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Disease Markers 2022This study aimed to investigate and analyse the clinical efficacy and safety of periocline-assisted periodontal foundation in the therapy of chronic periodontitis. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to investigate and analyse the clinical efficacy and safety of periocline-assisted periodontal foundation in the therapy of chronic periodontitis.
METHODS
From May 2018 to January 2021, 108 patients with chronic periodontitis were treated at our institution and randomly assigned equally to either the control or the experimental group. The plaque index (PLI), sulcus bleeding index (SBI), probing depth (PD), and periodontal attachment level (AI) were evaluated before and after periodontal basic therapy in the control group and periocline as an adjunct in the experimental group. Lactobacillus (LB) and (PG) concentrations in saliva were measured before and after therapy, and adverse responses during treatment were noted.
RESULTS
The levels of PLI, SBI, PD, and AI in the two groups were significantly lower in both groups at 1 and 3 months posttreatment compared to baseline; the levels of PLI and SBI were higher, and the levels of PD and AI were lower at 3 months after treatment compared to 1 month after treatment; compared with the control group at 1 month and 3 months after treatment, the levels of PLI, SBI, PD, and AI in the experimental group were lower than those in the control group ( < 0.05). The LB level was higher and the PG level was lower in both groups compared to baseline at 1 and 3 months posttreatment. The LB level was higher and the PG level was lower at 3 months posttreatment compared to 1 month after treatment. Compared with the control group at 1 month and 3 months after treatment, the LB level was higher, and the PG level was lower in the experimental group ( < 0.05). No significant adverse effects were observed in either group during the treatment period. Only 1 patient in the experimental group had mild gastrointestinal reactions, mainly nausea, without obvious neurological symptoms or abnormal blood changes, which did not affect the treatment.
CONCLUSION
Periodontal fundamental therapy with perioclines may be a potential treatment for persistent periodontitis. It improves the primary clinical indicators, increases dysbacteriosis control, and has a strong safety profile. It could effectively control the development of clinical symptoms of periodontitis and reduce tissue destruction, with obvious clinical treatment effects. It could be used as the first choice for topical treatment of chronic periodontitis. It is recommended for further study by a wide range of researchers.
Topics: Chronic Periodontitis; Humans; Periodontal Attachment Loss; Periodontal Index; Saliva; Treatment Outcome
PubMed: 36133438
DOI: 10.1155/2022/4601259 -
Journal of the American Dental... Feb 2019In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
BACKGROUND
In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
METHODS
The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones.
RESULTS
Approximately 60% of adults 30 through 79 years lived within 5 miles of a periodontist, 73% within 10 miles, 85% within 20 miles, and 97% within 50 miles. Proximity to a periodontist varied widely. In urban areas, 95% of adults resided within 10 miles of a periodontist and 100% within 20 miles. Only 24% of adults in rural areas lived within 10 miles of a periodontist. Most periodontists (96.1%) practiced in urban areas, clustering along the eastern and western coasts and in the Midwest, 3.1% in urban clusters elsewhere, and 0.8% in rural areas. Ratios of fewer than 8,000 adults with periodontitis to 1 or more periodontists within 10 miles were clustered mostly in the Northeast, central East Coast, Florida, West Coast, Arizona, and Midwest.
CONCLUSIONS
In this study, the authors identified wide variations in geographic proximity to a practicing periodontist for adults with severe periodontitis.
PRACTICAL IMPLICATIONS
Dental practitioners may provide preventive care and counseling for periodontitis and referrals for specialty care. Geographic proximity to specialized periodontal care may vary widely by locality.
