Basic Periodontal Therapy Research Articles

Adjunctive photobiomodulation to Basic Periodontal therapy using different low-power laser application techniques: a systematic review and meta-analysis.

To review current literature and synthesize clinical outcomes related to different low-level laser techniques as a complement to basic periodontal therapy (BPT). Electronic searches were conducted in PubMed, Cochrane, and Scopus, and clinical trials published from January 2013 to August 2023 using photobiomodulation as a complement to basic periodontal therapy, with a clear description of the laser technique, were included. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. Estimates of interest were calculated using random effects meta-analyses. A total of 947 references were retrieved, and 22 studies were included for qualitative synthesis. Ten studies used intrasulcular laser techniques, with 89% using infrared wavelength, and 12 studies used transgingival techniques, with 61.5% using red wavelength. The frequency of photobiomodulation after BPT ranged from 1 to 9 sessions, with follow-up periods ranging from 5 days to 12 months. Risk of bias was considered low in 16 studies and moderate in six studies. Meta-analysis of 13 studies showed that BPT reduced probing depth at 4-, 12- and 24-weeks post-treatment, and improved clinical level attachment at 6-, 12- and 24-weeks post-treatment. Studies suggest that photobiomodulation may be a valuable complement in the treatment of periodontitis, especially using transgingival application technique.

Effect of Basic Periodontal Therapy Combined with Probiotics on Oral Microecology and Blood Sugar Control in Patients with Diabetes and Periodontitis

Effect of Basic Periodontal Therapy Combined with Probiotics on Oral Microecology and Blood Sugar Control in Patients with Diabetes and Periodontitis

Recognizing the importance of basic periodontal therapy through a complex case on the verge of occlusal collapse

Recognizing the importance of basic periodontal therapy through a complex case on the verge of occlusal collapse

Juvenile spongiotic gingival hyperplasia: Presentation of two clinical cases

Juvenile spongiotic gingival hyperplasia is a benign lesion, first described by Darling and cols. in 2007, there are several etiopathogenic factors proposed. It is characterized by being in the anterior attached gingiva of the maxilla, clinically it is observed as macular or elevated, with a papillary, granular, or smooth surface, bright red in color, and its presentation can be localized or generalized. It is an asymptomatic entity and is not associated with biofilm-induced inflammation. We present two female patients (17 and 10 years old) with relevant and unprecedented medical history respectively, who presented multifocal lesions of bright red color, painless of velvety texture of soft consistency in the maxilla and jaw in which a conservative therapeutic setting and basic periodontal therapy, observation and controls were performed, did not show regression of the lesions after 6 months of observation. It is important for the dentist to recognize this entity and to make the different differential diagnoses, as these could be clinically very coincidental, to carry out an optimal treatment strategy.

ПРИМЕНЕНИЕ НЕСТЕРОИДНЫХ ПРОТИВОВОСПАЛИТЕЛЬНЫХ ПРЕПАРАТОВ ПРИ ПАРОДОНТАЛЬНОЙ ТЕРАПИИ ПАЦИЕНТОВ С КОМОРБИДНОЙ ПАТОЛОГИЕЙ

Subject. This paper covers the main aspects of non-steroidal anti-inflammatory drugs (NSAIDs) used on periodontal therapy in patients with cormobid pathology.
 Objectives. A domestic and foreign literature review on effects of NSAIDs on periodontal therapy in patients with cormobid pathology.
 Methodology. The literature review is based on the source literature available over the past five years starting 2015 by PubMed keywords in order to summarize the subject information.
 Conclusion. NSAIDs, therefore, remain the most essential medications on etiotropic, pathogenetic and symptomatic therapy of dental disorders. NSAIDs can help manage pain syndrome, control inflammation responses and regeneration with indulating inflammation-induced tissue destruction, prevent unnecessary complications during basic and supportive periodontal therapy including invasive techniques. Systemic and localized use of NSAIDs in the complex periodontal therapy based on the rational choice of the drug and the appropriate dose selection considering patient’s comorbidities must be necessarily supported by the dentist’s knowledge of pharmacodynamics and NSAIDs classifications with Clinical Guidance on rational use of NSAIDs (2015, revised 2018) and Clinical Guidance on comorbid pathology (2019) taken as the basis. These, therefore, will ensure the personified approach, efficacy and safety of NSAID use in patients.

The Effects of Non-Surgical Periodontitis Therapy on the Clinical Features and Serological Parameters of Patients Suffering from Rheumatoid Arthritis as Well as Chronic Periodontitis.

