia (e-mail: )
| | | | - Shahabe Abullais Saquib
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Saeed Abdullah Arem
- Department of Periodontics, Mamata Dental College, Khammam, Telangana, India
| | - Suma Sree
- Department of Orthodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Syed Mohammed Yassin
- Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Ibrahim
- Department of Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Mansoor Shariff
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | | | - Abdul Ahad Ghaffar Khan
- Department of Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
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Al-Kheraif AA, Alshahrani OA, Al-Shehri AM, Khan AA. Antimicrobial photodynamic therapy using chloro-aluminum phthalocyanine for treating advanced stage-III periodontitis in smoking patients. Photodermatol Photoimmunol Photomed 2022; 38:591-599. [PMID: 35811336 DOI: 10.1111/phpp.12816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the bacterial, clinical, and cytokine profile of adjunctive photodynamic therapy using chloro-aluminum phthalocyanine (CAP/aPDT) with root surface debridement (RSD) versus RSD alone in cigarette smokers (CS) and never-smokers (NS) during the period of 6 months. METHODS Twenty-nine patients [CS - 14 and NS - 15] were recruited for the trial having stage-III periodontitis. All candidates from the study groups were subjected to a split-mouth treatment technique receiving CAP/aPDT + RSD and RSD alone. Periodontal parameters including plaque levels (PL), bleeding on probing (BP), probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. Polymerase chain reaction (qPCR) assay was used to analyze the copy numbers of Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf). Levels of tumor necrosis factor-alpha (TNF-α) interleukin (IL)-6 in the crevicular fluid were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS CAP/aPDT+RSD decreased BP in smokers after 6 months (p < .05). Probing depth and CAL reported statistically significant reductions within both CAP/aPDT+RSD and RSD groups and also within the NS and CS (p < .05). Pg and Tf stayed elevated in smokers at the 6-month evaluation period (p < .01). Only CAP/aPDT+RSD significantly decreased Pg and Tf at 3- and 6-month follow-up in smokers (p < .05). CAP/aPDT+RSD showed decreased IL-6 levels in the NS during the 6-month follow-up (p < .01). TNF-α levels were significantly reduced in the CS group with CAP/aPDT+RSD and RSD alone until 6 months (p < .01). CONCLUSION CAP-mediated aPDT along with nonsurgical periodontal therapy helped to improve the bacteriological outcomes among smokers and never-smokers with stage-III CP patients.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Obaid Abdullah Alshahrani
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Al-Shehri
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Baghani Z, Shabestari SB, Karrabi M. Clinical attachment loss in the use of adjunctive antimicrobial photodynamic therapy in Stages II-IV Grade C molar-incisor periodontitis: A systematic review and meta-analysis. Bosn J Basic Med Sci 2022; 22:843-861. [PMID: 35656837 PMCID: PMC9589313 DOI: 10.17305/bjbms.2022.7157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/02/2022] [Indexed: 08/26/2023] Open
Abstract
This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.
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Affiliation(s)
- Zahra Baghani
- Department of Periodontics, Faculty of Dentistry, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Samira Basir Shabestari
- Department of Oral Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Malihe Karrabi
- Department of Periodontics, Faculty of Dentistry, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Ye Z, Cao Y, Miao C, Liu W, Dong L, Lv Z, Iheozor-Ejiofor Z, Li C. Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis. Cochrane Database Syst Rev 2022; 10:CD009197. [PMID: 36194420 PMCID: PMC9531722 DOI: 10.1002/14651858.cd009197.pub5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND There may be an association between periodontitis and cardiovascular disease (CVD); however, the evidence so far has been uncertain about whether periodontal therapy can help prevent CVD in people diagnosed with chronic periodontitis. This is the third update of a review originally published in 2014, and most recently updated in 2019. Although there is a new multidimensional staging and grading system for periodontitis, we have retained the label 'chronic periodontitis' in this version of the review since available studies are based on the previous classification system. OBJECTIVES To investigate the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis. SEARCH METHODS An information specialist searched five bibliographic databases up to 17 November 2021 and additional search methods were used to identify published, unpublished, and ongoing studies. We also searched the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure, the VIP database, and Sciencepaper Online to March 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared active periodontal therapy to no periodontal treatment or a different periodontal treatment. We included studies of participants with a diagnosis of chronic periodontitis, either with CVD (secondary prevention studies) or without CVD (primary prevention studies). DATA COLLECTION AND ANALYSIS Two review authors carried out the study identification, data extraction, and 'Risk of bias' assessment independently and in duplicate. They resolved any discrepancies by discussion, or with a third review author. We adopted a formal pilot-tested data extraction form, and used the Cochrane tool to assess the risk of bias in the studies. We used GRADE criteria to assess the certainty of the evidence. MAIN RESULTS There are no new completed RCTs on this topic since we published our last update in 2019. We included two RCTs in the review. One study focused on the primary prevention of CVD, and the other addressed secondary prevention. We evaluated both as being at high risk of bias. Our primary outcomes of interest were death (all-cause and CVD-related) and all cardiovascular events, measured at one-year follow-up or longer. For primary prevention of CVD in participants with periodontitis and metabolic syndrome, one study (165 participants) provided very low-certainty evidence. There was only one death in the study; we were unable to determine whether scaling and root planning plus amoxicillin and metronidazole could reduce incidence of all-cause death (Peto odds ratio (OR) 7.48, 95% confidence interval (CI) 0.15 to 376.98), or all CVD-related death (Peto OR 7.48, 95% CI 0.15 to 376.98). We could not exclude the possibility that scaling and root planning plus amoxicillin and metronidazole could increase cardiovascular events (Peto OR 7.77, 95% CI 1.07 to 56.1) compared with supragingival scaling measured at 12-month follow-up. For secondary prevention of CVD, one pilot study randomised 303 participants to receive scaling and root planning plus oral hygiene instruction (periodontal treatment) or oral hygiene instruction plus a copy of radiographs and recommendation to follow-up with a dentist (community care). As cardiovascular events had been measured for different time periods of between 6 and 25 months, and only 37 participants were available with at least one-year follow-up, we did not consider the data to be sufficiently robust for inclusion in this review. The study did not evaluate all-cause death and all CVD-related death. We are unable to draw any conclusions about the effects of periodontal therapy on secondary prevention of CVD. AUTHORS' CONCLUSIONS For primary prevention of cardiovascular disease (CVD) in people diagnosed with periodontitis and metabolic syndrome, very low-certainty evidence was inconclusive about the effects of scaling and root planning plus antibiotics compared to supragingival scaling. There is no reliable evidence available regarding secondary prevention of CVD in people diagnosed with chronic periodontitis and CVD. Further trials are needed to reach conclusions about whether treatment for periodontal disease can help prevent occurrence or recurrence of CVD.
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Affiliation(s)
- Zelin Ye
- Department of Imaging, West China School of Stomatology, Chengdu, China
| | - Yubin Cao
- Department of Head and Neck Oncology, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Miao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Dong
- Department of Cardiovascular Medicine, Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University, Luzhou, China
| | - Zongkai Lv
- Department of Stomatology, Nan Chong Central Hospital, Second Clinical Medical College of Chuan Bei Medical College, Nanchong, China
| | | | - Chunjie Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Aranowicz A, van den Brandt SL, Slankamenac K, Keller DI. Destructive osteomyelitis involving Parvimonas micra and Campylobacter rectus. BMJ Case Rep 2022; 15:15/9/e250886. [PMID: 36137645 PMCID: PMC9511579 DOI: 10.1136/bcr-2022-250886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We present a rare case of destructive osteomyelitis of the sternum caused by Parvimonas micra and Campylobacter rectus. A previously healthy female patient in her 40s presented to the emergency department due to a spontaneous rupture of an abscess located to the chest wall. Imaging confirmed abscess formation with osteomyelitis of the sternum. Emergent surgical debridement was performed, blood and bone cultures were taken and the patient received antibiotic treatment. Cultures of the bone and deep tissue revealed infection with Parvimonas micra and Campylobacter rectus, both being members of the oral flora and associated with chronic periodontitis. Receiving targeted antibiotic treatment, our patient made a quick recovery. After treatment of the osteomyelitis, our patient was referred to the dentist where chronic periodontitis could be confirmed. Invasive infections with Parvimonas micra and Campylobacter rectus are rare. Investigation of a dental origin is crucial to prevent recurrent infections.
