Improvement In Probing Pocket Depth Research Articles

Autogenous platelet concentrates for treatment of intrabony defects-A systematic review with meta-analysis.

To provide an overview of the use of autogenous platelet concentrates (APCs) in periodontal regeneration and to conduct a systematic review (SR) of the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) compared with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 21 categories and into five different groups as follows: Group I (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD versus Titanium-PRF (T-PRF) Group II, (3) Comparative PRF protocols (PRF vs. T-PRF), Group III (Comparative Studies to PRF): (4) OFD/PRP versus OFD/PRF, (5) OFD/bone graft(BG)/PRGF versus OFD/BG/PRF, (6) OFD/EMD versus OFD/PRF, (7) OFD/BG/EMD versus OFD/BG/PRF, (8) OFD/collagen membrane (CM) versus OFD/PRF, (9) OFD/BG/BM versus OFD/BG/PRF, (10) OFD/BG versus OFD/PRF, Group IV (Addition of PRF to treatment groups) (11) OFD/BG versus OFD/BG/PRF, (12) OFD/GTR versus OFD/GTR + PRF (13) OFD/EMD versus OFD/EMD/PRF (14) OFD/BG/BM versus OFD/BG/BM/PRF, Group V (Addition of Biomaterial/Biomolecule to PRF): OFD/PRF versus … (15) OFD/PRF/BG, (16) OFD/PRF/antibiotic, (17) OFD/PRF/Metformin, (18) OFD/PRF/Bisphosphonates, (19) OFD/PRF/Statins, (20) OFD/BG/PRF versus OFD/BG/PRF/Statins, and (21) OFD/PRF/low-level laser therapy (LLLT). Weighted means and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone fill (RBF). From 596 records identified, 55 RCTs were included. Group I: The use of OFD/PRF statistically significantly reduced PPD and improved CAL and RBF when compared to OFD. Group II: A significant difference between various PRF protocols was only observed for PPD. Group III: No significant advantage was found when comparing OFD/PRF to the following groups: OFD/PRP, OFD/EMD, OFD/BM, or OFD/BG. Group IV: The addition of PRF to OFD/BG led to significant improvements in PPD, CAL and RBF compared with OFD/BG alone. Group V: The addition of either a BG as well as three of the following biomolecules (metformin, bisphosphonates, and statins) to OFD/PRF led to statistically significant improvements in PPD, CAL, and/or RBF when compared to OFD/PRF alone. The use of PRF significantly improved clinical outcomes in intrabony defects when compared to OFD alone. Similar results were observed when OFD/PRF was compared with OFD/BG, OFD/EMD, OFD/PRP, and OFD/BM. The addition of PRF to a bone grafting material as well as the addition of various small biomolecules to PRF may offer additional clinical advantages, thus warranting further investigations. Future research investigating various protocols of PRF, longer-term outcomes, as well as PRF at the human histological level remains needed.

Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis.

The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins. Weighted means and forest plots were calculated for the reduction of probing pocket depth (PPD), gain of vertical and horizontal clinical attachment levels (VCAL and HCAL), gain in vertical and horizontal bone levels (VBL, HBL), and radiographic bone fill (RBF). From 45 articles identified, 21 RCTs reporting on class II furcations were included. The use of OFD/PRF and OFD/BG/PRF statistically significantly reduced PPD and improved VCAL and HCAL when compared to OFD or OFD/BG, respectively. The comparison between OFD/PRF alone versus OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2 led to similar outcomes for all investigated parameters, including a reduction in PPD, VCAL/HCAL gain, and RBF. The additional incorporation of a BG to OFD/PRF only mildly improved outcomes, whereas the addition of AM improved clinical outcomes. The addition of small biomolecules such as metformin, bisphosphonates, or statins all led to significant improvements in PPD, VCAL, and HCAL when compared to OFD/PRF alone. Noteworthy, a very high heterogeneity was found in the investigated studies. The use of PRF significantly improved clinical outcomes in class II furcation defects when compared to OFD alone, with similar levels being observed between OFD/PRF and/or OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future histological research investigating PRF in human furcation defects is largely needed. The use of PRF in conjunction with OFD statistically significantly improved PPD, VCAL, and HCAL values, yielding comparable outcomes to commonly used biomaterials. The combination of PRF to bone grafts or the addition of small biomolecules may offer additional clinical benefits, thus warranting future investigation.

Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study.

To assess the potential benefits of minimally invasive non-surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes. A multi-centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months. Eighty-four patients completed the 12-month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty-six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively. Improvements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally%20invasive%20non%20surgical%20therapy&locStr=UK&country=United%20Kingdom&distance=50&rank=2.

Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split-mouth randomized clinical trial.

The aim of this study was to assess the efficacy of photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) on clinical parameters and microbial composition in subgingival plaque of periodontitis patients. Seventeen patients were included in this split-mouth randomized clinical trial. Sites with probing pocket depth (PPD) ≥5mm in combination with bleeding on probing in different quadrants were randomized into the control group, the group with a single PDT application right after SRP, and the group with three repeated PDT applications 1week after SRP. The subgingival plaque was collected for 16S rRNA gene sequencing at baseline, Week 2, and Week 8. Seventeen patients with 60 sites completed this 8-week follow-up, and 157 subgingival plaques were successfully analyzed by sequencing. Significant improvements were observed in two primary outcomes: PPD at Week 8 and subgingival microbial composition. Compared to the control group, the repeated-PDT group showed a notable improvement in PPD, substantial alterations in the microbial profile, including a reduction in α-diversity and anaerobic bacteria, and an increase in aerobic bacteria at Week 2. Secondary outcomes, such as clinical attachment level and sulcus bleeding index, also showed improvement at Week 8. Furthermore, both the single- and repeated-PDT groups exhibited a decrease in periodontopathogens and an increase in beneficial bacteria compared with baseline. PDT promotes changes in the microbial composition of periodontitis patients' subgingival plaque in a direction favorable to periodontal health, and repeated PDT is a promising adjunctive therapy for periodontal treatment.

Improvement of periodontal parameters following intensive diabetes care and supragingival dental prophylaxis in patients with type 2 diabetes: A prospective cohort study.

This study aimed to investigate the effects of diabetes care on periodontal inflammation. This prospective cohort study included 51 Japanese patients with type 2 diabetes who underwent intensive diabetes care including educational hospitalization and regular outpatient treatment for 6 months. Dental prophylaxis without subgingival scaling was provided three times during the observational period. Associations between changes in periodontal parameters and glycaemic control levels were evaluated using multiple regression analysis. Overall, 33 participants (mean age: 58.7 ± 12.9) were followed up for 6 months. At baseline examination, 82% were diagnosed with Stage III or IV periodontitis. Haemoglobin A1c (HbA1c) level changed from 9.6 ± 1.8% at baseline to 7.4 ± 1.3% at 6 months. The ratio of probing pocket depth (PPD) ≥4 mm, bleeding on probing (BOP), full-mouth plaque control record (PCR), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) also significantly improved. The reduction in PPD and PESA was significantly associated with changes in both HbA1c and fasting plasma glucose (FPG) levels, and the reduction in PISA was significantly associated with an improvement in FPG after adjusting for smoking, change in body mass index and full-mouth PCR. This is the first study to report a significant improvement in PPD and BOP after intensive diabetes care and dental prophylaxis without subgingival scaling. UMIN000040218.

Clinical Evaluation of Diode Laser as an Adjunct to Scaling and Root Planing in Patients With Chronic Periodontitis and Type II Diabetes Mellitus: A Split-Mouth Study.

The primary goal of periodontal therapy is to arrest the inflammatory disease process which is done by non-surgical and surgical therapies in order to reduce the microorganisms.The outcome of periodontal therapy may not reveal the desired results owing to inaccessible areas for instrumentation, pathogenicity, resistance of the microorganisms, or even due to compromised host response to the treatment. Thus, adjunctive laser therapy has been proposed as a novel treatment modality in the treatment of periodontal disease. Aim: The aim of this study was to clinically evaluate the effect of a 980 nm diode laser (DEN10B; Wuhan Gigaa Optronics Technology Co., Ltd., Wuhan, China) therapy as an adjunct to scaling and root planing in patients with chronic periodontitis and type II diabetes. Twenty patients were divided into two groups in a split-mouth study design. Group I (Control) comprised mechanical debridement alone and Group II (test) comprised mechanical debridement followed by adjunctive laser therapy. The clinical parameters were recorded at baseline, six weeks, and three months, and the results were analyzed. There was a significant improvement in gingival and plaque index in the test group. Though there was no significant improvement in probing pocket depth and clinical attachment, the results in the test group were superior relative to the control group. Non-surgical periodontal therapy with adjunctive use of diode laser is effective in the management of generalized chronic periodontitis in patients with type II diabetes which led to a significant reduction in plaque score, gingival index score, probing pocket depth, and gain in clinical attachment level.

