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Turkish Journal of Medical Sciences 2024Laser biostimulation therapy (LBT) is suggested to have positive effects on periodontal healing. This study evaluated LBT with nonsurgical periodontal therapy (NSPT) in... (Randomized Controlled Trial)
Randomized Controlled Trial
Adjunctive use of laser biostimulation with nonsurgical periodontal therapy: a split-mouth, randomized, case-control study in diabetic and nondiabetic periodontitis patients.
BACKGROUND/AIM
Laser biostimulation therapy (LBT) is suggested to have positive effects on periodontal healing. This study evaluated LBT with nonsurgical periodontal therapy (NSPT) in diabetes mellitus (DM) and systemic health (SH) conditions.
MATERIALS AND METHODS
Thirty periodontitis patients (15 with DM and 15 with SH) were included in the study, which had a split-mouth design, by applying LBT in the mouth of the same systemic condition. Thus, 4 study groups were formed, as 1) NSPT - DM: NSPT alone in DM, 2) NSPT + LBT - DM: NSPT + LBT application in DM, 3) NSPT - SH: NSPT alone in SH, and 4) NSPT + LBT - SH: NSPT + LBT application in SH. NSPT was performed on days 15, 30, 37, 44, 51, 58, and 65. LBT was performed 6 times on days 30, 37, 44, 51, 58, and 65 with an Nd:YAG laser. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed as the clinical parameters and recorded at baseline and days 30, 37, and 72. Gingival crevicular fluid levels of interleukin 1 beta (IL-1β) and IL-10 were evaluated by ELISA as the biochemical parameters at baseline and on days 30, 37, and 72.
RESULTS
Clinical parameters had improved in all of the groups on day 72 (p < 0.01). PPD and CAL improved more in the DM group with NSPT and LBT group than in the DM group with NSPT without LBT on day 37 (p < 0.05). IL-1β decreased and IL-10 increased in all of the groups on day 72 (p < 0.01). This change was more evident in the DM group with NSPT and LBT than in the DM group with NSPT without LBT on day 7 (p < 0.05).
CONCLUSION
These results revealed the short-term impacts of LBT on periodontal healing, which return to ineffectiveness with repeated irradiation. Therefore, it may be speculated that LBT via the protocol herein may have a short-term antiinflammatory contribution to NSPT, only in impaired healing conditions such as DM.
Topics: Humans; Male; Female; Middle Aged; Adult; Case-Control Studies; Periodontitis; Gingival Crevicular Fluid; Periodontal Index; Low-Level Light Therapy; Interleukin-1beta; Laser Therapy; Interleukin-10
PubMed: 38812655
DOI: 10.55730/1300-0144.5797 -
Turkish Journal of Medical Sciences 2024Scaling and root planing remain inadequate in periodontitis treatment caused by dysbiotic microbial dental plaque. The aim of this clinical trial is to evaluate the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND/AIM
Scaling and root planing remain inadequate in periodontitis treatment caused by dysbiotic microbial dental plaque. The aim of this clinical trial is to evaluate the effects of probiotics and kefir consumption in initial periodontal therapy (IPT) on oral microbiota composition and treatment outcomes in patients with periodontitis.
MATERIALS AND METHODS
The study was carried out in the Gazi University Department of Periodontology, including a sample size of 36 individuals and utilizing a randomized controlled design. Thirty-six patients with periodontitis were randomly allocated to three groups: one receiving probiotic treatment, another receiving kefir, and a third serving as the control group. Obtaining subgingival microbial samples, we recorded plaque, gingival index, bleeding on probing, periodontal pocket depth, and clinical attachment level (periodontal clinical indices) and then performed IPT. For 14 days, patients took either probiotics, kefir, or no supplements. Data for the first and third months were collected using periodontal clinical indices. DNA sequencing was performed to detect , , and in subgingival plaque samples collected at baseline and three months.
RESULTS
Significant differences were observed regarding periodontal clinical indices among groups in the intragroup comparisons. Moreover, levels of were significantly decreased in all groups.
CONCLUSION
Kefir can be administered in addition to IPT, providing results similar to those observed with probiotics.
Topics: Humans; Probiotics; Male; Dysbiosis; Female; Adult; Middle Aged; Porphyromonas gingivalis; Kefir; Tannerella forsythia; Periodontitis; Treponema denticola; Periodontal Index; Treatment Outcome; Periodontal Diseases
PubMed: 38812644
DOI: 10.55730/1300-0144.5798 -
Experimental Animals May 2024The study aimed to evaluate the periodontal disease status in different age groups and clarify the relationship between aging and the severity of periodontal disease....