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Affiliation(s)
- Amos Aranowicz
- Emergency Department, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Dagmar I Keller
- Emergency Department, University Hospital Zurich, Zurich, Switzerland
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Chatzopoulos GS, Karakostas P, Kavakloglou S, Assimopoulou A, Barmpalexis P, Tsalikis L. Clinical Effectiveness of Herbal Oral Care Products in Periodontitis Patients: A Systematic Review. Int J Environ Res Public Health 2022; 19:10061. [PMID: 36011693 PMCID: PMC9408146 DOI: 10.3390/ijerph191610061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The use of herbal products in oral cavity has shown an increased popularity and potential benefits due to their additional anti-inflammatory and antioxidant properties as well as the lack of side effects related to their use. OBJECTIVE To assess the clinical effectiveness of herbal dental products (mouthwash, dentifrice, gel) when compared to conventional products or placebo in periodontitis patients. MATERIAL AND METHODS A systematic review with 22 studies was carried out using MEDLINE/Pubmed, EMBASE and Web of Science databases in addition to hand searches. Randomized and non-randomized clinical trials that evaluated the effect of any herbal dental product and compared it with conventional products or placebo in periodontitis patients and published up to March 2022, were screened. RESULTS Herbal products used as adjuncts to scaling and root planing (SRP) or supragingival debridement (SPD) led to superior clinical outcomes than placebo or no adjuncts (8 studies). In conjunction with SRP, these products showed comparable outcomes with chlorhexidine (6 studies) or better (4 studies). When used as adjuncts to SPD, herbal oral care products demonstrated comparable outcomes with chlorhexidine and conventional products (4 studies). CONCLUSIONS Within the limitations of this systematic review, herbal oral care products may play a key role in the management of periodontal disease. Further well-designed studies are needed to establish their efficacy.
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Affiliation(s)
- Georgios S. Chatzopoulos
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Panagiotis Karakostas
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Stefania Kavakloglou
- Faculty of Dentistry, Medical University of Sofia, 1431 Sofia, Bulgaria
- 424 General Military Training Hospital, 56429 Thessaloniki, Greece
| | - Andreana Assimopoulou
- School of Chemical Engineering, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Panagiotis Barmpalexis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Mishra SM, Ravishankar PL, Pramod V, Rajula PB, Gayathri K, Alam MK, Raj AT, Bhandi S, Patil S. Effect of Supplementation of Vitamin D in Patients with Periodontitis Evaluated before and after Nonsurgical Therapy. Biomed Res Int 2022; 2022:5869676. [PMID: 35978636 PMCID: PMC9377921 DOI: 10.1155/2022/5869676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Background Vitamin D has anti-inflammatory properties and the potential to increase the generation of antimicrobial peptides like cathelicidin and defensins that may have a good impact on oral health. Higher vitamin D consumption has also been linked to a reduced risk of periodontal disease progression. Hence, the primary objective of this study was to evaluate and compare the clinical and laboratory parameters of oral supplementation of vitamin D as an adjuvant to scaling and root planing and to assess the bone mineral density via qualitative ultrasound bone density scanner in chronic periodontitis patients. Methodology. This study included 40 patients with periodontitis categorized into 2 groups with twenty patients each, Group I comprising scaling and root planing (SRP) alone and Group II comprising SRP along with vitamin D supplementation. Plaque index, gingival index, probing pocket depth, and clinical attachment loss was measured as clinical parameters. Serum vitamin D levels were assessed before and after SRP at both baseline and 6 weeks. Results The intergroup comparison of clinical parameters (PI, GI, PPD, and CAL) at 6 weeks for both the groups showed statistical significance. Intragroup comparison of clinical parameters from baseline to 6 weeks showed a statistically significant reduction in both groups. The mean bone mineral density level in both the control and test groups demonstrated a mean T score of -1.3 and -1.21, respectively. The mean vitamin D levels were 27.8460 and 28.1020 for the test and control groups, respectively, which was statistically insignificant (p = 0.705) and those at six-week intervals improved to 31.3650 and 28.0240 which were statistically significant (p ≤ 0.001). Conclusion It could be stated that a positive relationship exists between periodontitis and osteopenia which could aggravate periodontal destruction. All periodontitis cases should thus be evaluated for BMD and supplemented with vitamin D3 in an appropriate dosage and time frame to treat both these diseases.
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Affiliation(s)
- Shree Mohan Mishra
- Department of Periodontology, New Horizon Dental College, Bilaspur, 495001 Chattisgarh, India
| | - P. L. Ravishankar
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - V. Pramod
- Department of Periodontology, New Horizon Dental College, Bilaspur, 495001 Chattisgarh, India
| | - Prem Blaisie Rajula
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - K. Gayathri
- Department of Periodontology, SRM Kattankulathur Dental College & Hospital, SRM lnstitute of Science and Technology, SRM Nagar, Kattankulathur, 603203 Kancheepuram, Chennai, Tamil Nadu, India
| | - Mohammad Khursheed Alam
- Orthodontics, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil lnternational University, Dhaka, Bangladesh
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Department of Cariology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600 077, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Science, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Jazan 45412, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600 077, India
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Abstract
BACKGROUND Periodontitis is a highly prevalent, chronic inflammation that causes damage to the soft tissues and bones supporting the teeth. Conventional treatment is quadrant scaling and root planing (the second step of periodontal therapy), which comprises scaling and root planing of teeth in one quadrant of the mouth at a time, with the four different sessions separated by at least one week. Alternative protocols for anti-infective periodontal therapy have been introduced to help enhance treatment outcomes: full-mouth scaling (subgingival instrumentation of all quadrants within 24 hours), or full-mouth disinfection (subgingival instrumentation of all quadrants in 24 hours plus adjunctive antiseptic). We use the older term 'scaling and root planing' (SRP) interchangeably with the newer term 'subgingival instrumentation' in this iteration of the review, which updates one originally published in 2008 and first updated in 2015. OBJECTIVES To evaluate the clinical effects of full-mouth scaling or full-mouth disinfection (within 24 hours) for the treatment of periodontitis compared to conventional quadrant subgingival instrumentation (over a series of visits at least one week apart) and to evaluate whether there was a difference in clinical effects between full-mouth disinfection and full-mouth scaling. SEARCH METHODS An information specialist searched five databases up to 17 June 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) lasting at least three months that evaluated full-mouth scaling and root planing within 24 hours, with or without adjunctive use of an antiseptic, compared to conventional quadrant SRP (control). Participants had a clinical diagnosis of (chronic) periodontitis according to the International Classification of Periodontal Diseases from 1999. A new periodontitis classification was launched in 2018; however, we used the 1999 classification for inclusion or exclusion of studies, as most studies used it. We excluded studies of people with systemic disorders, taking antibiotics or with the older diagnosis of 'aggressive periodontitis'. DATA COLLECTION AND ANALYSIS Several review authors independently conducted data extraction and risk of bias assessment (based on randomisation method, allocation concealment, examiner blinding and completeness of follow-up). Our primary outcomes were tooth loss and change in probing pocket depth (PPD); secondary outcomes were change in probing attachment (i.e. clinical attachment level (CAL)), bleeding on probing (BOP), adverse events and pocket closure (the number/proportion of sites with PPD of 4 mm or less after treatment). We followed Cochrane's methodological guidelines for data extraction and analysis. MAIN RESULTS We included 20 RCTs, with 944 participants, in this updated review. No studies assessed the primary outcome tooth loss. Thirteen trials compared full-mouth scaling and root planing within 24 hours without the use of antiseptic (FMS) versus control, 13 trials compared full-mouth scaling and root planing within 24 hours with adjunctive use of an antiseptic (FMD) versus control, and six trials compared FMS with FMD. Of the 13 trials comparing FMS versus control, we assessed three at high risk of bias, six at low risk of bias and four at unclear risk of bias. We assessed our certainty about the evidence as low or very low for the outcomes in this comparison. There was no evidence for a benefit for FMS over control for change in PPD, gain in CAL or reduction in BOP at six to eight months (PPD: mean difference (MD) 0.03 mm, 95% confidence interval (CI) -0.14 to 0.20; 5 trials, 148 participants; CAL: MD 0.10 mm, 95% CI -0.05 to 0.26; 5 trials, 148 participants; BOP: