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The Saudi Dental Journal Jan 2021This systematic review aims to assess the efficacy chlorhexidine chip as an adjunctive therapy of scaling and root planning on periodontal disease treatment. (Review)
Review
OBJECTIVE
This systematic review aims to assess the efficacy chlorhexidine chip as an adjunctive therapy of scaling and root planning on periodontal disease treatment.
MATERIAL AND METHODS
This study follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and was registered in the PROSPERO database (CRD42019148221). The search was performed in PubMed/MEDLINE, Scopus, and Cochrane databases until April 2020. The PICO question was: "Is the chlorhexidine chip (CHX) effective as an adjunctive therapy of scaling and root planning on periodontal disease treatment?". Inclusion criteria involved: randomized controlled clinical trials, with a minimum of 15 patients included on the sample and each patient has two sites of probing depth of ≥5 mm; The minimum follow up was at least 1 months of follow-up and the outcomes present in the studies probing depth (PD), plaque index (PI) and clinical attachment level (CAL) after scaling and root planning (SRP).
RESULTS
After searching the databases, 13 articles were selected for qualitative and 8 for quantitative analysis. Were included 427 patients, with a mean age of 45.6 years. The results shown that the association of chlorhexidine chips to scaling and root planning reduce periodontal pocket depths ( < 0.00001; MD -0.77 [CI -1.0 to -0.55]; I = 23%, = 0.24), gain on the clinical attachment level ( < 0.0001; MD -0.57 [CI -0.86 to -0.27]; I = 33%, P = 0.18P < 0.0001) and reduction on plaque index (P = 0.04; MD -0.23 [CI -0.45 to -0.01]; I = 91%, P < 0.00001).
CONCLUSIONS
Thus, we can conclude that chlorhexidine chip when used associated to scaling and root planning promoted a significant improvement the reduction of periodontal diseases.
PubMed: 33473236
DOI: 10.1016/j.sdentj.2020.11.002 -
Materials (Basel, Switzerland) Mar 2022The aim of this systematic review of randomized controlled trials was to evaluate the adjunctive use of leucocyte- and platelet-rich fibrin (L-PRF) in periodontal... (Review)
Review
The aim of this systematic review of randomized controlled trials was to evaluate the adjunctive use of leucocyte- and platelet-rich fibrin (L-PRF) in periodontal endosseous and furcation defects, as compared without L-PRF. The endosseous defect group was subclassified into: L-PRF/open flap debridement (L-PRF/OFD) versus OFD, L-PRF/osseous graft (L-PRF/OG) versus OG, L-PRF/Emdogain (L-PRF/EMD) versus EMD, and L-PRF/guided tissue regeneration (L-PRF/GTR) versus GTR. The furcation defect group was subclassified into L-PRF/OFD versus OFD, and L-PRF/OG versus OG. Mean difference, 95% confidence intervals and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL) and radiographic defect depth (DD). Nineteen studies concerning systemically healthy non-smokers were included. The results of this systematic review and meta-analysis showed in two- and/or three-wall endosseous defects that the adjunctive use of L-PRF to OFD or OG was significantly beneficial for PPD reduction, CAL gain and DD reduction, as compared without L-PRF. Furthermore, the data showed that for two- and/or three-wall endosseous defects, the adjunctive use of L-PRF to GTR was significantly beneficial for CAL and DD improvement, whereas adding L-PRF to EMD had no significant effect, and that for class II furcation defects, the addition of L-PRF to OFD was significantly beneficial for PPD, CAL and DD improvement, whereas the addition of L-PRF to OG was significantly clinically beneficial. In conclusion, this systematic review and meta-analysis found that there was significant clinical and radiographic additive effectiveness of L-PRF to OFD and to OG in two- and/or three-wall periodontal endosseous defects of systemically healthy non-smokers, as compared without L-PRF.
PubMed: 35329540
DOI: 10.3390/ma15062088 -
Clinical Oral Investigations Sep 2021The present study aimed to systematically assess current evidence on effects of locally delivered antibiotics during periodontal surgery compared to periodontal surgery... (Meta-Analysis)
Meta-Analysis Review
AIM
The present study aimed to systematically assess current evidence on effects of locally delivered antibiotics during periodontal surgery compared to periodontal surgery alone on clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, recession depth (RD) changes, gingival index (GI), bleeding on probing (BOP), and plaque index (PI).