Topics: Adult; Counseling; Dentists; Humans; Periodontics; Periodontitis; Referral and Consultation; United States
PubMed: 30470389
DOI: 10.1016/j.adaj.2018.09.021 -
Phase IIa clinical trial of complement C3 inhibitor AMY-101 in adults with periodontal inflammation.The Journal of Clinical Investigation Dec 2021BackgroundGingivitis and periodontitis are prevalent inflammatory diseases of the periodontal tissues. Current treatments are often ineffective or do not prevent disease... (Randomized Controlled Trial)
Randomized Controlled Trial
BackgroundGingivitis and periodontitis are prevalent inflammatory diseases of the periodontal tissues. Current treatments are often ineffective or do not prevent disease recurrence. Uncontrolled complement activation and the resulting chronic gingival inflammation are hallmarks of periodontal diseases. We determined the efficacy and safety of a complement 3-targeted therapeutic, AMY-101, which was locally administered to adult patients with periodontal inflammation.MethodsThirty-two patients with gingival inflammation were enrolled in a randomized, placebo-controlled, double-blind, split-mouth phase IIa trial that followed a dose escalation study to select a safe and effective dose in an additional 8 patients. Half of the patient's mouth was randomly assigned to AMY-101 (0.1 mg/site) or placebo injections at sites of inflammation, administered on days 0, 7, and 14, and then evaluated for safety and efficacy outcomes on days 28, 60, and 90. The primary efficacy outcome was a change in gingival inflammation, measured by a modified gingival index (MGI), and secondary outcomes included changes in bleeding on probing (BOP), the amount of plaque, pocket depth, clinical attachment level, and gingival crevicular fluid levels of matrix metalloproteinases (MMPs) over 90 days.ResultsA once-weekly intragingival injection of AMY-101 for 3 weeks was safe and well tolerated in all participants and resulted in significant (P < 0.001) reductions in clinical indices measuring gingival inflammation (MGI and BOP). AMY-101 significantly (P < 0.05) reduced MMP-8 and MMP-9 levels, indicators of inflammatory tissue destruction. These therapeutic effects persisted for at least 3 months after treatment.ConclusionAMY-101 treatment resulted in a significant and sustainable reduction in gingival inflammation without adverse events and, we believe, merits further investigation for the treatment of periodontitis and other oral or peri-implant inflammatory conditions.Trial registrationClinicalTrials.gov identifier NCT03694444.FundingAmyndas Pharmaceuticals.
Topics: Adult; Complement C3; Double-Blind Method; Drug Administration Schedule; Female; Gingival Crevicular Fluid; Gingivitis; Hemorrhage; Humans; Inflammation; Male; Middle Aged; Peptides, Cyclic; Periodontal Index; Periodontitis; Placebos
PubMed: 34618684
DOI: 10.1172/JCI152973 -
Animal : An International Journal of... Feb 2021The work presented in this pilot study aimed to identify potential risk factors associated with bovine periodontitis development. Bovine periodontitis is a...
The work presented in this pilot study aimed to identify potential risk factors associated with bovine periodontitis development. Bovine periodontitis is a multifactorial polymicrobial infectious disease for which the aetiopathogenesis and risk factors are not fully understood. From cattle slaughtered in an abattoir in Scotland, 35 dental arcades with periodontal lesions and 40 periodontally healthy arcades were selected over seven visits for study. Multivariable logistic regression analysis was used to evaluate the association between periodontitis and the independent variables, gender, age and breed. For every increase in year of age, cattle were 1.5 times more likely to have periodontitis. A graphical analysis indicated that within the limits of this study, we could not detect any major influence of breed on the age-effect. Although logistic regression analysis demonstrated that periodontitis lesions are more prevalent with increasing age of cattle the underlying mechanisms remain unclear. It is likely that periodontitis is an important cause of oral pain in older cattle and can contribute to reduced productivity/performance. Further studies with a larger sample size are necessary to elucidate the associations between potential risk factors and periodontitis in cattle and to define its effects on animal welfare and productivity.
Topics: Animals; Cattle; Cattle Diseases; Periodontitis; Pilot Projects; Risk Factors; Scotland
PubMed: 33712212
DOI: 10.1016/j.animal.2020.100121 -
BMC Oral Health Feb 2016The treatment of periodontitis begins with a non-surgical phase that includes scaling and root planing(SRP) and on occasion the use of systemic antibiotics. The goal was... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The treatment of periodontitis begins with a non-surgical phase that includes scaling and root planing(SRP) and on occasion the use of systemic antibiotics. The goal was to systematically evaluate in systemic healthy adults the effect of the concomitant administration of amoxicillin (amx) and metronidazole (met) adjunctive to SRP compared to SRP alone.
METHODS
The PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to November 2014 to identify appropriate studies. Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding on Pocket Probing(BOP) and Plaque Indices(PI) were selected as outcome variables. Based on the extracted data a meta-analysis was conducted.
RESULTS
A total of 526 unique articles were found, 20 studies met the eligibility criteria. A meta-analysis showed that SRP + amx + met provided significantly better effects overall and more pronounced PD reduction in periodontal pockets initially measuring ≥6 mm (DiffM:-0.86 mm, p < 0.00001) and gain in CAL(DiffM:+0.75 mm, p = 0.0001). The meta-analysis for the secondary inflammatory parameter BOP showed that SRP + amx + met provided full mouth significantly greater reduction in BOP than SRP alone (DiffM:-6.98 %, p = 0.0001).