MD 2.64%, 95% CI -8.81 to 14.09; 3 trials, 80 participants). There was evidence of heterogeneity for BOP (I² = 50%), but none for PPD and CAL. Of the 13 trials comparing FMD versus control, we judged four at high risk of bias, one at low risk of bias and eight at unclear risk of bias. At six to eight months, there was no evidence for a benefit for FMD over control for change in PPD or CAL (PPD: MD 0.11 mm, 95% CI -0.04 to 0.27; 6 trials, 224 participants; low-certainty evidence; CAL: 0.07 mm, 95% CI -0.11 to 0.24; 6 trials, 224 participants; low-certainty evidence). The analyses found no evidence of a benefit for FMD over control for BOP (very low-certainty evidence). There was no evidence of heterogeneity for PPD or CAL, but considerable evidence of heterogeneity for BOP, attributed to one study. There were no consistent differences in these outcomes between intervention and control (low- to very low-certainty evidence). Of the six trials comparing FMS and FMD, we judged two trials at high risk of bias, one at low risk of bias and three as unclear. At six to eight months, there was no evidence of a benefit of FMD over FMS for change in PPD or gain in CAL (PPD: MD -0.11 mm, 95% CI -0.30 to 0.07; P = 0.22; 4 trials, 112 participants; low-certainty evidence; CAL: MD -0.05 mm, 95% CI -0.23 to -0.13; P = 0.58; 4 trials, 112 participants; low-certainty evidence). There was no evidence of a difference between FMS and FMD for BOP at any time point (P = 0.98; 2 trials, 22 participants; low- to very low-certainty evidence). There was evidence of heterogeneity for BOP (I² = 52%), but not for PPD or CAL. Thirteen studies predefined adverse events as an outcome; three reported an event after FMD or FMS. The most important harm identified was an increase in body temperature. We assessed the certainty of the evidence for most comparisons and outcomes as low because of design limitations leading to risk of bias, and the small number of trials and participants, leading to imprecision in the effect estimates. AUTHORS' CONCLUSIONS The inclusion of nine new RCTs in this updated review has not changed the conclusions of the previous version of the review. There is still no clear evidence that FMS or FMD approaches provide additional clinical benefit compared to conventional mechanical treatment for adult periodontitis. In practice, the decision to select one approach to non-surgical periodontal therapy over another should include patient preference and the convenience of the treatment schedule.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Jörg Eberhard
- Faculty of Dentistry, The University of Sydney, Sydney Dental Hospital, Sydney, Australia
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
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Alshibani N, Al-Kattan R, Alssum L, Basudan A, Shaheen M, Alqutub MN, Al Dahash F. Postoperative Analgesic and Anti-inflammatory Effectiveness of Ginger (Zingiber officinale) and NSAIDs as Adjuncts to Nonsurgical Periodontal Therapy for the Management of Periodontitis. Oral Health Prev Dent 2022; 20:227-232. [PMID: 35695692 DOI: 10.3290/j.ohpd.b3125633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The authors hypothesize that ginger (Zingiber officinale) tablets and non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing postoperative self-rated pain and periodontal parameters (plaque index [PI], gingival index [GI], and probing depth [PD], clinical attachment loss [AL] and marginal bone loss) following non-surgical periodontal therapy (NSPT) in patients with periodontitis. The aim was to compare the postoperative analgesic and anti-inflammatory effectiveness of ginger tablets and NSAIDs as adjuncts to nonsurgical periodontal therapy for the management of periodontitis. Materials and Methods: Patients with periodontitis were included. All patients underwent NSPT. In groups 1 and 2, patients received postoperative ginger (400 mg) and non-steroidal anti-inflammatory drugs (400 mg), respectively. Demographic data were collected, and full-mouth periodontal parameters (PI, GI, PD and CAL) were evaluated at baseline and at 7, 14 and 21 days. Self-rated pain scores were assessed at baseline, and at 24 h, 3 and 7 days of follow-up. In both groups, self-rated pain was assessed pre- and postoperatively using the numeric rating scale (NRS). Power analysis was performed on data from a pilot investigation and group comparisons were done. Statistical significance was set at p < 0.01. RESULTS Baseline mean NRS scores in groups 1 and 2 were 4.19 ± 0.12 and 4.13 ± 0.08, respectively. All participants had stage II/grade B periodontitis. At baseline, self-rated pain scores were significantly higher among patients in groups 1 and 2 at 24 h (p < 0.01) and 3 days (p < 0.01) of follow-up. In groups 1 (p < 0.01) and 2 (p < 0.01), self-rated pain scores were significantly higher at 24 h compared with 3 days of follow-up. In both groups, there was a significant reduction in PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) at 7, 14 and 21 days of follow-up compared with baseline. CONCLUSION Ginger and traditional NSAIDs are effective in reducing postoperative pain and inflammation following NSPT in patients with moderate periodontitis.
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Goswami V, Yeltiwar RK, Kujur S, Agrawal P, Bodhi S, Bhatnagar S. Evaluation of efficacy of subgingival administration of 1% chlorhexidine gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis - A clinical and microbiological study. Indian J Dent Res 2022; 33:174-179. [PMID: 36254955 DOI: 10.4103/ijdr.ijdr_936_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
AIM The aim of the present study was to evaluate the clinical and microbiological effects of subgingival administration of 1% chlorhexidine gel (Chlorhexamed® 1% gel) in patients with chronic periodontitis. SETTINGS AND DESIGN The study was done in a parallel-arm design with a total of 30 patients with 60 sites suffering from chronic periodontitis. The patients were divided into control and experimental groups. MATERIALS AND METHODS The clinical parameters recorded were plaque index, gingival index, modified sulcular bleeding index, probing pocket depth and relative attachment level at baseline, 1 month and 3 month. Microbiological colony-forming units were assessed for Porphyromonas gingivalis, Fusobacterium nucleatum and Tannerella forsythia at baseline, 1 week, 1 month and 3 months. The control group received scaling and root planing (SRP) after baseline evaluation; however, the experimental group received the application of Chlorhexamed® gel within 48 hours after SRP. Then, the values obtained were subjected to statistical analysis. RESULTS Both groups showed significant improvement from the baseline to 3 months in all clinical and microbiological parameters. The experimental group showed better improvement in all parameters. CONCLUSION The use of Chlorhexamed® gel has proven to be an efficacious adjunct with SRP in the treatment of chronic periodontitis.
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Affiliation(s)
- Varsha Goswami
- Department of Periodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Ramreddy K Yeltiwar
- Department of Periodontology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Shirish Kujur
- Department of Periodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Parul Agrawal
- Department of Periodontology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Sonika Bodhi
- Department of Periodontics, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Shruti Bhatnagar
- Department of Periodontology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
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Yuan Q, Wang Y, Zeng J, Luan Q. Integrated effects of ultrasonic scaling and subgingival irrigation with 0.12% chlorhexidine by a newly designed ultrasonic scaler tip in chronic periodontitis. Quintessence Int 2022; 53:298-305. [PMID: 34881842 DOI: 10.3290/j.qi.b2407777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the integrated efficacy of completely simultaneous ultrasonic scaling and subgingival irrigation with chlorhexidine in chronic periodontitis. METHOD AND MATERIALS This was a split-mouth randomized controlled trial including 19 patients with moderate to severe chronic periodontitis. After calculus removal, the test side received simultaneous ultrasonic scaling and subgingival irrigation with 0.12% chlorhexidine, and the control side received simultaneous ultrasonic scaling and subgingival irrigation with distilled water. A newly designed ultrasonic scaler tip with a liquid outlet on the terminal was used. Clinical parameters were assessed, and gingival crevicular fluid was collected before treatment at baseline and 1.5, 3, and 6 months after baseline. RESULTS On follow-up, both sides showed significant reductions in clinical parameters and concentration of inflammatory mediators in gingival crevicular fluid. Adjunct application of CHX resulted in an additional periodontal pocket reduction (0.27 to 0.29 mm, P < .05) compared to the control side, in sites with initial probing depth of 4 to 5 mm. Within the initial probing depth ≥ 6 mm, the additional probing depth reduction was 0.44 to 0.60 mm (P < .05), with clinical attachment loss, concentration of interleukin-6, and concentration of matrix metalloproteinase-8 being 0.32 to 0.38 mm, 2.64 to 3.40 µg/L, and 19.78 to 22.39 ng/L, respectively (all P < .05). CONCLUSION In this study, treatment outcomes of chronic periodontitis could be improved by treating the root surface with simultaneous ultrasonic scaling and chlorhexidine irrigation. The adjunctive use of 0.12% chlorhexidine with a newly designed ultrasonic scaler tip in the treatment of moderate to severe chronic periodontitis demonstrated significant clinical benefits and decrease in inflammatory mediator when compared with scaling and root planing plus placebo.