METHODOLOGY
MEDLINE-PubMed, Cochrane-CENTRAL and Scopus databases were searched up to April 2021 for randomized clinical trials (RCT), evaluating effects of locally delivered antibiotics during periodontal surgery. CAL gain served as primary, while PPD reduction, RD changes, GI and PI as secondary outcomes. The Cochrane Risk of Bias Tool was used to assess possible bias. Data were extracted, and meta-analysis was performed where appropriate.
RESULT
Screening of 2314 papers resulted in nine eligible studies. No adverse events were reported. Data on outcome variables were pooled and analyzed using generic inverse variance model and presented as weighted mean difference (WMD) and 95% confidence interval (95% CI). Statistically significant improvements in favor of antibiotics' delivery were observed in studies with follow-up of ≤6 months for CAL gain (WMD = 0.61 mm (95% CI [0.07, 1.14]; p = 0.03), PPD reduction (WMD = 0.41 mm (95% CI [0.02, 0.80]; p = 0.04)) and BOP (WMD = -28.47% (95% CI [-33.00, -23.94]); p < 0.001), while for GI improvements were notable for >6 to 12 months (WMD = -0.27 (95% CI [-0.49, -0.06]; p = 0.01)).
CONCLUSION
Within the current review's limitations, locally delivered antibiotics during surgical periodontal therapy results in post-surgical improvements for CAL, PPD, and BOP (≤6 months) with a longer-lasting GI improvement. Further randomized controlled trials are needed with true periodontal end-points to assess the ideal antibiotic agent, dosage, and delivery methods.
CLINICAL RELEVANCE
Local delivery of antibiotics during periodontal surgery improved clinical parameters for up to 6-month follow-up, with beneficial longer effects on gingival inflammation. Within the current study's limitation, the presented evidence could support the elective usage of locally delivered antibiotics during surgical periodontal therapy.
Topics: Anti-Bacterial Agents; Dental Care; Dental Scaling; Humans; Oral Surgical Procedures; Periodontal Index
PubMed: 34283285
DOI: 10.1007/s00784-021-04056-7 -
Journal of Dental Research, Dental... 2021It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The... (Review)
Review
It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The present review investigated the peri-implant marginal bone loss (MBL) and pocket depths and failure rates of dental implants with laser-microtextured collars. An electronic search was run in the PubMed and Embase databases until September 15, 2019. Randomized and prospective clinical studies comparing peri-implant MBL and pocket depths and failure rates between implants with laser-microtextured and machined collar surfaces were included. Five studies (two cohort studies and three RCTs) were included in the meta-analysis after the inclusion and exclusion criteria and qualitative assessments were applied. The risk ratio of osseointegrated implant failure and mean differences in peri-implant MBL and pocket depths were calculated using the Comprehensive Meta-Analysis (CMA) software. Implants with laser-microtextured collars exhibited significantly better marginal bone level scores ( < 0.001; MD: 0.54; 95% CI: 0.489‒0.592) and a significant reduction in peri-implant probing depths than implants with machined collars ( < 0.001; MD: 1.01; 95% CI: 0.90‒1.13). The assessed studies showed that 17 out of 516 implants failed (3.29%), comprising nine implants with machined (3.62%) and eight implants with laser-microtextured collars (2.98%). However, no significant differences were detected in the implant neck surface characterization ( = 0.695; RR: 1.205; 95% CI: 0.472‒3.076). This study suggests that laser-microtexturing of implant collar significantly affected the peri-implant MBL and probing depths. Although no significant differences were noted in implant failure rates between implants with laser-microtextured and machined collar surfaces, the peri-implant MBL and probing depths with laser-microtextured collars were significantly lower than the machined collars.
PubMed: 35070185
DOI: 10.34172/joddd.2021.048 -
Clinical Oral Investigations Jun 2022To assess the potential additional benefit of the local application of enamel matrix derivative (EMD) on the clinical outcomes following non-surgical periodontal therapy... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the potential additional benefit of the local application of enamel matrix derivative (EMD) on the clinical outcomes following non-surgical periodontal therapy (NSPT) (steps 1 and 2 periodontal therapy).
MATERIALS AND METHODS
A systematic literature search was performed in several electronic databases, including Medline/PubMed, Embase, The Cochrane Register of Central Trials (CENTRAL), LILACS, and grey literature. Only randomized controlled clinical trials (RCTs) were eligible for inclusion. Clinical attachment level (CAL) change (primary outcome), probing pocket depth (PPD), and bleeding on probing (BoP) reductions (secondary outcomes) were evaluated. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the quality of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between test and control sites were estimated using a random-effect model for amount of mean CAL and PPD change.