ObjectiveThe present study aims to evaluate the effects of basic periodontal disease therapy on the general condition and serum inflammatory indicators of patients with rheumatoid arthritis (RA) combined with chronic periodontitis (CP).MethodsForty patients with RA were enrolled in the study and, based on the results of an oral examination and in line with the 2018 periodontitis diagnostic criteria, they were divided into a group with CP (the RA + CP group) and a group without CP (the RA group). Twenty-nine patients with CP who attended the periodontal department of our hospital were recruited as a group with only CP (the CP group), and 20 volunteers without any systemic or periodontal disease were recruited as a healthy control group (the H group). The periodontal and joint conditions of the subjects in the four groups were recorded; anti-cyclic citrullinated protein antibodies, interleukin 6 (IL-6), C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and rheumatoid factor levels, which reflect the severity of the RA, were detected, and the differences between the groups were analyzed. The probing depth (PD), clinical attachment loss, and sulcus bleeding index (SBI), which reflect the severity of the periodontitis, were correlated with the factor levels. The RA + CP and CP groups received therapeutic intervention, and the differences in each indicator before and six weeks after the treatment were compared, and their data were compared with those of patients in the RA group and H groups.ResultsCompared with the RA group, the serum expressions of ESR, CRP, and IL-6 were significantly higher in the RA + CP group. There were significant differences in the levels of PD, SBI, IL-6, and CRP in the patients receiving basic periodontal disease therapy before and after the treatment.ConclusionA relatively large proportion of patients with RA have chronic periodontitis, and the local inflammatory state of CP might exacerbate the systemic inflammatory response in RA. Basic periodontal disease therapy may improve the oral condition of patients with RA and reduce the serum levels of the inflammatory factors.

DEVELOPMENT OF CLINICAL INNOVATIVE TECHNOLOGIES AND THEIR IMPLEMENTATION IN DENTAL PRACTICE

Introduction. The complexity of the pathology and insufficient effectiveness of dental treatment of inflammatory processes in the oral cavity determines the relevance of the study of the oral microbiome. Analysis of recent research and publications. Data from scientific literature sources confirm the leading role of various types of microorganisms in the etiology and pathogenesis of inflammatory diseases of the oral cavity, the microbiome of which is a complex biomarker of its diseases. Formulation of the purpose of the research. The purpose of the research: a scientific solution to the problem of providing dental care to the population by applying modern technologies of individualized approaches to diagnosis, treatment and normalization of the microbiome of the oral cavity. Research materials and methods. The methodological basis of the study was a holistic understanding of the human body and definition of the concept of health as a unity of physical, psychological and social well-being. The following methods of scientific research were used: analytical (analysis of data sources of scientific literature on the problem of dental treatment of inflammatory processes in the oral cavity); clinical and laboratory diagnostics (for examination of dental patients, evaluation of the microbiological status of the oral cavity and determination of the levels of individual sensitivity to antibacterial drugs); medical and statistical (for statistical processing of research results). In the course of the study, a clinical examination and dental treatment of 67 patients with inflammatory processes of the oral cavity were carried out (22 patients with chronic periodontitis of a mild degree of severity, 24 of moderate degree and 21 of severe degree). Research results. The conducted study showed that when using antibiotic therapy in accordance with the established sensitivity of pathogenic microorganisms to drugs, as well as in the case of combining this therapeutic scenario with accompanying probiotic therapy, the results of treatment of patients with a severe degree of chronic periodontitis were statistically significantly (p<0.05) better than in cases of using basic periodontal drug therapy or its combination only with the empirical accompanying prescription of antibiotics. Discussion of research results. In the course of the conducted clinical study, a statistically significant (р≦0.05) advantage of the implementation of personalized therapy algorithm approaches was revealed, which, in addition to basic periodontal interventions, also included accompanying antibiotic therapy in accordance with the indicators of a previous study of the sensitivity of microorganisms to various forms of antimicrobial drugs, and its combination with auxiliary probiotic therapy. Conclusions and prospects for further research. The effectiveness of the developed algorithm of a personalized approach to dental treatment, which includes the isolation of the pathogen, its identification, establishment of antibiotic sensitivity, normalization of the microbiome of the oral cavity and control of treatment, has been proven. Statistically reliable (р≤0.05) the predominant success rate of treatment of all forms of severity (mild, moderate, severe) of chronic periodontitis when implementing the proposed approaches of personalized medicine in dentistry with the use of antibiotic therapy in accordance with the established sensitivity of pathogenic microorganisms to drugs, as well as in the case of a combination of this therapeutic scenario with accompanying probiotic therapy. Prospects for further research will be aimed at finding innovative approaches to dental interventions in therapeutic dentistry and orthodontics.