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Mourão LC, Alhanati M, Gonçalves LS, Holandino C, Canabarro A. Comparative Evaluation of Homeopathic Therapy in the Treatment of Chronic Periodontitis. Altern Ther Health Med 2022; 28:100-106. [PMID: 34197339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CONTEXT AND OBJECTIVE Periodontitis and type 2 diabetes (T2D) are chronic diseases generally treated with conventional therapies alone. The aim of this study was to compare the effects of homeopathy as an adjunct to conventional periodontal therapy in individuals with periodontitis and T2D. DESIGN 85 individuals, age between 35 and 70 years, of both genders, participated in this randomized study; 70 patients were from the Institute of Endocrinology and Diabetes of Rio de Janeiro, Brazil. They were divided into 2 groups: G1, individuals with periodontitis without systemic conditions; and G-2, individuals with periodontitis and T2D. Both groups received homeopathic treatment and were evaluated in clinical and laboratory examinations. The medication used was chosen based on the similarity principle: Berberis 6CH, Mercurius Solubilis/Belladona /Hepar Sulfur and a Pyrogenium 200CH biotherapic. Medications were prescribed in diluted low ultra-diluted concentration doses for all signs and symptoms, while biotherapics were used for chronic stimulation. SETTING The study was performed in Brazil by university research professors of homeopathy and periodontics. RESULTS Both groups showed significant clinical and laboratory improvements during the study from baseline to 1 year with reductions in total cholesterol (total-C), triglycerides, glucose, glycated hemoglobin (A1cHb), uric acid and C-reactive protein (CRP). Statistical and descriptive analyses were performed. For most parameters, G1 performed better than G2 (P < .05). CONCLUSION Homeopathy as an adjunct to periodontal treatment improves local and systemic clinics and can provide better health conditions for patients with or without T2D.
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Kumar A, Mahendra J, Mahendra L, Abdulkarim HH, Sayed M, Mugri MH, Ahmad ZH, Bhati AK, Faqehi HH, Algregri WO, Varadarajan S, Balaji TM, Baeshen HA, Patil S. Synergistic Effect of Biphasic Calcium Phosphate and Platelet-Rich Fibrin Attenuate Markers for Inflammation and Osteoclast Differentiation by Suppressing NF-κB/ MAPK Signaling Pathway in Chronic Periodontitis. Molecules 2021; 26:molecules26216578. [PMID: 34770985 PMCID: PMC8587053 DOI: 10.3390/molecules26216578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Periodontitis is characterized by excessive osteoclastic activity, which is closely associated with inflammation. It is well established that MAPK/NF-kB axis is a key signaling pathway engaged in osteoclast differentiation. It is stated that that biphasic calcium phosphate (BCP) and platelet-rich fibrin (PRF) have significant antiostoeclastogenic effects in chronic periodontitis. Objective: We aimed to elucidate the synergetic effect of PRF/BCP involvement of the nuclear factor kappa–light–chain–enhancer of activated B cells (NF-kB) and the mitogen-activated protein kinase (MAPK) signaling pathway in osteoclast differentiation in chronic periodontitis. Methods: We induced osteoclast differentiation in vitro using peripheral blood mononuclear cells (PBMCs) derived from patients with chronic periodontitis. We assessed osteoclast generation by tartrate-resistant acid phosphatase (TRAP) activity, proinflammatory cytokines were investigated by ELISA and NF-κB, and IKB by immunoblot, respectively. MAPK proteins and osteoclast transcription factors were studied by Western blot analysis and osteoclast transcriptional genes were assessed by RT-PCR. Results: The results showed that the potent inhibitory effect of PRF/BCP on osteoclastogenesis was evidenced by decreased TRAP activity and the expression of transcription factors, NFATc1, c-Fos, and the osteoclast marker genes, TRAP, MMP-9, and cathepsin-K were found to be reduced. Further, the protective effect of PRF/BCP on inflammation-mediated osteoclastogenesis in chronic periodontitis was shown by decreased levels of proinflammatory cytokines, NF-kB, IKB, and MAPK proteins. Conclusions: PRF/BCP may promote a synergetic combination that could be used as a strong inhibitor of inflammation-induced osteoclastogenesis in chronic periodontitis.
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Affiliation(s)
- Anil Kumar
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
- Correspondence: (J.M.); (S.P.)
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai 213620, United Arab Emirates;
| | - Hesham H. Abdulkarim
- Advanced Periodontal and Dental Implant Care, Missouri School of Dentistry and Oral Health, A. T. Still University, St. Louis, MO 63104, USA;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Zeeshan Heera Ahmad
- Dental College Hospital, King Saud University Medical City, Riyadh 12372, Saudi Arabia;
| | - Ashok Kumar Bhati
- Division of Periodontics Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | | | | | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Thodur Madapusi Balaji
- Department of Periodontology, Tagore Dental College and Hospital, Chennai 600127, India;
| | - Hosam Ali Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
- Correspondence: (J.M.); (S.P.)
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Olszewska-Czyz I, Kralik K, Prpic J. Biomolecules in Dental Applications: Randomized, Controlled Clinical Trial Evaluating the Influence of Hyaluronic Acid Adjunctive Therapy on Clinical Parameters of Moderate Periodontitis. Biomolecules 2021; 11:biom11101491. [PMID: 34680123 PMCID: PMC8533205 DOI: 10.3390/biom11101491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
The biological activity of hyaluronic acid (HA) has been well-researched during the past decades; however, there are few randomized, controlled trials of its clinical effects in periodontal therapy. The purpose of this study was to evaluate the effect of hyaluronic acid on the principal parameters of periodontal healing. A specific, commercially available formulation designed and registered for professional dental application, composed of 16 mg/mL of cross-linked and 2 mg/mL of non-cross-linked HA, was used as an adjunctive to non-surgical periodontal therapy, and clinical parameters were evaluated after 3 months. The addition of HA to periodontal therapy demonstrated more favorable clinical results regarding reduction in inflammation, measured by bleeding on probing (-6% compared to the control group) and gain in periodontal attachment (1 mm more than control group), while it had no effect on probing depth reduction. No side effects were reported. Our study demonstrated that HA is a safe and easy-to-use biological agent; due to its wide array of properties, it may significantly improve the results of periodontal therapy. However, more long-term studies are needed to investigate whether these favorable effects remain over time.
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Affiliation(s)
- Iwona Olszewska-Czyz
- Department of Periodontology and Oral Pathology, Dental Institute, Medical Faculty, Jagielonian University, 31155 Krakow, Poland
- Correspondence:
| | - Kristina Kralik
- Department of Medical Statistics and Medical Informatics, Medical Faculty Osijek, University Josip Juraj Strossmayer of Osijek, 31000 Osijek, Croatia;
| | - Jelena Prpic
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
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Abstract
Periodontitis is an inflammatory disease caused by host immune response, resulting in a loss of periodontium and alveolar bone. Immune cells, such as T cells and macrophages, play a critical role in the periodontitis onset. Halofuginone, a natural quinazolinone alkaloid, has been shown to possess anti-fibrosis, anti-cancer, and immunomodulatory properties. However, the effect of halofuginone on periodontitis has never been reported. In this study, a ligature-induced mice model of periodontitis was applied to investigate the potential beneficial effect of halofuginone on periodontitis. We demonstrated that the administration of halofuginone significantly reduced the expression levels of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) in vivo, and markedly suppressed immune cell infiltration into the infected sites. Furthermore, we also observed that halofuginone treatment blocked the T-helper 17 (Th17) cell differentiation in vivo and in vitro. We demonstrated for the first time that halofuginone alleviated the onset of periodontitis through reducing immune responses.