RESULTS
Six RCTs were included for the qualitative analysis, while data from 4 studies were used for meta-analysis. Overall analysis of CAL gain (3 studies) and PPD reduction (4 studies) presented WMD of 0.14 mm (p = 0.74; CI 95% - 0.66; 0.94) and 0.46 mm (p = 0.25; CI 95% - 0.33; 1.26) in favor of NSPT + EMD compared to NSPT alone respectively. Statistical heterogeneity was found to be high in both cases (I = 79% and 87%, respectively).
CONCLUSIONS
Within their limitations, the present data indicate that the local application of EMD does not lead to additional clinical benefits after 3 to 12 months when used as an adjunctive to NSPT. However, due to the high heterogeneity among the studies, additional well-designed RCTs are needed to provide further evidence on this clinical indication for the use of EMD.
CLINICAL RELEVANCE
The adjunctive use of EMD to NSPT does not seem to additionally improve the clinical outcomes obtained with NSPT alone.
Topics: Dental Care; Dental Scaling; Humans; Randomized Controlled Trials as Topic
PubMed: 35389113
DOI: 10.1007/s00784-022-04474-1 -
Journal of Dentistry Nov 2021This study aimed to investigate the additional clinical benefit of tricalcium phosphate (TCP) (-containing) biomaterials compared to open flap debridement (OFD) in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This study aimed to investigate the additional clinical benefit of tricalcium phosphate (TCP) (-containing) biomaterials compared to open flap debridement (OFD) in periodontal infra-bony defects.
DATA
A literature search was conducted in Pubmed, Embase and Cochrane library for entries published up to 14th July 2021. All randomized controlled trials (RCTs) that compared a TCP (-containing) material with OFD and studies that assessed a beta-TCP group alone, with vertical defect sites with PPD of ≥ 6 mm and/or presence of infra-bony defects of ≥ 3 mm and a minimum follow-up of 6 months were included. Risk of bias was assessed with the Oxford scale. The random-effects (RE) model was synthesized as differences between weighted average (MD) for probing pocket depth (PPD) and clinical attachment level (CAL) between TCP and OFD groups. An RE analysis was also performed for the beta-TCP group alone.
STUDY SELECTION
Data from 16 RCTs were included in the analysis. Six studies that represented 151 patients and sites were selected for meta-analysis. The overall MD with 95% CI at 6 months was calculated to be -0.47 [-0.83, -0.12; P = 0.0087] and -1.06 [-1.67, -0.46; P = 0.0006] for PPD and CAL, respectively. Whereas MD at 12 months for PPD and CAL was -0.89 [-1.54, -0.23; P = 0.0078] and -1.25 [-1.85, -0.66; P<0.0001], respectively. All results were in favor of TCP (-containing) group over OFD.
CONCLUSIONS
The results of the study suggest that the use of a TCP (-containing) material may have the potential for additional clinical improvement in PPD and CAL compared with OFD in infra-bony defects, given the limitations of the included evidence.
CLINICAL SIGNIFICANCE
The use of TCP as a bone graft substitute is becoming increasingly common. Therefore, it would be advantageous if an adjunctive benefit in the regeneration of infra-bony defects could be demonstrated to facilitate material selection.
Topics: Alveolar Bone Loss; Biocompatible Materials; Bone Substitutes; Calcium Phosphates; Follow-Up Studies; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Attachment Loss; Treatment Outcome
PubMed: 34530060
DOI: 10.1016/j.jdent.2021.103812 -
Journal of Oral Biology and... 2023This study aimed to conduct a systematic evaluation of the literature on whether individuals exposed to alcohol intake present differences in the subgingival microbial... (Review)
Review
OBJECTIVES
This study aimed to conduct a systematic evaluation of the literature on whether individuals exposed to alcohol intake present differences in the subgingival microbial composition compared to those unexposed.
METHODS
Five databases (MEDLINE, EMBASE, LILACS, SCOPUS and Web of Science) and one source of grey literature (Google Scholar) were searched by two independent reviewers up to December 2022 according to pre-specified eligibility criteria. No restrictions were imposed regarding the date and language of publication and the periodontal status of the participants. The Newcastle-Ottawa Scale was used for methodological quality appraisal and a narrative synthesis was performed.
RESULTS
Eight cross-sectional studies and one cross-sectional analysis nested in a cohort were considered for qualitative analysis, including data of 4636 individuals. Overall, the studies exhibited considerable heterogeneity in terms of characteristics of the participants and microbiological methods. Four studies have high methodological quality. Exposed individuals have higher overall quantity of periodontal pathogens in shallow and moderate to deep pockets. Findings on richness, relative abundance, alpha- and beta-diversity were limited and inconclusive.
