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The Journal of Contemporary Dental... Dec 2019This study aimed to assess the use of doxycycline in adjunct to periodontal therapy on the glycemic levels for chronic periodontitis patients with type 2 diabetes... (Randomized Controlled Trial)
Randomized Controlled Trial
AIMS
This study aimed to assess the use of doxycycline in adjunct to periodontal therapy on the glycemic levels for chronic periodontitis patients with type 2 diabetes mellitus (DM).
MATERIALS AND METHODS
Fifty-one diabetic subjects with chronic periodontitis were selected and randomly assigned into 3 groups with 17 subjects each. Scaling and root planing (SRP) was done in group I, SRP and doxycycline was given in group II, and group III did not receive any periodontal treatment till 3 months. Probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and metabolic parameters were evaluated at baseline (day 0) and after 3 months (day 90). The statistical analysis was carried out using SPSS 17.0 software with significance fixed at 95% CI ( < 0.05).
RESULTS
The mean difference between baseline and day 90 for all periodontal parameters was significantly higher ( < 0.01) in group I and group II compared to control (group III). The metabolic parameters such as fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG), and glycated hemoglobin (HbA1c%) level were reduced in groups I and II compared to group III; however, only HbA1c% values were found significantly reduced ( < 0.01) at day 90. Group II showed significantly better metabolic parameters than group I at day 90.
CONCLUSION
The adjunct of doxycycline to conventional periodontal therapy provides additional benefit in reducing glycemic level and improves periodontal health.
CLINICAL SIGNIFICANCE
The prevalence of diabetes as well as periodontitis is increasing nowadays in the world. With treatment of periodontitis, it is found that there is reduction of glycemic level in diabetes. So it is an alert to health professionals about the relation of diabetes and periodontitis and so that they conduct a multidisciplinary treatment.
Topics: Anti-Bacterial Agents; Chronic Periodontitis; Dental Scaling; Diabetes Mellitus, Type 2; Doxycycline; Humans; Root Planing
PubMed: 32381843
DOI: No ID Found -
Clinical Oral Investigations Jan 2020This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and...
Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes.
OBJECTIVES
This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and non-diabetic subjects for up to 1 year. Secondary aim was to evaluate the effects of this therapy on the salivary levels of periodontal pathogens between diabetics and non-diabetics.
MATERIAL AND METHODS
Twenty-six type 2 diabetic subjects and 28 non-diabetic subjects with mild-to-moderate periodontitis received full-mouth scaling and root planing within 24 h, application of chlorhexidine digluconate (CHX) gel in pockets and tongue plus CHX rinses for 14 days. Clinical monitoring was performed at baseline, 3, 6, and 12 months post-therapy. Salivary levels of red complex bacterial species were evaluated at baseline, 6, and 12 months post-therapy by qPCR.
RESULTS
Intention-to-treat analyses were performed for seven diabetics and three non-diabetics that did not return for the 12-month evaluation. Most clinical parameters improved significantly at 3, 6, and 12 months post-therapies for both groups (p < 0.05). Overall, there were no significant differences in clinical parameters between groups after therapy (p > 0.05). At 1 year, 39.3% and 50.0% of the non-diabetic and diabetic subjects, respectively, achieved the desired clinical endpoint for treatment (≤ 4 sites with probing depth ≥ 5 mm) (primary outcome variable) (p > 0.05). FMD did not promote changes in the salivary levels of pathogens in either of the groups (p > 0.05). Levels of T. forsythia were lower in diabetic than in non-diabetic subjects at 6 months post-therapy (p < 0.05).
CONCLUSIONS
Type 2 diabetic subjects and systemically healthy subjects with mild-to-moderate periodontitis responded similarly to the proposed FMD protocol for up to 1 year.
CLINICAL RELEVANCE
There is a general thought that diabetics do not answer as well as non-diabetics to periodontal treatments. However, this study showed that diabetics and non-diabetics respond equally to the FMD protocol.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02643771.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Chronic Periodontitis; Dental Scaling; Diabetes Mellitus, Type 2; Disinfection; Female; Humans; Male; Periodontal Index; Periodontitis; Root Planing
PubMed: 31102044
DOI: 10.1007/s00784-019-02927-8 -
Dentistry Today Nov 1997A gingivectomy performed with a laser is a short, easy procedure that produces an immediately dramatic effect. Compared to a scalpel gingivectomy, there is excellent...