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Affiliation(s)
- Jiang Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry & Emergency, the Hospital of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Bo Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Center, the Hospital of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xin Lv
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry & Emergency, the Hospital of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yingjie Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry & Emergency, the Hospital of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi, China
- Yingjie Wang, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry & Emergency, the Hospital of Stomatology, the Fourth Military Medical University, Xi’an, Shaanxi 710032, China.
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Luo W, Yan H, Guo S. Evaluation of the efficiency of antibiotics in treating adult patients with symptomatic apical periodontitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26405. [PMID: 34160426 PMCID: PMC8238317 DOI: 10.1097/md.0000000000026405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND When a person feels dental pain, it brings great discomfort and damages the quality of life. Symptomatic apical periodontitis is identified as the most frequent cause that triggers dental pain. Symptomatic apical periodontitis arises from an infection or inflammation in the pulpless root canal structure. According to clinical guidelines, the primary form of therapy for such teeth entails removing the inflammation or infection source through local surgical procedures. Presently, systemic antibiotics are recommended only for cases where there is clear indication of an infectious spread or a systemic involvement. Therefore, this study aims to assess the efficacy and level of safety of using antibiotics to treat adult symptomatic apical periodontitis patients. METHODS The present protocol study will conduct a search on electronic databases to look for randomized controlled trials (RCTs) that have evaluated the effectiveness and safety of antibiotics when used to treat adult patients with symptomatic apical periodontitis. The databases will be search from their beginning to April 2021. The search is not bound by publication status or language restrictions. The following databases will be searched: Web of Science, PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure, and EMBASE. This study will employ ZETOC Conference Proceedings and OpenGrey to identify potential grey literature. Afterwards, 2 independent authors will select the studies, extract data from the studies, and conduct a risk assessment to check for bias. All discrepancies between the authors will be resolute via discussion involving a third independent author. The data synthesis and statistical analysis of this study will be done with the RevMan software (Version: 5.3). RESULTS The present protocol report will provide high-quality evidence related to the efficacy and level of safety when using antibiotics to treat mature symptomatic apical periodontitis patients. CONCLUSION The outcomes of the present study will update the evidence available for assessing the efficacy and safeness of using antibiotics to treat mature symptomatic apical periodontitis patients. ETHICS AND DISSEMINATION This study does not require an ethical approval since individual patient data is not included in any form. REGISTRATION NUMBER DOI 10.17605/OSF.IO/CVP8 M (https://osf.io/cvp8m/).
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Affiliation(s)
| | | | - Sijie Guo
- Department of Clinical Laboratory, Wuchang Hospital of Wuhan, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei Province, China
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Vieceli PS, Juiz PJL, Lauria PSS, Couto RD, Tomassini TCB, Ribeiro IM, Soares MBP, Villarreal CF. Physalis angulata reduces the progression of chronic experimental periodontitis by immunomodulatory mechanisms. J Ethnopharmacol 2021; 273:113986. [PMID: 33675915 DOI: 10.1016/j.jep.2021.113986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/01/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Physalis angulata is an herb found in tropical and subtropical regions of the world; it is widely applied in popular medicine due to the therapeutic properties of the whole plant and its parts. Extracts and infusions of this plant have been extensively applied in folk medicine worldwide to treat inflammatory and immune-mediated diseases, including oral inflammatory conditions such as sore throat and gingivitis. AIM OF THE STUDY The present study was designed to investigate the protective effects of the ethanolic extract of P. angulata (EEPA) in a murine model of chronic periodontitis, aiming to corroborate its traditional use as an anti-inflammatory and immunomodulatory agent, and to point out possible mechanisms involved in these effects. MATERIALS AND METHODS EEPA was obtained from the stems of P. angulata collected in Belém (PA, Brazil). Chronic periodontitis was induced in male C57BL/6 mice by 12 administrations of lipopolysaccharide (LPS; 20 μg/1μL) into the gingival papilla in the course of 28 days. Starting from the 15th day after the first LPS injection, mice were daily treated with EEPA (50 or 100 mg/kg), nimesulide (25 mg/kg, reference drug), or vehicle by oral route for 14 days. At the end of the experimental period, alveolar bone loss was evaluated along with the gingival expression of biomarkers of periodontitis and cytokines by RT-q-PCR and ELISA. Hematological and biochemical parameters suggestive of systemic toxicity were also evaluated. The transcriptional activity of NF-κB was investigated using the luciferase assay in macrophages. RESULTS Mice with chronic experimental periodontitis suffered alveolar bone loss that was prevented by the treatment with EEPA (50 or 100 mg/kg) or nimesulide (25 mg/kg). EEPA (50 and 100 mg/kg) and nimesulide (25 mg/kg) reduced mRNA levels of MMP-9 mRNA, but not of TIMP-1 in gingival tissue of periodontitis-induced mice. Both treatments also reduced the production of the pro-inflammatory cytokines IL-1β and IL-6. The treatment with EEPA (100 mg/kg) increased the production of the anti-inflammatory cytokine TGF-β. No hematological or biochemical alterations were caused by the daily treatment with EEPA. In vitro luciferase assay suggested that a putative mechanism of EEPA is reducing the transcriptional activity of NF-κB. CONCLUSIONS EEPA exhibited a disease-modifying effect in the chronic experimental periodontitis, along with unidentifiable systemic toxicity. This work corroborates the traditional use of P. angulata in oral inflammatory conditions and provides mechanistic hypotheses to explain its therapeutic effects.
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Affiliation(s)
| | | | | | | | | | | | | | - Cristiane Flora Villarreal
- College of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil; Gonçalo Moniz Institute, FIOCRUZ, Salvador, Bahia, Brazil.
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Dalvi S, Benedicenti S, Hanna R. Is antimicrobial photodynamic therapy an effective treatment modality for aggressive periodontitis? A systematic review of in vivo human randomized controlled clinical trials. Photodiagnosis Photodyn Ther 2021; 34:102314. [PMID: 33932563 DOI: 10.1016/j.pdpdt.2021.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/11/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Limitations of scaling and root planing (SRP) have directed research to utilize additional therapies to enhance conventional techniques. The present systematic review was conducted to evaluate and present a comprehensive overview on effectiveness of antimicrobial photodynamic therapy (aPDT) in the management of aggressive periodontitis (AgP). METHODOLOGY The PRISMA statement guidelines and Cochrane Collaboration recommendations were followed to conduct this systematic review. The review protocol is registered in PROSPERO (CRD 42019143316). A structured electronic and manual search strategy was implied to gather the relevant published data on in vivo human RCTs from their earliest records until 31st October 2019. Relevant data was extracted from the eligible studies, analysed and impartially appraised for its quality. RESULTS Eleven papers met the eligibility criteria and included in this review. The data on standardized study protocol, ideal photosensitizer (PS) dye-wavelength combination, optimal parameters was inconclusive and a high risk of bias in majority of the studies noted, which are fundamental in establishing a standardized and replicable protocol. CONCLUSION Ultimately researchers should conduct well-designed and robust RCTs performed by trained clinicians in order to determine the effectiveness of aPDT, if any, after acknowledging the drawbacks highlighted in this systematic review.
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Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy; Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India.
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy; Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK.