Impact of 0.12% Chlorhexidine Gluconate Mouthwash on Peri-Implant Mucositis and Gingivitis After Nonsurgical Treatment: A Multilevel Analysis.

This study investigated the impact of 0.12% chlorhexidine gluconate mouthwash on dental implants with periimplant mucositis and contralateral teeth with gingivitis at 6 months of follow-up after nonsurgical treatment. This was a secondary analysis of data from a previous controlled, randomized, double-blinded clinical trial of 30 patients diagnosed with peri-implant mucositis and gingivitis in contralateral teeth, at 6 months following treatment. Patients were randomly assigned into a test group (basic periodontal therapy + 0.12% chlorhexidine mouthwash) or a control group (basic periodontal therapy + placebo). Therapy consisted of an adaptation of the full-mouth scaling and root planing protocol. The clinical parameters of visible Plaque Index, Gingival Bleeding Index, probing depth, bleeding on probing, keratinized mucosa width, and gingival and peri-implant phenotype were evaluated at baseline and at 1, 3, and 6 months posttherapy. Data were analyzed using Poisson multilevel regression analysis with a significance level of .05. The study analyzed 47 implants and contralateral teeth (376 sites) in the test group and 49 implants and contralateral teeth (392 sites) in the control group. No differences were found between the groups at the patient level. At the site level, the teeth and implants presented statistical differences in bleeding on probing, probing depth, and keratinized mucosa width at 3 months for both treatment groups. However, no difference was observed in bleeding on probing in the test group (P = .484) at 6 months, whereas the control group demonstrated increased bleeding on probing (indicating more inflammation) at implant sites than at teeth sites (P = .039). Additionally, implant sites with a thin peri-implant phenotype (P < .001) and located posteriorly (P = .002) presented greater inflammation. Use of a 0.12% chlorhexidine mouthwash for 14 days was beneficial for implant sites with peri-implant mucositis, compared to contralateral teeth sites with gingivitis, as indicated by the reduced percentage of teeth with bleeding on probing.

Clinical utility of oral management in allogeneic hematopoietic stem cell transplantation recipients: microbiological evidence based on molecular analysis of oral bacteria.

This study aimed to clarify the clinical utility of oral management to prevent bloodstream infections by oral bacteria microbiologically in patients undergoing allogeneic hematopoietic stem cell transplantation (ASCT). Ten consecutive patients with hematological malignancies undergoing ASCT were enrolled in this study. We implemented dental treatments before transplantation, if required, and carried out oral hygiene instructions and oral management every other day after transplantation. Molecular analysis of bacterial DNA for seven oral species using a polymerase chain reaction (PCR) assay was performed for oral samples and peripheral blood once a week for 3weeks after transplantation. Periodontitis was found in all 10 patients (mild grade in 3 and middle grade in 7) for whom basic periodontal therapy was conducted. Necessary dental procedures, including tooth extraction were performed in 5 patients. After transplantation, oral mucositis occurred in 10 patients (grade 1 in 3, grade 2 in 2, and grade 3 in 5) for whom oral hygiene instruction and oral care were continued every other day. PCR-identified three to six bacterial species in oral samples from nine patients, but none in peripheral blood from any patient during the observation period. Our study suggests that oral management could prevent bloodstream infections by oral bacteria in ASCT recipients despite the existence of periodontitis or oral mucositis. Its utility was confirmed by microbiological evidence based on molecular data.

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

Clinical and microbiological evaluation of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis

The aim of this study was to evaluate the effectiveness of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis. Clinical and microbiological studies were conducted before and 14 days, 1, 3 and 6 months after the periodontal treatment in 46 patients (144 implants with fixed dentures) with peri-implant mucositis. The patients were divided into 3 groups: test, comparison and control. Basic periodontal therapy in all groups included professional cleaning and individual oral hygiene training. Test group (15 patients) received basic periodontal therapy plus 0.20% chlorhexidine with hyaluronic acid mouthwash, the comparison group (15 patients) - basic periodontal therapy +0.05% chlorhexidine mouthwash. In control group (16 patients), treatment was limited to basic periodontal therapy only. At the initial stages of observations, there was a statistically significant improvement in the clinical indices in all treatment groups (p<0.001). The use of 0.20% chlorhexidine with hyaluronic acid mouthwash revealed a higher quality of treatment. After 6 months of observation, the clinical features in patients of the control group was almost similar to the state before treatment. The patients of the test group had a more pronounced elimination of facultative and periodontal pathogens in comparison with other groups. The use of 0.20% chlorhexidine with hyaluronic acid containing mouthwash allows the clinician to achieve a better results in the treatment of peri-implant mucositis. The evaluation the oral microflora in patients with peri-implant mucositis can be used as a prognostic criterion for the outcomes of rehabilitation.