A gingivectomy performed with a laser is a short, easy procedure that produces an immediately dramatic effect. Compared to a scalpel gingivectomy, there is excellent hemostasis, which improves visualization, requires less need for periodontal packing, and results in minimal postoperative discomfort. Tissue rebound also is minimal. Use of lasers requires specific training. The only approved function in periodontics at this time according to the American Academy of Periodontology is soft tissue surgery. Some periodontal applications include frenectomy, soft tissue crown lengthening, distal wedge procedures, soft tissue tuberosity reductions, gingivectomy, gingivoplasty, stage II of implants, operculectomies, biopsies, coagulation of graft donor sites, hemorrhage disorder patients, and stripping procedures for various leukoplakias.
Topics: Aged; Aged, 80 and over; Calcium Channel Blockers; Chronic Disease; Dental Scaling; Gingival Hyperplasia; Gingivectomy; Humans; Laser Therapy; Male; Periodontitis
PubMed: 9560737
DOI: No ID Found -
Journal of Periodontology May 2010Smoking is the most important environmental risk factor for periodontal disease. Elevated levels of serum-soluble CD44 (sCD44) have been detected in smokers and also... (Comparative Study)
Comparative Study
BACKGROUND
Smoking is the most important environmental risk factor for periodontal disease. Elevated levels of serum-soluble CD44 (sCD44) have been detected in smokers and also have been recognized as a diagnostic marker in some smoking-induced diseases. The present study investigates the salivary sCD44 profiles of smokers and non-smokers with and without chronic periodontitis in response to scaling and root planing (SRP).
METHODS
The study included 44 subjects divided into two groups: 22 patients with chronic periodontitis and 22 periodontally healthy subjects. Both groups were equally subdivided into smokers (n = 11) and non-smokers (n = 11). Plaque index, gingival index, probing depth, and clinical attachment level were recorded only for chronic periodontitis patients. Salivary samples were collected from all 44 patients at baseline and after 1 month of SRP from the 22 chronic periodontitis patients. Assay for salivary sCD44 was carried out by enzyme-linked immunosorbent assay.
RESULTS
Baseline salivary sCD44 profiles were significantly higher when smokers were compared to non-smokers in both chronic periodontitis patients and the control subjects (P <0.001) with the highest levels recorded in smokers within the chronic periodontitis group. There was a significant decline in salivary sCD44 levels after treatment in the chronic periodontitis group for both smokers and non-smokers (P <0.01); however, the difference between groups was insignificant.
CONCLUSIONS
Salivary sCD44 might be considered a biomarker of periodontal destruction in smokers and non-smokers. The research opens the door to further research into a role for CD44 as a diagnostic marker for periodontitis.
Topics: Adult; Biomarkers; Chronic Periodontitis; Dental Plaque Index; Dental Scaling; Female; Follow-Up Studies; Gingival Hemorrhage; Humans; Hyaluronan Receptors; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Pilot Projects; Root Planing; Salivary Proteins and Peptides; Smoking; Subgingival Curettage
PubMed: 20429650
DOI: 10.1902/jop.2010.090630 -
American Journal of Orthodontics and... Feb 2018A 49-year-old woman with several missing and periodontically compromised teeth was referred to the orthodontic department of National Health Insurance Service Ilsan...
A 49-year-old woman with several missing and periodontically compromised teeth was referred to the orthodontic department of National Health Insurance Service Ilsan Hospital by the periodontic department for interdisciplinary treatment. Multiple posterior teeth had been extracted 10 days earlier. Her chief complaint was crowding of the anterior teeth, and she wanted to improve both esthetics and function. Orthodontic, periodontic, and prosthodontic treatments were undertaken in the proper timing and sequence with an interdisciplinary approach. As a result, improved periodontal health and a stable occlusion and vertical dimension were achieved. Although there were limited teeth and alveolar bone for anchorage, good esthetic and functional treatment results were obtained through the application of temporary anchorage devices and proper biomechanics.
Topics: Cephalometry; Esthetics, Dental; Female; Humans; Interdisciplinary Communication; Middle Aged; Periodontics; Periodontitis; Prosthodontics; Radiography, Dental; Radiography, Panoramic; Tooth Loss
PubMed: 29407506
DOI: 10.1016/j.ajodo.2016.10.043 -
Journal of Periodontal Research Jul 1992Guidelines for clinical trials demonstrating equivalence or superiority for treatments for periodontitis are badly needed because of the great variety of drugs, agents,...