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Elbehwashy MT, Hosny MM, Elfana A, Nawar A, Fawzy El-Sayed K. Clinical and radiographic effects of ascorbic acid-augmented platelet-rich fibrin versus platelet-rich fibrin alone in intra-osseous defects of stage-III periodontitis patients: a randomized controlled clinical trial. Clin Oral Investig 2021; 25:6309-6319. [PMID: 33842996 PMCID: PMC8531044 DOI: 10.1007/s00784-021-03929-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 12/13/2022]
Abstract
Aim To assess platelet-rich fibrin (PRF) with ascorbic acid (AA) versus PRF in intra-osseous defects of stage-III periodontitis patients. Methodology Twenty stage-III/grade C periodontitis patients, with ≥ 3 mm intra-osseous defects, were randomized into test (open flap debridement (OFD)+AA/PRF; n = 10) and control (OFD+PRF; n = 10). Clinical attachment level (CAL; primary outcome), probing pocket depth (PPD), gingival recession depth (RD), full-mouth bleeding scores (FMBS), full-mouth plaque scores (FMPS), radiographic linear defect depth (RLDD) and radiographic defect bone density (RDBD) (secondary-outcomes) were examined at baseline, 3 and 6 months post-surgically. Results OFD+AA/PRF and OFD+PRF demonstrated significant intragroup CAL gain and PPD reduction at 3 and 6 months (p < 0.001). OFD+AA/PRF and OFD+PRF showed no differences regarding FMBS or FMPS (p > 0.05). OFD+AA/PRF demonstrated significant RD reduction of 0.90 ± 0.50 mm and 0.80 ± 0.71 mm at 3 and 6 months, while OFD+PRF showed RD reduction of 0.10 ± 0.77 mm at 3 months, with an RD-increase of 0.20 ± 0.82 mm at 6 months (p < 0.05). OFD+AA/PRF and OFD+PRF demonstrated significant RLDD reduction (2.29 ± 0.61 mm and 1.63 ± 0.46 mm; p < 0.05) and RDBD-increase (14.61 ± 5.39% and 12.58 ± 5.03%; p > 0.05). Stepwise linear regression analysis showed that baseline RLDD and FMBS at 6 months were significant predictors of CAL reduction (p < 0.001). Conclusions OFD+PRF with/without AA significantly improved periodontal parameters 6 months post-surgically. Augmenting PRF with AA additionally enhanced gingival tissue gain and radiographic defect fill. Clinical relevance PRF, with or without AA, could significantly improve periodontal parameters. Supplementing PRF with AA could additionally augment radiographic linear defect fill and reduce gingival recession depth. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-03929-1.
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Affiliation(s)
- Mohamed Talaat Elbehwashy
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt
| | - Manal Mohamed Hosny
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt
| | - Ahmed Elfana
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt
| | - Alaa Nawar
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Karim Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt.
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany.
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Isola G, Polizzi A, Iorio-Siciliano V, Alibrandi A, Ramaglia L, Leonardi R. Effectiveness of a nutraceutical agent in the non-surgical periodontal therapy: a randomized, controlled clinical trial. Clin Oral Investig 2021; 25:1035-1045. [PMID: 32556659 DOI: 10.1007/s00784-020-03397-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/05/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Nutraceutical agents have been demonstrated as adjuncts for the treatment of several inflammatory diseases. The present study analyzed and compared new nutraceutical agent as an adjunct to Scaling and root planing (SRP) versus SRP alone for the treatment of periodontitis. MATERIALS AND METHODS Sixty-six patients with moderate periodontitis were enrolled. Through a randomized design, the patients were randomly assigned to SRP + nutraceutical agent (test group) or SRP alone (control group). Patients were regularly examined the clinical, inflammatory mediators and visual analogue scale (VAS) changes over a 6-month period. Clinical attachment level (CAL) was the primary outcome variable chosen. Gingival crevicular fluid (GCF) inflammatory mediator change and the impact of treatment on VAS were evaluated through a linear regression model. RESULTS Both treatments demonstrated an improvement in periodontal parameters compared with baseline. After 6 months of treatment, compared with the control group, the test group determined a significant probing depth (PD) (p = 0.003) and bleeding on probing (BOP) reduction (p < 0.001), while CAL gain was significantly obtained at 30 and 60 days after treatment (p < 0.05). In the test group, the level of inflammatory mediators was significantly reduced compared with the control group (p < 0.05). The linear regression analysis demonstrated that the nutraceutical agent exerted, in the test group, a significant influence on VAS at 6, 12, 24, and 48 h after treatment (p < 0.05). CONCLUSIONS Nutraceutical agent resulted in a more significant reduction in clinical, inflammatory mediators and short-term pain compared with SRP alone. CLINICAL RELEVANCE Nutraceutical agent, when combined with SRP, was demonstrated to be effective in reducing periodontal parameters and controlling the levels of inflammatory mediators and pain in patients with periodontitis.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Vincenzo Iorio-Siciliano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Piazza Pugliatti 1, Messina, 98123, Italy
| | - Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
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Jia J, Zhou Y, Wang X, Liu Y. Subgingival microbiome dynamic alteration associated with necrotizing periodontal disease: A case report. Medicine (Baltimore) 2021; 100:e24311. [PMID: 33663048 PMCID: PMC7909097 DOI: 10.1097/md.0000000000024311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/11/2020] [Accepted: 12/24/2020] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Necrotizing periodontal diseases (NPDs) are a group of infectious diseases varying in severity, and microorganisms are responsible for these diseases. Currently, the oral microbiota in early disease has been poorly investigated; thus, the causative pathogen and dynamic alteration of the microbiome in NPDs remain unclear. PATIENT CONCERNS We report a case of a 33-year-old female patient with severe gingival pain and localized necrotizing ulcerative gingival lesions. Conventional therapy was performed, but the necrotizing lesion continued to develop. DIAGNOSES X-ray examination showed marginal alveolar bone loss in the involved teeth. Histological examination of a biopsy from the gingival lesion showed chronic inflammatory cell infiltration in the tissue, and no cancer cells were observed. Subgingival swabs were taken from the ulcerative gingiva and the gingiva that was not yet affected, and the composition of the microbiota was analyzed by targeted pyrosequencing of the V3-V4 hypervariable regions of the small subunit ribosomal RNA. We found that Neisseria spp., Corynebacterium spp., and Prevotella spp. were clearly enriched in the lesion site. However, Fusobacteria was more abundant in the not-yet-affected gingiva, and Leptotrichia spp. were the most abundant phylotype. INTERVENTIONS After clinical assessment, a tooth with poor prognosis was extracted, and minocycline hydrochloride was locally administered in the involved tooth pocket every day. Additionally, the patient received 100 mg of hydrochloric acid doxycycline twice per day. OUTCOMES Remarkable improvement was obtained after 3 days, and the lesion completely healed after 1 week. The follow-up examination 1 year later showed a complete recovery with no recurrent episodes of pain. LESSONS Changes in the subgingival microbiome can occurr before clinical symptoms appears, and Fusobacteria may be involved in the imbalance of the subgingival flora in the early stage of NPDs. Moreover, Neisseria is a potential bacterial candidate that deserves further study.
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Affiliation(s)
- Jia Jia
- Lanzhou Hospital of Stomatology, Lanzhou, Gansu Province
- Department of Oral Medicine
| | - You Zhou
- Department of Preventive Dentistry, School of Stomatology, The Fourth Military Medical University
- Shaanxi Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology
| | - Xinwen Wang
- Department of Oral Medicine
- Shaanxi Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology
| | - Yuan Liu
- Shaanxi Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology
- Department of Oral Histology and Pathology, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi Province, China
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Akimov VV, Kuzmina D, Fedoskina A, Vlasova T, Dvaladze L, Ryzhkov V, Akimov VP. ASSESSMENT OF LASER AND ANTIOXIDANT THERAPY EFFICACY IN TREATMENT OF CHRONIC GENERALIZED PERIODONTITIS. Georgian Med News 2021:54-57. [PMID: 33814391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Chronic generalized parodontitis is one of the most prevalent disorders among diseases of oral cavity, making the search for optimal treatment modalities of this disorder one of the mostressing matters to this day. The purpose of this study was to assess outcomes of conventional therapy and secondary prevention of chronic generalized parodontitis with in combination with use of laser therapy and antioxidant drug treatment. The study is presented as a joint multi-site investigation conducted by the group of authors from St. Petersburg and Saransk medical teaching and clinical institutions. The aim of the study was to improve the treatment and secondary prevention of chronic generalized parodontitis based on a pathogenetically substantiated scheme of laser and antioxidant therapy. The total of 98 patients (31 male and 67 female) aged 30-50 years) with the 3 to 10 year history of moderate chronic generalized parodontitis were selected for the prospective study. All patients were approximately equally divided into three groups according to the received treatment regimens: conventional treatment, laser therapy, and laser therapy with antioxidant medication. Several clinical indices were utilized for parodontal tissue assessment (PMA, SBI, AP), resistance of gingival capillary bed, osteal resorption. The lipid peroxide oxidation was determined by MDA, Fe2+ MDA and phospholipase A2. Additional implementation of laser and metabolic therapies sufficiently increases efficacy of conventional therapy and improves secondary prevention of chronic parodontitis. A marked decrease in structural-functional deviations and apparent recovery of microcirculatory vascular bed of parodontal tissue has been achieved. .