A Systematic Review and Meta-Analysis of Systemic and Local Antibiotic Therapy in the Surgical Treatment of Peri-Implantitis.

(1) Background: Given the existing controversy regarding the use of antibiotics in the treatment of peri-implantitis, this systematic review and meta-analysis aim to ascertain how beneficial the role of systemic and local antibiotics is in peri-implant surgical therapy, considering the harmful effects that they represent and the abuse of antibiotics in terms of global health. (2) Methods: To determine the therapeutic efficacy of the administration of antibiotics in the surgical treatment of peri-implantitis in terms of probing pocket depth (PPD) and bleeding on probing (BoP), electronic and manual bibliographic searches were carried out in the Embase and PubMed databases, collecting data that related to before and after treatment. (3) Results: The adjunctive use of local antibiotics provides significant improvements in PPD (MD = 1.29; 95% CI: 0.56 to 2.02; p ≤ 0.0006; I2 = 0%) when compared with surgical treatment alone. No significant differences were found in the other subgroup; that is, the use of systemic antibiotics did not significantly improve PPD changes in the surgical treatment of peri-implantitis (MD = 0.40; 95% CI: -0.15 to 0.95; p = 0.15; I2 = 0). (4) Conclusions: The use of local antibiotics in the surgical treatment of peri-implantitis seems to offer treatment improvements in terms of PPD and BoP, unlike that observed with the use of systemic antibiotics. However, these results should be taken with caution as they also depend on the type of surgical technique used, whether regenerative or resective. More research is needed on this topic to understand the role of local and systemic antibiotics in the treatment of peri-implantitis.

Evaluation of efficacy of locally delivered Herbal extract in treatment of Chronic periodontitis –A Randomised controlled trial

Background: Various locally delivered agent are used as an adjunct to scaling and root planning (SRP). 8- Hydroxydeoxyguanosine (8-OHdG) is best documented biomarker of oxidative stress in periodontitis. Objective: To evaluate the efficacy of locally delivered Ocimum sanctum gel by assessing the levels of 8-OHdG in Gingival crevicular fluid (GCF) of smokers and nonsmokers with periodontitis. Material and Methods: The study included 50 patients divided into 3 groups, group I - periodontally healthy, group II- smokers with stage II periodontitis and group III- non-smokers with stage II periodontitis. Smokers and non-smokers with stage II periodontitis received the locally delivered 10% OS gel as an adjunct to SRP at the test site at baseline and after 1 week recall, while SRP alone at control site. Result: 8-OHdG GCF levels were analyzed with enzyme-linked immunosorbent assay (ELISA) at baseline, and 6-months follow up. Probing pocket depth (PPD) in test site significantly reduced to 2.75 ±0.64, 2.50 ±0.68 at 6 month after periodontal therapy in group 2 and 3 respectively. Similarly, clinical attachment level (CAL) in test site significantly reduced to 3.15 ±0.81, 2.85 ±0.93 at 6 month after periodontal therapy in group 2 and 3 respectively. Conclusion: The application of 10% Ocimum sanctum L. gel showed significant improvement in PPD, CAL and PI and GI and reduction in GCF 8-OHdG levels.

Clinical And Radiographic Assessment Of Autogenous Dentin Nanoparticles In Treatment Of Stage Iii Periodontitis: A Split-Mouth Clinical Study.