Aspectos da assistência odontológica a pacientes internados em clínica médica de um hospital universitário

Introdução: O contexto atual de abordagem multiprofissional em saúde fundamenta-se na qualidade do atendimento e segurança ao paciente, com contribuição importante do cirurgião-dentista na equipe hospitalar para melhoria de saúde dos hospitalizados. Objetivo: Caracterizar o perfil sistêmico e bucal de pacientes atendidos em clínica médica de um Hospital Universitário do Sistema de Saúde Pública do Brasil, visando fornecer subsídios no direcionamento da assistência odontológica ao atendimento multidisciplinar em âmbito hospitalar. Métodos: Foi realizado estudo observacional retrospectivo em 104 fichas clínicas com coleta de dados sobre características gerais, alterações sistêmicas, hábitos, situação bucal e tratamentos odontológicos de pacientes internados, atendidos pelo odontólogo. Resultados: Verificou-se alta frequência de pacientes hipertensos (36,5%) e com problemas cardíacos (33,6%). Observou-se associação significativa de diabetes (60%) e hipertensão (50%) na faixa etária de 60 a 75 anos de idade. Para a maioria dos pacientes, a higiene bucal foi realizada menos que três vezes ao dia (54,3%), sem uso de fio dental (85,7%). Biofilme (73,3%), cálculo dental (70,5%), uso de próteses (25,7%), com higiene deficiente (14,3%), e estomatite protética (8,6%) foram registradas. Dentre os tratamentos realizados, destacam-se a terapia básica periodontal (71,4%) e exodontias (39%). Conclusão: A alta frequência de presença de biofilme, cálculo dental, próteses com higiene deficiente e a terapia básica periodontal executada durante o período de internação denotam a necessidade de atuação odontológica com atividades preventivas.

Microbial contamination and plaque scores of nanogold-coated toothbrush.

The study aimed to evaluate the microbial contamination and plaque scores of nanogold-coated and uncoated toothbrushes. This study was designed as a single-centre, parallel, examiner-blinded, randomized, two-group clinical trial. Eighty-four participants were enrolled and randomly assigned to receive either a nanogold or uncoated toothbrush. Basic periodontal therapy was performed for all the recruited subjects, and plaque scores of zero were considered baseline values. All participants were instructed to follow a twice-daily brushing regimen without dentifrice and to refrain from other oral hygiene care during the one-week study period. Plaque levels were assessed after oneweek using the Turesky modification of the Quigley-Hein Plaque Index (TMQHPI). The bristles were tested for microbial contamination by viable cell counting. The recorded data were statistically analysed, and a P-value of <.05 was accepted as statistically significant. After oneweek of brushing without using toothpaste, the mean plaque index scores were 0.37±0.07 in the nanogold group and 0.58±0.10 in the uncoated group. A significant difference in the mean plaque scores was observed between the groups (P<.001). The mean colony-forming unit (CFU) was 21±48.8 for the nanogold-coated group and 100±128.4 for the uncoated group. The difference in the mean CFUs observed between the groups was significant (P=.014). The use of a nanogold-coated toothbrush demonstrated significantly lower bristle contamination and lower plaque scores after oneweek compared with uncoated toothbrushes without using dentifrice.