CONCLUSION
Adjunctive systemic amoxicillin and metronidazole medication to SRP significantly improved the clinical outcomes with respect to mean PD, CAL and BOP compared to SRP alone. There is moderate to strong evidence in support of the recommendation that adjunctive amx + met therapy to SRP significantly improves the clinical outcomes, with respect to mean PD and CAL compared to SRP alone especially in initially deep (≥6 mm) pockets. No major side effects associated with the intake of amx + met were reported. This treatment regimen is an efficacious, minimally invasive, practical and inexpensive approach for periodontitis therapy. The key components are mechanical tooth and pocket debridement, supportive treatment of the disease with systemic antibiotics and attention to proper self-care.
Topics: Amoxicillin; Anti-Bacterial Agents; Dental Scaling; Humans; Metronidazole; Periodontal Pocket; Periodontitis; Root Planing; Treatment Outcome
PubMed: 26928597
DOI: 10.1186/s12903-015-0123-6 -
European Review For Medical and... Mar 2022Periodontitis is a chronic inflammatory disease caused by microbial dental plaque which leads to the destruction and loss of supporting tissues of the tooth. Microbial...
OBJECTIVE
Periodontitis is a chronic inflammatory disease caused by microbial dental plaque which leads to the destruction and loss of supporting tissues of the tooth. Microbial plaque alone, however, is not enough to cause the disease. The body's response plays an important role, in which an imbalance between the pro-inflammatory and anti-inflammatory effects of cytokines leads to an inflammatory reaction.
PATIENTS AND METHODS
We detected changes in mRNA expression and protein levels of MIP-1α, and metalloproteinases (MMP-2, MMP-9) contributing to cascades in the initiation and progression of inflammatory bone resorption and destruction of periodontal soft tissues in patients with aggressive (AP) or chronic (CP) forms of periodontitis in comparison with healthy individuals (control).
RESULTS
MIP-1α mRNA levels were highest in AP (280 ± 23% higher than the control) also in comparison with CP. The difference in protein level was less pronounced. MMP-2 mRNA expression values were similar (300 ± 12% higher in comparison with control), but protein levels were lower, also when compared to CP. Only in CP MMP-9 mRNA levels were significantly higher than the control (30 ± 8%), while protein levels were again higher in AP. Both AP and CP showed a positive correlation between the level of MIP-1a and MMP-2 (0.879, and 0.954 respectively). However, a strong positive correlation was only found between the levels of MMP-2 and MMP-9 in CP (0.812).
CONCLUSIONS
MIP-1α, MMP-2 and MMP-9 mRNA expression, along with the concentration of proteins in saliva in patients with periodontal disease, is higher than in healthy individuals and correlates with the severity of the disease.
Topics: Gingival Crevicular Fluid; Humans; Periodontal Index; Periodontitis; Periodontium; Saliva
PubMed: 35363329
DOI: 10.26355/eurrev_202203_28326 -
Indian Journal of Dental Research :... 2020The quantification of neutrophils in blood is done to primarily screen the patients with acute infections. On the other hand, the neutrophils have also shown the...
AIM
The quantification of neutrophils in blood is done to primarily screen the patients with acute infections. On the other hand, the neutrophils have also shown the antimicrobial activity by allowing the host cells to perform the primary function of preventing the wounds from being infected. The aim of this study was to quantify the blood neutrophil count in patients with chronic gingivitis and chronic periodontitis and to compare with the healthy controls in order to assess the protective role of neutrophils in periodontal inflammation.
METHODS AND MATERIAL
A total of 30 subjects in the age group of 30-55 years were selected. Based on the clinical examination, the subjects were divided into three groups Group I (healthy), Group II (chronic gingivitis) and Group III (chronic periodontitis). The clinical parameters such as modified gingival index (MGI) and clinical attachment level (CAL) were recorded. Two millilitres of venous blood was collected from each participant in all the groups and the differential neutrophil counts were obtained using the Neubauer's chamber under a light microscope. One way ANOVA test was used to calculate the mean and standard deviation for MGI, CAL and blood neutrophil count among various groups.