The study aimed to evaluate the periodontal disease status in different age groups and clarify the relationship between aging and the severity of periodontal disease. The test animals were cynomolgus monkeys that were born and raised at the Tsukuba Primate Research Center of the National Institutes of Biomedical Innovation, Health, and Nutrition. The participants were divided into three groups: young (5-10 years old), middle (10-19 years old), and old (≥20 years old). The plaque Index (PLI), Gingival Index (GI), probing pocket depth (PPD), and Bleeding on probing (BOP) were used for the periodontal examination. Representative teeth were also examined. Polymerase chain reaction (PCR) was used to identify Porphyromonas macacae in dental plaque. Multiple comparisons and regression analyses were used to analyze the relationship between each age group and each oral examination index. Statistically significant differences were found between the age groups and periodontal examination index. Multiple regression analysis revealed that age was strongly correlated with each oral examination index. Based on these results, oral examinations of cynomolgus monkeys kept in the same environment confirmed an association between aging and periodontal disease severity. Monkeys at this facility are expected to serve as new experimental models for elucidating the mechanisms underlying the progression of age-related periodontal disease.
PubMed: 38811232
DOI: 10.1538/expanim.23-0141 -
Clinics and Practice May 2024This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD).
Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial.
BACKGROUND
This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD).
METHODS
This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment.
RESULTS
PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643).
CONCLUSIONS
Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.
PubMed: 38804408
DOI: 10.3390/clinpract14030076 -
Cureus Apr 2024Periodontal diseases are widely spread, particularly in adults. Chitosan has non-toxicity and biocompatibility properties, as it has been studied in many studies in...
Periodontal diseases are widely spread, particularly in adults. Chitosan has non-toxicity and biocompatibility properties, as it has been studied in many studies in various surgical applications. This case report includes two female patients (aged 23 and 48) who were treated by the application of Chitosan gel 15% during open flap debridement in an aggregate of 26 periodontal pockets. Several clinical measurements were evaluated (probing depth, gingival recession, and bleeding on probing) for the treated periodontal pockets, between two periods, the first in baseline and then after six months. The results showed a reduction in probing depth of (3.30±0.27) after six months. The bleeding on probing also decreased from 84.61% to 0%. This case report concluded that the application of Chitosan gel 15% reduced pocket depth and bleeding on probing when applied in open flap debridement.
PubMed: 38800269
DOI: 10.7759/cureus.58965 -
Cureus Apr 2024Aim This retrospective study aimed to evaluate if E-max veneers over five years caused changes in gingival, periodontal health, and veneer failures. Background As...
Aim This retrospective study aimed to evaluate if E-max veneers over five years caused changes in gingival, periodontal health, and veneer failures. Background As aesthetic dentistry progresses, dental veneers are becoming increasingly popular in both general and specialized dental practices. Due to technological advancements in dental ceramics and adhesive systems, porcelain veneers have become a highly sought-after solution for improving aesthetics in dental patients. The success of porcelain laminate veneers, a commonly used method for aesthetic restoration, relies on various factors. E-max veneers are frequently utilized, with their long-term durability contingent upon factors such as color stability, resistance to abrasion, as well as good compressive, tensile, and shear strength, along with maintaining marginal integrity. Methodology In this study, data was collected through a checklist form used to record clinical parameters. The clinical parameters evaluated were inflammation and bleeding on probing (BOP). The gingival health was evaluated by gingival index, gingival color, texture, and bleeding on probing, and periodontal health was evaluated by the pocket depth and radiographic evaluations. Finally, the veneer was visually inspected for chipping, staining, and debonding history. The score for most of the cases ranged between 0-1, with only 10 cases displaying moderate gingival inflammation and BOP (Gingival Index 2). Siemens Orthopantomogram (OPG) systems were used for radiological evaluation and documentation of cases. E-max porcelain veneers were only included in the research. Results Out of 28 patients, each with 6-to-10-unit veneer cases was examined, 18 patients (64.3%) displayed healthy gingival status with no bleeding area recorded in none of the veneers amongst the 6 to 10 units. In 10 patients (35.7%) most of the veneers had inflamed gingival tissue that was bleeding on probing. The majority revealed the presence of stippling (92.9%), absence of recession (96.4%), and pocket depth (67.9%). Half of our participants had their veneer for more than five years (50%) and the majority presented with no significant changes in veneer recorded like marginal staining, debonding, or chipping (89.3%). Conclusion Multiple factors such as patient selection, proper treatment planning, and design, including material selection, play a significant role in the long-lasting success of ceramic veneers. The retrospective study indicated that proper oral hygiene measures are vital for the long-term sustainability of E max veneers.