Periodontal management of a patient with chronic kidney disease: a case report

Introduction: The association between periodontal disease and chronic kidney disease (CKD) has been recognized over the years. Gingival overgrowth may be a side effect of some of the drugs prescribed for patients with CKD. Objective: The objective of this manuscript was to report the dental management of a patient with chronic renal disease who presented periodontitis and gingival overgrowth. Case report: A 55 years old male patient sought dental treatment, and was diagnosed with generalized periodontitis in advanced stage and gingival overgrowth. The overgrowth was associated to the use of amlodipine, a longacting calcium channel blocker. The treatment consisted of interruption of amlodipine, sessions of oral hygiene instruction and basic periodontal therapy. Thereafter, conventional periodontal therapy, with scaling and root planning of the four hemiarches, surgical periodontal therapy and gingivectomy of the overgrowth were performed. Considering periodontal sites with a probing depth (PD) > 4mm at baseline, mean PD was reduced (baseline: 5.94 ± 1.80; follow-up: 2.76 ± 1.38), as well as mean clinical attachment loss (baseline: 5.55 ± 1.51; followup: 4.52 ± 1.47). Periodontal disease was controlled and there was no recurrence of gingival overgrowth after 18 months of follow-up. Conclusion: The management of the reported patient with CKD and periodontal involvement included discontinuation of amlodipine, basic and advanced periodontal therapy and gingivectomy. Proper oral hygiene may help to prevent recurrence of the gingival overgrowth and to maintain periodontal health.

The Effect of Miswak versus Chlorhexidin Gel on Subgingival Microbiota (Clinical and Microbiological Study)

Aim: This study evaluates the clinical and microbiological effect of miswak and chlorhexidine gel on subgingival microbiota. Subjects and Methods: A full mouth randomized controlled clinical trial that carried out on 45 patients of both sex with mild to moderate chronic periodontitis. Selected patients were classified randomly into three equal group. After receiving the basic periodontal therapy group I used miswak 5 time a day (in accordance with the religious tradition), group II used CHX gel with tooth brush twice time daily, group III used tooth brush alone twice time daily. They evaluated clinicaly by Gingival Index, Plaque Index, Propping Depth and Attachment level at base line, after scalling and root blanning, one week, one month and finally after three month of using of each method, and microbiologically for detection and assessment of P.gingivalis at base line , after scalling and root blanning, one week, one month and finally after three month. Resultes: The present study exhibit that miswak more effective than tooth brush, as antimicrobial aginist p. gingivalis. There was no significant difference in the efficacy of miswak and CHX. Conclusion: Miswak more effective than tooth brush, as antimicrobial agonist.

Clinical attachment loss and molecular profile of inflamed sites before treatment.

To monitor early periodontal disease progression and to investigate clinical and molecular profile of inflamed sites by means of crevicular fluid and gingival biopsy analysis. Eighty-one samples of twenty-seven periodontitis subjects and periodontally healthy individuals were collected for the study. Measurements of clinical parameters were recorded at day -15, baseline and 2 months after basic periodontal treatment aiming at monitoring early variations ofthe clinical attachment level. Saliva, crevicular fluid and gingival biopsies were harvested from clinically inflamed and non-inflamed sites from periodontal patients and from control sites of healthy patients for the assessment of IL-10, MMP-8, VEGF, RANKL, OPG and TGF-β1 protein and gene expression levels. Baseline IL-10 protein levels from inflamed sites were higher in comparison to both non-inflamed and control sites (p<0.05). Higher expression of mRNA for IL-10, RANK-L, OPG, e TGF-β1 were also observed in inflamed sites at day -15 prior treatment (p<0.05). After the periodontal treatment and the resolution of inflammation, seventeen percent of evaluated sites still showed clinically detectable attachment loss without significant differences in the molecular profile. Clinical attachment loss is a negative event that may occur even after successful basic periodontal therapy, but it is small and limited to a small percentage of sites. Elevated inflammation markers of inflamed sites from disease patients reduced to the mean levels of those observed in healthy subjects after successful basic periodontal therapy. Significantly elevated both gene and protein levels of IL-10 in inflamed sites prior treatment confirms its modulatory role in the disease status.

Comparison between 940 nm Laser Diode and Topical 5 % Potassium Nitrate for Tooth Desensitization. Randomized Controlled Clinical trial

Purpose: To compare the effectiveness of two dental desensitization therapies, 940 nm laser diode and potassium nitrate, in patients with dental hypersensitivity (DH) symptoms. Methods: This randomized clinical trial included 30 patients who initially underwent basic periodontal therapy and presented gingival recessions Class I and II (Miller 1985) with symptoms of DH. Subjects were randomly assigned into two groups. The first group (n = 15) received laser 940 nm application for 90 seconds on the surface of the recession and were given a tube of glycerin to be applied daily in order to avoid generating bias. Patients in the second group (n = 15) were exposed to inactive laser simulating the actual application of the laser, and they were given a desensitizing gel containing 0.5 g of potassium nitrate to be applied twice daily during 14 days. Controls were carried out at 15 minutes, 8 days, 15 days, and 4 weeks. Data obtained were filled out in an Excel table. For comparison between groups the Mann Whitney U and t student tests were used (p=0.05). Results: All patients involve in the study experienced reduction in DH (p&lt;0.01) and differences between the two interventions performed. Conclusions: Laser and nitrate therapies were effective to manage DH after basic periodontal therapy. However, a statistically significant higher sensitivity reduction was observed in laser therapy group.