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Affiliation(s)
- V V Akimov
- 1Saint Petersburg State University, Department of Clinical Dentistry SPbU; Russian Federation
| | - D Kuzmina
- 1Saint Petersburg State University, Department of Clinical Dentistry SPbU; 2GOU VPO «N.P. Ogarev Mordovia State University», Saransk; 3FSBI «North-West Regional Scientific and Clinical Center Named After L.G. Sokolov» of FMBA Saint-Petersburg; 4North-Western State Medical University Named After I.I. Mechnikov, Under the Ministry of Public Health, Saint-Petersbur, Russian Federation
| | - A Fedoskina
- 2GOU VPO «N.P. Ogarev Mordovia State University», Saransk; Russian Federation
| | - T Vlasova
- 2GOU VPO «N.P. Ogarev Mordovia State University», Saransk; Russian Federation
| | - L Dvaladze
- 3FSBI «North-West Regional Scientific and Clinical Center Named After L.G. Sokolov» of FMBA Saint-Petersburg; Russian Federation
| | - V Ryzhkov
- 4North-Western State Medical University Named After I.I. Mechnikov, Under the Ministry of Public Health, Saint-Petersbur, Russian Federation
| | - V P Akimov
- 1Saint Petersburg State University, Department of Clinical Dentistry SPbU; Russian Federation
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Qamar Z, Almohana SA, Khalid Alanazi A, Khalid Alanazi A, Almohana AA, Zeeshan T. Clinical Evaluation of the Effects of Topical Indocyanine-green Mediated Photosensitiser vs Aloe Vera Gel as Adjunct Therapy to Scaling and Root Planing in Chronic Periodontitis Patients. Oral Health Prev Dent 2021; 19:489-494. [PMID: 34585874 DOI: 10.3290/j.ohpd.b2082037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To clinically evaluate and compare the efficacy of indocyanine green mediated photodynamic therapy (PDT) and aloe vera (AV) gel when used as adjunct therapy to scaling and root planing (SRP) for treatment of chronic periodontitis. MATERIALS AND METHODS One hundred fifty patients were randomly assigned to three treatment groups: group 1 (SRP), group 2 (SRP+PDT) and group 3 (SRP+AV). Four clinical parameters - plaque index (PI), bleeding on probing (BoP), periodontal (PD) pocket depth and clinical attachment level (CAL) - were evaluated at baseline and 3 and 6 months post treatment. Additionally, the amount of three inflammatory - cytokines IL-6, IL-8 and TNF-α - in gingival crevicular fluid (GCF) was identified using an enzyme-linked immune-sorbent assay (ELISA). RESULT Statistically significant improvement was observed for all clinical parameters in group 3 at follow-up in comparison to groups 1 and 2. Individuals treated with adjunct PDT showed statistically significant reduction in moderate (4-5 mm) and deep (≥6 mm) PD pockets at the 3-month follow-up. Group-2 and -3 patients displayed statistically significant reductions in cytokines IL-6, IL-8 and TNF-α at the 3-month follow-up in comparison to group 1 patients. This reduction in cytokines was maintained at the 6-month follow-up. CONCLUSION Adjunct treatment regimens PDT and AV gel statistically significantly contributed to decreasing inflammation in periodontal tissue. AV /gel showed potential to decrease BoP, whereas PDT can facilitate increasing the clinical attachment level.
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Sablina SN, Elovikova TM, Grigorjev SS, Koscheev AS. [Clinical parameters of the oral cavity in postmenopausal women during the course of a nonsteroidal anti-inflammatory drug]. Stomatologiia (Mosk) 2021; 100:29-34. [PMID: 34953185 DOI: 10.17116/stomat202110006129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
THE AIM OF THE STUDY Was to assess the clinical effectiveness of the course of ketoprofen lysine salt after its oral application in postmenopausal women with vitamin D deficiency in the complex therapy of inflammatory periodontal diseases. MATERIALS AND METHODS The study comprised 100 women with decreased bone mineral density and chronic generalized mild to moderate periodontitis. The average age was 55.3±1.9 years with menopause lasting for more than 5 years (6.0±0.8) and the average age for the onset of menopause of 48.9±1.5 years. The study participants were divided into four groups (two main groups and two comparison groups). The patients underwent periodontal treatments and received native vitamin D prescriptions in accordance with clinical guidelines and treatment protocols. RESULTS Serum vitamin D for the patents of the first and second groups was 11.4±1.9. Vitamin D level in the comparison groups was 34.6±3.2. The study reveals the direct correlation of chronic periodontitis, the level of bone mineral density and vitamin D deficiency in older female patients. The effects are proved by reduction of indices like PMA, Mulleman bleeding index and periodontal index for all study groups. Correlation of anti-inflammatory activity of the solution with the reduction in pockets depths was 0.46 mm along with improvements in syalometry. Organoleptic properties of the tested oral solution of ketoprofen lysine salt were positively evaluated by all participants, subjective assessments of «color», «treatment effect» and «prolonged analgesic effect» received the highest scores. CONCLUSION Ketoprofen lysine salt solution has shown significant anti-inflammatory, antioedemic and hemostatic activity of the drug in therapy of chronic generalized mild to moderate periodontitis in older female patients.
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Affiliation(s)
- S N Sablina
- Ural State Medical University of the Ministry of Health of the Russian Federation, Ekaterinburg, Russia
| | - T M Elovikova
- Ural State Medical University of the Ministry of Health of the Russian Federation, Ekaterinburg, Russia
| | - S S Grigorjev
- Ural State Medical University of the Ministry of Health of the Russian Federation, Ekaterinburg, Russia
| | - A S Koscheev
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Ekaterinburg, Russia
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Mi L, Zhang X, Hao W, Wang S. Two Transition Metal Coordination Polymers: Luminescent Sensing Properties and Treatment Effect on Chronic Periodontitis by Reducing IL-6 and TNF-α Content. J Fluoresc 2021; 31:165-173. [PMID: 33188483 DOI: 10.1007/s10895-020-02650-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
Two novel sulfonic functionalized coordination polymers (CPs) {[Cd1.5(dimb)(5-sip)(H2O)3]·3H2O}n (1, dimb = 1,4-di(1H-imidazol-1-yl)butane) and [Co2(iptz)(Hiptz)(5-sip)(H2O)]·4H2O (2, Hiptz = 1-(4-(1H-imidazole-5-yl)phenyl)-1H-1,2,4-triazole) were acquired via different metal(II) salts reacting with the mixed ligands containing 1-(4-(1H-imidazole-5-yl)phenyl)-1H-1,2,4-triazole, 1,4-di(1H-imidazol-1-yl)butane and sodium 5-sulfoisophthalate (NaH2sip), respectively. Furthermore, the complex 1 based on Cd(II) could be utilized as the luminescent senor for picric acid (PA) detection in water. In bio-research, compounds 1 and 2 treatment effect on chronic periodontitis was assessed and the specific mechanism was discussed. First of all, the RT-PCR was performed to measure the HmuY and fimA genes relative expression level in P.gingivalis after treated by compounds 1 and 2. Then, the TNF-α and IL-6 content in the fluid of gingival crevicular after compounds treatment was determined with ELISA detection kit.