PubMed: 38800248
DOI: 10.7759/cureus.58957 -
Medicina (Kaunas, Lithuania) May 2024This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap... (Randomized Controlled Trial)
Randomized Controlled Trial
This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Sixty systemically healthy patients with at least two teeth presenting suprabony periodontal defects were randomly assigned with a 1:1 allocation ratio using computer-generated tables into a test (OFD + HA) or control group (OFD). The main outcome variable was clinical attachment level (CAL). The secondary outcome variables were changes in mean probing pocket depth (PPD), gingival recession (GR), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS). All clinical measurements were carried out at baseline and 12 months. Sixty patients, thirty in each group, were available for statistical analysis. The mean CAL gain was statistically significantly different ( < 0.001) in the test group compared with the control group (3.06 ± 1.13 mm vs. 1.44 ± 1.07 mm). PPD reduction of test group measurements (3.28 ± 1.14 mm) versus the control group measurements (2.61 ± 1.22 mm) were statistically significant ( = 0.032). GR changes were statistically significant only in the test group 0.74 ± 1.03 mm ( < 0.001). FMBS and FMPS revealed a statistically significant improvement mostly in the test group. Suprabony periodontal defects could benefit from the additional application of HA in conjunction with OFD in terms of improvement of the clinical parameters compared with OFD alone.
Topics: Humans; Hyaluronic Acid; Female; Male; Middle Aged; Adult; Debridement; Surgical Flaps; Treatment Outcome; Wound Healing; Gingival Recession; Periodontal Debridement
PubMed: 38793012
DOI: 10.3390/medicina60050829 -
Journal of Functional Biomaterials May 2024Probiotic microorganisms are used in a variety of food supplements and medical formulations to promote human health. In periodontal therapy, probiotics are mainly used...
Probiotic microorganisms are used in a variety of food supplements and medical formulations to promote human health. In periodontal therapy, probiotics are mainly used in the form of gels, tablets or rinses that often tend to leak from the periodontal pocket, resulting in a strongly reduced therapeutic effect. In this pilot in vitro study, we present biodegradable alginate-based particles as an alternative, highly efficient system for a periodontal delivery of probiotic bacteria to the inflammation site. For this purpose, was encapsulated using a standardized pump-controlled extrusion-dripping method. Time-dependent bacterial release in artificial saliva was investigated over 9 days. The effect of freeze drying was explored to ensure long-term storage of -loaded particles. Additionally, the particles were bound to dentin surface using approved bioadhesives and subjected to shear stress in a hydrodynamic flow chamber that mimics the oral cavity in vitro. Thus, round particles within the range of 0.80-1.75 mm in radius could be produced, whereby the diameter of the dripping tip had the most significant impact on the size. Although both small and large particles demonstrated a similar release trend of , the release rate was significantly higher in the former. Following lyophilization, particles could restore their original shape within 4 h in artificial saliva; thereby, the bacterial viability was not affected. The attachment strength to dentin intensified by an adhesive could resist forces between 10 and 25 N/m. Full degradation of the particles was observed after 20 days in artificial saliva. Therefore, alginate particles display a valuable probiotic carrier for periodontal applications that have several crucial advantages over existing preparations: a highly stable form, prolonged continuous release of therapeutic bacteria, precise manufacturing according to required dimensions at the application site, strong attachment to the tooth with low risk of dislocation, high biocompatibility and biodegradability.
PubMed: 38786639
DOI: 10.3390/jfb15050129 -
Dentistry Journal May 2024The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the... (Review)
Review
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: "In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?". Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (-0.88, 2.97) = 0.29] and PPD reduction [MD = 1.32; 95% CI (-0.25, 2.88) = 0.10]. The same also applied to GR [MD = -0.08; 95% CI (-0.79, 0.63) = 0.83] and RBG [MD = 0.50; 95% CI (-0.88, 1.88) = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures.
PubMed: 38786543
DOI: 10.3390/dj12050145 -
Dentistry Journal May 2024In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a...
A Low-Cost Protocol Using the Adjunctive Action of Povidone-Iodine Irrigations and Sodium Hypochlorite Rinsing Solution in Step 2 of Periodontal Therapy for Patients with Stage III-IV Periodontitis: A Single-Blind, Randomized Controlled Trial.
In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. : This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone-iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy. : Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone-iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months. : After three months, notable differences were found in the bacterial detection scores for (a significant reduction in detection frequency was observed in the test compared to the control ( = 0.021)), and there were significant reductions in detection in the test group for and , showing undetectable levels ( < 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly ( = 0.0005); similarly, bleeding on probing showed a marked decrease ( < 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant. : Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations.
PubMed: 38786542
DOI: 10.3390/dj12050144