Efekat bazične terapije parodontopatije na kvalitet života pacijenata starije životne dobi

The quality of life related to oral health is an important measure of the disease and the outcome of therapeutic interventions. Periodontitis is an inflammatory disease that is associated with the general state of the patient's organism and negatively affects the quality of life. The aim of this study was to examine the effect of basic periodontal therapy on the quality of life in elderly patients with periodontitis. Materials and methods: A total of 88 patients with periodontitis were randomly assigned to the group (n=44) who underwent basic therapy, while the control group (n=44) did not receive any treatment. The protocol included filling out a questionnaire OHIP-14 prior to and one month after the treatment, clinical examination and basic periodontal therapy. Patients also filled up additional questions about the gingival health as well as the impact of periodontal disease on the quality of life. Results: Clinical periodontal parameters did not show a significant difference between the groups at the beginning of the study. Improvement of all clinical parameters showing the periodontium state and a significant difference between the investigated groups (p<0.05), as well as in the treated group before and after treatment (p<0.001) was noted at the checkup. Statistically significant changes (p<0.001) like food impaction, avoiding the intake of certain foods, breath, avoiding laughing, and the presence of an abscess were recorded mainly in the treated group. Gingival health was rated or very bad with 42.73% of respondents. The impact of periodontitis on everyday activities is expressed by a simple questionnaire. All patients who answered often or always were considered to have the most common problems associated with these activities. Conclusion: The basic periodontal therapy has significantly affected the quality of life in elderly patients with periodontitis. Significant differences between the responses before and after treatment were identified.

Dental management of patients treated with intravenous bisphosphonates. A case report

Bisphosphonates are drugs used for the inhibition of osteoclastic bone resorption. Their therapeutic use is indicated for Paget’s disease, hypercalcemia of cancer, bone metastases, and osteoporosis. The main side effect of these drugs is osteonecrosis of the jaw, which is difficult to control. The aim of the present study was to report a patient, who was referred to the Special Needs Clinics of the Ribeirão Preto Dental School, University of São Paulo, for dental treatment. His medical history revealed a diagnosis of multiple myeloma with bone marrow transplantation in November 2007. Since then, he has been using zometa every 3 months. After physical examination and complementary exams, a diagnosis of angular cheilitis, erythematous candidiasis, caries, localized chronic periodontitis, pulp necrosis and partial edentulousness was established. The treatment plan was based on control of angular cheilitis candidiasis, basic periodontal therapy, supportive periodontal therapy, endodontic treatment, and partial mandibular and maxillary dentures. All invasive procedures were performed with antibiotic prophylaxis. The patient is under treatment and care is being taken to avoid osteonecrosis of the jaws. The authors highlight the need for knowledge of the side effects of bisphosphonates to prevent such effects and to maintain the oral health of the patients.

Comparison of two different methods for detecting periodontal pathogenic bacteria

Aim: To perform a comparative analysis between two methods for detecting Porphyromonas gingivalis, Tannerella forsythia and Porphyromonas endodontalis in periodontal plaque samples. Methods: The study sample consisted of twenty systemically healthy patients showing generalized chronic periodontitis. The subgingival samples for microbiological analysis were collected before (baseline) and 60 days after a basic periodontal therapy from 30 non-adjacent affected sites (Probing Depth (PD): 5-7 mm, Clinical Attachment Loss (CAL) ≥ 5 mm, positive for Bleeding on Probing (BOP)). Microbiological analysis was performed by PCR and qPCR. To allow a comparative analysis between both methods, qPCR was divided in three different scores (score 2: presence of more than 100 bacteria; score 1: presence of 10-100 bacteria, and score 0: absence of bacteria), in accordance to DNA quantity, while for PCR two scores were assigned: presence or absence of bacteria. Results: qPCR demonstrated higher sensitivity in the detection of these pathogens compared with PCR when scores 1 and 2 were considered positive. However, when only score 2 was considered positive, PCR and qPCR showed better agreement. Conclusions: qPCR demonstrated higher sensitivity than conventional PCR for detection of low numbers of microorganisms and can be useful for the quantification of periodontopathogens.