Guidelines for clinical trials demonstrating equivalence or superiority for treatments for periodontitis are badly needed because of the great variety of drugs, agents, and devices now being developed. This paper focuses on three design issues. These are primary outcome variables and their measurement, disease-active vs disease-inactive sites and patients, and study duration. Determinants for selection of outcome variables include the biologic events to be observed, changes that are specific for periodontitis, and methods chosen to detect those changes. The primary outcome variables specific for periodontitis and appropriate for use in clinical trials are periodontal attachment level and alveolar bone status. Improved methods for measurement of both with excellent accuracy and reproducibility are now becoming available. Studies performed on untreated patients over the past decade demonstrate clearly that disease-active and disease-inactive pockets exist, at any given point in time most are inactive, disease progression is episodic and in most patients infrequent, and a rather small portion of the population--possibly around 5%--are unusually susceptible to rapid disease progression. These observations need to be taken into account in enrolling subjects into periodontitis clinical trials. Conducting a prestudy to identify actively diseased sites and susceptible subjects, or screening to enrich the proportion of active sites, is recommended. Determination of study duration is a very complex issue. It is related to the length of time required for maximal change and stabilization to occur in the biological events to be observed, the outcome variable(s) used to detect change, and the nature of the therapeutic interventions to be studied. No single duration is applicable to all periodontitis clinical trials. Large gaps in our knowledge about the design of periodontitis trials still exist, and additional research is needed.
Topics: Alveolar Bone Loss; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Clinical Trials as Topic; Disease Susceptibility; Gingival Crevicular Fluid; Humans; Longitudinal Studies; Patients; Periodontal Index; Periodontal Pocket; Periodontics; Periodontitis; Research Design; Risk Factors; Time Factors; Treatment Outcome
PubMed: 1507028
DOI: 10.1111/j.1600-0765.1992.tb01704.x -
Journal of Periodontology Jan 2000Periodontal probing is one of the most common methods used in diagnosing periodontal disease. The purpose of this study was to determine the importance of the diameter... (Comparative Study)
Comparative Study Review
BACKGROUND
Periodontal probing is one of the most common methods used in diagnosing periodontal disease. The purpose of this study was to determine the importance of the diameter of periodontal probing tips in diagnosing and evaluating periodontal disease.
METHODS
The literature discussing periodontal probe diameters in human, dog, and monkey studies was reviewed and compared. Tip diameters varied from 0.4 to over 1.0 mm in these studies. Probe advancement between the gingiva and the tooth is determined by the pressure exerted on the gingival tissues and resistance from the healthy or inflamed tissue. The pressure is directly proportionate to the force on the probe and inversely proportionate to the probe tip diameter. The larger probing diameters reduced probe advancement into inflamed connective tissue. This effect of change in probe diameter reduced the pressure in a greater manner than an increase of similar change in probe force.
RESULTS
In the studies reviewed, the pressure used to place the probe tip at the base of the periodontal sulcus/pocket was approximately 50 N/cm2 and at the base of the junctional epithelium, 200 N/cm2. A tip diameter of 0.6 mm was needed to reach the base of the pocket. Clinical inflammation did not necessarily reflect the severity of histological inflammation, and the recordings may not illustrate probing depth. Furthermore, probing depth did not identify anatomical locations at the base of the pocket.
CONCLUSIONS
Probe tips need to have a diameter of 0.6 mm and a 0.20 gram force (50 N/cm2) to obtain a pressure which demonstrates approximate probing depth. This pressure was needed to measure the reduction of clinical probing depth, which included formation of a long junctional epithelium as a result of therapy. In addition, different forces or diameter tips are needed to measure healthy or inflamed histological periodontal probing depths.
Topics: Animals; Dogs; Equipment Design; Gingiva; Haplorhini; Humans; Periodontal Diseases; Periodontal Pocket; Periodontics; Periodontitis; Pressure; Stress, Mechanical; Surface Properties; Tooth
PubMed: 10695944
DOI: 10.1902/jop.2000.71.1.96 -
Photobiomodulation, Photomedicine, and... Sep 2020To explore the influence of photobiomodulation (PBMT) as an adjuvant to scaling and root planing (SRP) for treating periodontitis among chewers. Self-reported... (Randomized Controlled Trial)
Randomized Controlled Trial
To explore the influence of photobiomodulation (PBMT) as an adjuvant to scaling and root planing (SRP) for treating periodontitis among chewers. Self-reported smokeless-tobacco () users were enrolled; and underwent SRP with (test group) and without (control group) PBMT. Full-mouth plaque index (P-I), bleeding upon probing (BUP), probing depth (P-D) clinical attachment loss (CAL), marginal bone loss (MBL) (on mesial and distal surfaces of the teeth), and number of missing teeth were recorded before treatment and at 3 and 6 months. Group comparisons were performed and < 0.05 was referred significant. In the control group, P-I ( < 0.013), BUP ( < 0.001), and P-D ( < 0.012) were high at baseline compared with 3 months follow-up. P-I, BUP, and P-D were higher in the test group, at baseline in comparison with the 3-month ( < 0.001) and 6-month ( < 0.01) follow-up. At 3 and 6 months, scores of P-I, BUP, and P-D were high in the control compared with the test group. No difference in CAL, and mesial and distal MBL was found among patients of both groups at 3 and 6 months. Among chewers, SRP with PBMT is more efficient than SRP alone in the management of periodontitis.