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Affiliation(s)
- Lei Mi
- Department of Stomatology, Yulin First Hospital, Yulin, Shaanxi, China
| | - Xue Zhang
- Department of Stomatology, Tangshan Central Hospital, Tangshan, Hebei, China.
| | - Wenjing Hao
- Department of Chemistry, Qingdao Medical University, Qingdao, Shandong, China
| | - Shuai Wang
- Department of Chemistry, Qingdao Medical University, Qingdao, Shandong, China
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Khattri S, Kumbargere Nagraj S, Arora A, Eachempati P, Kusum CK, Bhat KG, Johnson TM, Lodi G. Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis. Cochrane Database Syst Rev 2020; 11:CD012568. [PMID: 33197289 PMCID: PMC9166531 DOI: 10.1002/14651858.cd012568.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Systemic antimicrobials can be used as an adjunct to mechanical debridement (scaling and root planing (SRP)) as a non-surgical treatment approach to manage periodontitis. A range of antibiotics with different dosage and combinations are documented in the literature. The review follows the previous classification of periodontitis as all included studies used this classification. OBJECTIVES To assess the effects of systemic antimicrobials as an adjunct to SRP for the non-surgical treatment of patients with periodontitis. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 9 March 2020: Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, and Embase. The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) which involved individuals with clinically diagnosed untreated periodontitis. Trials compared SRP with systemic antibiotics versus SRP alone/placebo, or with other systemic antibiotics. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 45 trials conducted worldwide involving 2664 adult participants. 14 studies were at low, 8 at high, and the remaining 23 at unclear overall risk of bias. Seven trials did not contribute data to the analysis. We assessed the certainty of the evidence for the 10 comparisons which reported long-term follow-up (≥ 1 year). None of the studies reported data on antimicrobial resistance and patient-reported quality of life changes. Amoxicillin + metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -16.20%, 95% CI -25.87 to -6.53; 1 study, 44 participants); clinical attachment level (CAL) (MD -0.47 mm, 95% CI -0.90 to -0.05; 2 studies, 389 participants); probing pocket depth (PD) (MD -0.30 mm, 95% CI -0.42 to -0.18; 2 studies, 389 participants); and percentage of bleeding on probing (BOP) (MD -8.06%, 95% CI -14.26 to -1.85; 2 studies, 389 participants) was of very low certainty. Only the results for closed pockets and BOP showed a minimally important clinical difference (MICD) favouring amoxicillin + metronidazole + SRP. Metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -12.20%, 95% CI -29.23 to 4.83; 1 study, 22 participants); CAL (MD -1.12 mm, 95% CI -2.24 to 0; 3 studies, 71 participants); PD (MD -1.11 mm, 95% CI -2.84 to 0.61; 2 studies, 47 participants); and percentage of BOP (MD -6.90%, 95% CI -22.10 to 8.30; 1 study, 22 participants) was of very low certainty. Only the results for CAL and PD showed an MICD favouring the MTZ + SRP group. Azithromycin + SRP versus SRP for chronic/aggressive periodontitis: we found no evidence of a difference in percentage of closed pockets (MD 2.50%, 95% CI -10.19 to 15.19; 1 study, 40 participants); CAL (MD -0.59 mm, 95% CI -1.27 to 0.08; 2 studies, 110 participants); PD (MD -0.77 mm, 95% CI -2.33 to 0.79; 2 studies, 110 participants); and percentage of BOP (MD -1.28%, 95% CI -4.32 to 1.76; 2 studies, 110 participants) (very low-certainty evidence for all outcomes). Amoxicillin + clavulanate + SRP versus SRP for chronic periodontitis: the evidence from 1 study, 21 participants for CAL (MD 0.10 mm, 95% CI -0.51 to 0.71); PD (MD 0.10 mm, 95% CI -0.17 to 0.37); and BOP (MD 0%, 95% CI -0.09 to 0.09) was of very low certainty and did not show a difference between the groups. Doxycycline + SRP versus SRP in aggressive periodontitis: the evidence from 1 study, 22 participants for CAL (MD -0.80 mm, 95% CI -1.49 to -0.11); and PD (MD -1.00 mm, 95% CI -1.78 to -0.22) was of very low certainty, with the doxycycline + SRP group showing an MICD in PD only. Tetracycline + SRP versus SRP for aggressive periodontitis: we found very low-certainty evidence of a difference in long-term improvement in CAL for the tetracycline group (MD -2.30 mm, 95% CI -2.50 to -2.10; 1 study, 26 participants). Clindamycin + SRP versus SRP in aggressive periodontitis: we found very low-certainty evidence from 1 study, 21 participants of a difference in long-term improvement in CAL (MD -1.70 mm, 95% CI -2.40 to -1.00); and PD (MD -1.80 mm, 95% CI -2.47 to -1.13) favouring clindamycin + SRP. Doxycycline + SRP versus metronidazole + SRP for aggressive periodontitis: there was very low-certainty evidence from 1 study, 27 participants of a difference in long-term CAL (MD 1.10 mm, 95% CI 0.36 to 1.84); and PD (MD 1.00 mm, 95% CI 0.30 to 1.70) favouring metronidazole + SRP. Clindamycin + SRP versus metronidazole + SRP for aggressive periodontitis: the evidence from 1 study, 26 participants for CAL (MD 0.20 mm, 95% CI -0.55 to 0.95); and PD (MD 0.20 mm, 95% CI -0.38 to 0.78) was of very low certainty and did not show a difference between the groups. Clindamycin + SRP versus doxycycline + SRP for aggressive periodontitis: the evidence from 1 study, 23 participants for CAL (MD -0.90 mm, 95% CI -1.62 to -0.18); and PD (MD -0.80 mm, 95% CI -1.58 to -0.02) was of very low certainty and did not show a difference between the groups. Most trials testing amoxicillin, metronidazole, and azithromycin reported adverse events such as nausea, vomiting, diarrhoea, mild gastrointestinal disturbances, and metallic taste. No serious adverse events were reported. AUTHORS' CONCLUSIONS There is very low-certainty evidence (for long-term follow-up) to inform clinicians and patients if adjunctive systemic antimicrobials are of any help for the non-surgical treatment of periodontitis. There is insufficient evidence to decide whether some antibiotics are better than others when used alongside SRP. None of the trials reported serious adverse events but patients should be made aware of the common adverse events related to these drugs. Well-planned RCTs need to be conducted clearly defining the minimally important clinical difference for the outcomes closed pockets, CAL, PD, and BOP.
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Affiliation(s)
- Shivi Khattri
- Department of Periodontics, Subharti Dental College and Hospital, Meerut, India
| | - Sumanth Kumbargere Nagraj
- Department of Oral Medicine and Oral Radiology, Faculty of Dentistry, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Ankita Arora
- Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Melaka-Manipal Medical College, Melaka, Malaysia
| | - Prashanti Eachempati
- Department of Prosthodontics, Faculty of Dentistry, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Chandan Kumar Kusum
- Department of Prosthodontics, Subharti Dental College and Hospital, Meerut, India
| | - Kishore G Bhat
- Department of Molecular Biology and Immunology, Maratha Mandal's NGH Institute of Dental Sciences and Research Centre, Belgaum, India
| | - Trevor M Johnson
- Faculty of General Dental Practice (UK), RCS England, London, UK
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Wang J, Wang B, Lv X, Wang L. NIK inhibitor impairs chronic periodontitis via suppressing non-canonical NF-κB and osteoclastogenesis. Pathog Dis 2020; 78:ftaa045. [PMID: 32860691 DOI: 10.1093/femspd/ftaa045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022] Open
Abstract
Periodontitis is an inflammatory disease that causes damages to periodontium and alveolar bone. Overactivation and formation of osteoclasts can cause bone destruction, which contributes to periodontitis development. Receptor activator of nuclear factor κB ligand (RANKL)-mediated NF-κB signaling plays an essential role in osteoclasts differentiation. We aimed to study the effects of NIK-SMI1, an NF-κB-inducing kinase (NIK) inhibitor, on the osteoclastogenesis in vitro and periodontitis progression in vivo. A ligature-induced mice model of periodontitis was incorporated to test the potential therapeutic effect of NIK-SMI1 on periodontitis. The target protein and mRNA expression levels were determined by Western blot assay and real-time PCR assay, respectively. We found that the administration of NIK-SMI1 strongly inhibited the RANKL-stimulated non-canonical NF-κB signaling as demonstrated by decreased nuclear p52 expression and activity. Blocking NIK activity also resulted in reduced osteoclasts specific genes expression and enhanced IFN-β expression. NIK-SMI1 treatment resulted in attenuated periodontitis progression and pro-inflammatory cytokines expression in vivo. Our study suggested that NIK-SMI1 exerts beneficial effects on the mitigation of osteoclastogenesis in vitro and periodontitis progression in vivo. Application of NIK-SMI1 may serve as a potential therapeutic approach for periodontitis.
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Affiliation(s)
- Jiang Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, The Hospital of Stomatology, The Fourth Military Medical University, Shaanxi 710000, China
| | - Bo Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Center, The Hospital of Stomatology, The Fourth Military Medical University, Shaanxi 710000, China
| | - Xin Lv
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, The Hospital of Stomatology, The Fourth Military Medical University, Shaanxi 710000, China
| | - Lei Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Hospital of Stomatology, The Fourth Military Medical University, Shaanxi 710000, China
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