CONCLUSION
The subgingival microbiota of individuals exposed to alcohol intake has higher overall quantity of red (i.e., ) and orange-complex (i.e., ) bacteria when compared to those unexposed.
PubMed: 36866164
DOI: 10.1016/j.jobcr.2023.02.002 -
Dental Research Journal 2023Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world's population. Several studies have mentioned that there may...
BACKGROUND
Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world's population. Several studies have mentioned that there may be a link between the two. The purpose of this systematic review was to determine whether there was a difference in response to nonsurgical periodontal therapies (NSPTs) between obese and nonobese individuals.
MATERIALS AND METHODS
An online search was assembled with a combination of Medical Subject Headings terms and free-text words of the literature published up to December 2020, to identify interventional studies limited to an adult human population. Titles, abstracts, and finally full texts were scrutinized for possible inclusion by two independent investigators. Reduction in periodontal pocket depth was the primary parameter used to assess the outcome of NSPT.
RESULTS
The primary search yielded 639 significant titles and abstracts. After filtering, data extraction, and quality assessment, 34 full-text studies were selected. All studies matching inclusion criteria, suggest a positive association between obesity and periodontal disease.
CONCLUSION
Although a possible correlation exists between periodontitis and obesity, as with other oral-systemic disease implications, some controversy exists. While some studies have reported a distinct correlation between periodontitis and obesity, other papers have suggested only moderate or no association between the two conditions at all. These results advise of a difference between response to NSPT amid obese and nonobese individuals. However, with few quality studies and variable reported findings, there is limited evidence of any significant difference in clinical practice. However, it can be a positive warning that obesity is a risk factor toward the outcome of periodontal disease treatment.
PubMed: 38020246
DOI: No ID Found -
Journal of Clinical Medicine Jan 2020The objective of this systematic review and meta-analysis was to analyze the periodontal behavior around teeth prepared with horizontal finishing crowns supporting fixed... (Review)
Review
BACKGROUND
The objective of this systematic review and meta-analysis was to analyze the periodontal behavior around teeth prepared with horizontal finishing crowns supporting fixed metal-ceramic and zirconia full coverage crowns and fixed partial dentures (FDPs).
MATERIALS AND METHODS
An electronic search was conducted to locate relevant clinical trials in four databases: PubMed, Embase, Cochrane, and Scopus. A manual search was made in the reference sections of the articles identified for any additional articles. No restrictions were applied regarding year of publication or language. The following variables were considered in quantitative and qualitative analysis: probing pocket depth (PPD); probing attachment level (PAL); plaque control record (PCR); bleeding on probing (BOP); and gingival margin migration.
RESULTS
Twenty articles were selected for qualitative synthesis, and of these, nine underwent meta-analysis. Higher PCR was found in control teeth, while BOP, PPD, and PAL were higher around teeth prepared with horizontal finishing lines supporting complete coverage crowns/FDPs Gingival migration results were the clearest manifestation of compromised periodontal health around teeth prepared with horizontal finishing lines.
CONCLUSIONS
Meta-analysis revealed that teeth prepared with horizontal finishing lines supporting crowns and FDPs present more periodontal disorders than untreated control teeth.
PubMed: 31963494
DOI: 10.3390/jcm9010249 -
Journal of Indian Society of... 2019There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with... (Review)
Review
BACKGROUND
There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with chronic periodontitis (CP). This meta-analysis is aimed to explore the effect of NSPT, exclusively scaling and root planing (SRP) as monotherapy on glycemic control and periodontal parameters in patients of T2DM with CP.
MATERIALS AND METHODS
Two databases, MEDLINE and EMBASE, were searched from June 2006 to June 2016. Initially, 464 potentially relevant studies were evaluated. Randomized controlled trials with duration of ≥3 months, based on the treatment group managed with SRP without any supportive use of local drug delivery or systemic antibiotics, while the control group received no periodontal therapy, were selected. This resulted in six appropriate articles with a total of 812 patients of T2DM with CP. Alteration in glycated hemoglobin (HbA1c) was the primary outcome measure, whereas the changes in clinical attachment level (CAL) and probing pocket depth (PPD) were the secondary outcome measures.
RESULTS
SRP treatment resulted in a decrease in HbA1c by 0.26% ( = 0.17) at 3-4 months compared to the control group. Further, on subgroup analysis, SRP therapy revealed a decrease in PPD and CAL at 3-4 months, though statistically insignificant.
CONCLUSION
SRP treatment leads to modest improvement in glycemic status and periodontal parameters in T2DM patients with CP at 3-4 months.
PubMed: 31367125
DOI: 10.4103/jisp.jisp_417_18