RESULTS
The mean neutrophil counts in the various study groups were 63.300, 64.100 and 60.800 in Group I, Group II and Group III, respectively. Though there was a decrease in the mean neutrophil count from Group II to Group III, there was no statistically significant difference between the groups.
CONCLUSION
In our study, there was no significant increase in neutrophil count in chronic periodontitis as compared to healthy controls, thereby explaining the protective role of neutrophils in periodontal inflammation.
Topics: Adult; Chronic Periodontitis; Gingivitis; Humans; Inflammation; Middle Aged; Neutrophils; Periodontal Attachment Loss; Periodontal Index
PubMed: 33753656
DOI: 10.4103/ijdr.IJDR_106_19 -
Medicina (Kaunas, Lithuania) Jun 2023: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study...
: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) in patients with stage II and stage III periodontitis. Before starting the SRP, all the periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL), were measured. The anxiety level of the patients was also assessed using the modified dental anxiety scale (MDAS) questionnaire. Pain perception of the patients was recorded with the visual analog scale (VAS) after performing the SRP. Patients were asked to mark their pain level on the VAS sheet after two hours, four hours, eight hours, 24 h, and 48 h after the periodontal treatment. The following cut-off points were used for the pain intensity in the VAS: 0 = no pain, 1-4 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain. Patients were advised to take analgesics if the pain was intolerable. Multivariate logistic regression was performed to conduct the association of all dependent variables and the pain perception of patients. A nonparametric Friedman test was conducted to assess pain perception at different times. A total of 52 patients including 32 males and 20 females participated in the current study, with a mean age of 43.10 ± 12.33 years. Multivariate analyses showed that MDAS and analgesic consumption is significantly associated with pain perception. Other clinical variables are not associated with pain perception. The Friedman test exhibited that pain perception is significantly associated ( < 0.05) with time. Analgesic consumption and anxiety level are significantly associated with pain perception after SRP treatment.
Topics: Male; Female; Humans; Adult; Middle Aged; Root Planing; Pain Measurement; Periodontitis; Pain; Analgesics; Dental Scaling; Follow-Up Studies
PubMed: 37512015
DOI: 10.3390/medicina59071203 -
Biomolecules Oct 2023Naturally sourced products like propolis are commonly employed for the non-surgical treatment of periodontal pockets. The use of nanoparticle formulations of these... (Randomized Controlled Trial)
Randomized Controlled Trial
Naturally sourced products like propolis are commonly employed for the non-surgical treatment of periodontal pockets. The use of nanoparticle formulations of these natural remedies has the potential to improve treatment outcomes. The aim of the present study was to evaluate the efficacy of sub-gingivally delivered propolis nanoparticles in the non-surgical management of periodontal pockets. Forty patients diagnosed with periodontitis presenting at least one periodontal pocket with a probing pocket depth between 4 and 6 mm were selected. Patients were randomly assigned into the control group ( = 20), which received scaling and root planing (SRP) and saline (SRP + Saline), and the test group ( = 20), which received SRP and sub-gingivally delivered propolis nanoparticles (PRO) into the periodontal pocket (SRP + PRO). The clinical parameters recorded were plaque index (PI), gingival index (GI), relative attachment loss (RAL), probing pocket depth (PPD), and bleeding on probing (BOP). They were assessed at baseline, one month, and three months post therapy. The results indicated that there was a significant improvement in clinical parameters ( < 0.05) in the test sites compared with the control sites at the end of the study. The gingival index at one month and three months was found to be significantly better in the SRP + PRO group than the SRP + Saline group, with a value of <0.001. The BOP, PPD, and RAL showed significant improvement with the SRP + PRO group at the end of the 3-month follow-up with values of 0.0001, 0.001, and 0.05, respectively. The subgingival delivery of propolis nanoparticles showed promising results as an adjunct to SRP in patients with periodontitis presenting periodontal pockets.
Topics: Humans; Periodontal Pocket; Propolis; Periodontitis; Treatment Outcome; Root Planing
PubMed: 38002260
DOI: 10.3390/biom13111576 -
Medicine Dec 2022Production of reactive oxygen species (ROS) by polymorpho nuclear neutrophils occurs in chronic periodontitis. These ROS are mainly involved in bacterial destruction....
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.
Topics: Humans; Chronic Periodontitis; Antioxidants; Spirulina; Reactive Oxygen Species; Root Planing; Dental Scaling
PubMed: 36550811
DOI: 10.1097/MD.0000000000031521