Topics: Dental Scaling; Humans; Periodontal Index; Periodontitis; Root Planing; Tobacco, Smokeless
PubMed: 32833578
DOI: 10.1089/photob.2020.4819 -
Journal of Investigative and Clinical... Aug 2019The aim of the present study was to evaluate the effect of non-surgical periodontal therapy (NSPT) on gingival crevicular fluid (GCF) and serum leptin levels and...
Effect of non-surgical periodontal treatment on gingival crevicular fluid and serum leptin levels in periodontally healthy chronic periodontitis and chronic periodontitis patients with type 2 diabetes mellitus.
AIM
The aim of the present study was to evaluate the effect of non-surgical periodontal therapy (NSPT) on gingival crevicular fluid (GCF) and serum leptin levels and glycemic status in periodontally healthy patients with chronic periodontitis (CP) with and without type 2 diabetes mellitus (T2DM).
METHODS
Ninety patients were divided into three groups: periodontally healthy (group 1), CP (group 2) and CP with T2DM (group 3). The groups were evaluated for clinical parameters of probing pocket depth (PPD), clinical attachment level (CAL), plaque index, gingival index, biochemical parameters of GCF, serum leptin levels, and glycemic status pre- and post-NSPT.
RESULTS
The baseline PPD and CAL for group 2 was 4.98 ± 0.49 mm and 5.35 ± 0.55 mm, respectively; for group 3 it was 5.60 ± 0.38 mm and 6.01 ± 0.38 mm, respectively. There was a considerable reduction in these parameters post-NSPT, with group 2 showing better resolution. Pretreatment serum leptin levels revealed increasing values from group 1 to group 3 and decreasing GCF values from group 3 to group 1, exhibiting an inverse relationship. Group 3 also showed an improvement in glycemic status post-NSPT.
CONCLUSION
NSPT was effective in improving clinical parameters, increasing GCF, reducing serum leptin levels, and also improving glycemic status in patients with CP and CP with T2DM.
Topics: Chronic Periodontitis; Diabetes Mellitus, Type 2; Gingival Crevicular Fluid; Humans; Leptin; Periodontal Attachment Loss; Periodontal Index
PubMed: 31172690
DOI: 10.1111/jicd.12420 -
Journal of Periodontology Mar 1985Actinobacillus actinomycetemcomitans is a Gram-negative oral microorganism, which has been implicated in the etiology of localized juvenile periodontitis and in severe...
Actinobacillus actinomycetemcomitans is a Gram-negative oral microorganism, which has been implicated in the etiology of localized juvenile periodontitis and in severe medical infections such as bacterial endocarditis. This study evaluated the ability of periodontal probes to transmit A actinomycetemcomitans from juvenile periodontitis lesions to healthy gingival sulci in the same patient. Localized juvenile periodontitis patients exhibiting first molar and incisor alveolar bone loss and with large numbers of A actinomycetemcomitans in deep periodontal pockets were included in this study. A periodontal probe was inserted into periodontal pockets of 6 mm or greater depth. The probe was then placed into a healthy gingival sulcus of 3 mm or less, in the same subject. Fifty-five transfers by probing were made and A actinomycetemcomitans in both the donor and recipient sites was assessed by a selective culture technique. The results indicate that periodontal probes can become contaminated with A actinomycetemcomitans from juvenile periodontitis lesions during routine dental examinations and can transfer this microorganism from infected to previously uninfected sites. However, A actinomycetemcomitans inoculated into the healthy gingival sulci did not permanently colonize these sites since the organisms were eliminated within 3 weeks.
Topics: Actinobacillus; Adolescent; Adult; Aggressive Periodontitis; Child; Gingiva; Humans; Periodontal Diseases; Periodontal Pocket; Periodontics; Time Factors
PubMed: 3857321
DOI: 10.1902/jop.1985.56.3.127