To compare autogenous dentin nanoparticles with allograft bone grafts in the treatment of stage III periodontitis. The randomised study was conducted at the Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Kafrelsheikh University Hospital, Egypt, from January 2021 to January 2022, and comprised adult patients of either gender with stage III periodontitis. Each patient's bilateral intrabony defect was randomly treated with an allograft on one side and a graft made of dentin nanoparticles on the testside. Each patient'sremoved tooth was ground into these nanoparticles. Both groups had their probing pocket depth and clinical attachment loss evaluated at baseline and six months aftersurgery. Additionally, digital periapical films were collected in both groups at baseline and six months after therapy to assess vertical bone loss. Data was analysed using SPSS 20. Of the 20 patients, 8(40%) were males and 12(60%) were females with overall mean age 31.00±4.06 years(range: 18-50 years). Of the 40 sites, 20(50%) each were in test and control groups. Compared to baseline values, both groups showed significant improvement in probing pocket depth, clinical attachment loss and vertical bone loss post intervention (p<0.05). There was no significant difference between the postoperative outcomes of the two groups(p>0.05). Autogenous dentin nanoparticles were found to be an effective and promising biomaterial for bone regeneration in intrabony defects. NCT05258006 link: https://clinicaltrials.gov/ct2/show/NCT05258006, Registration date of the Trial 10/2/2022.

A comparative study of demineralized freeze-dried bone allograft alone and with 1% metformin in the treatment of intrabony defects in patients with chronic periodontitis: A randomized clinical trial.

Periodontal disease is ubiquitous and its treatment requires a detailed treatment plan. Biomaterials are often used along with demineralized freeze-dried bone allograft (DFDBA) for periodontal regeneration. One percent metformin has evolved as a regeneration material. This study was initiated to assess and compare the regenerative potential of DFDBA alone and with 1% metformin in the treatment of intrabony defects in subjects with chronic periodontitis. 20 sites with intrabony defects were diagnosed of which 10 were assigned to Group A (1% Metformin + DFDBA) and 10 to Group B (DFDBA alone). Clinical parameters were measured at baseline, 3, 6, and 9 months postoperatively, whereas radiographic parameters were measured at baseline and 9 months postoperatively, and data were statistically analyzed. Both the groups showed a statistically significant improvement in probing pocket depth and relative attachment level at 9 months. Radiographically, a statistically significant reduction in defect depth was seen in both the groups at 9 months. There was no statistically significant difference between the two groups as far as crestal bone loss is concerned. No statistically significant difference was seen for clinical and radiographic parameters between the test and control groups. The addition of 1% metformin to DFDBA did not have any additional benefits in the treatment of subjects with defects which are intrabony.

Outcome of Combined Periodontal-Orthodontic Treatment of Pathologic Tooth Migration: A Longitudinal Study

Introduction: A number of periodontal bone abnormalities, most of which are horizontal, have been associated with flared and long incisors. Individuals with anterior incisor displacement and periodontal disease may benefit from orthodontic-periodontal therapy. Objective: To determine the outcome of combined periodontal-orthodontic treatment of pathologic tooth migration Study design: A longitudinal study Place and Duration: This study was conducted at Rehman college of dentistry Peshawar, Pakistan from February 2022 to July 2022 Methodology: A 4-person team designed the study's procedures. On 56 maxillary incisors with horizontal bone anomalies, this surgery was performed to remove circumferential supracrestal fibrotomy and orthodontic-periodontal therapy. To compensate for the angular bone shortage in front teeth treated with orthodontics, guided tissue regeneration and periodontal regenerative surgery were performed. Before, throughout, and six months after guided tissue regeneration treatment (T1), cone-beam computed tomography images were done (T2). At each of the first three time points, the depth of the probing pocket and the degree of clinical attachment loss were determined. Paired t-tests were used to analyse the data. Results: Clinical attachment loss decreased by 0.28 mm from T0 to T1 (P &lt;0.05). The distance between the cementoenamel junction and the bone top decreased by 0.65 mm (P &lt;0.05). Alveolar bone thickness decreased by 0.45 mm on both the lingual and labial sides of the bone (P&lt;0.05). Bone anomalies in some teeth have been converted from horizontal to vertical. From T1 to T2, radiographic testing revealed a 2.16 mm vertical and 1.45 mm horizontal bone redeposition (P&lt;0.05), as well as improvements in probing pocket depth and clinical attachment loss (P&lt;0.05). During combination therapy, the cementoenamel distance decreased from 2.10 mm to 1.31 mm (P &lt;0.05). Conclusion: We were able to address periodontal diseases caused by improper bone implantation by combining orthodontic and periodontal treatment. By altering the bone structure, it is possible to improve the outcome of directed tissue regeneration following orthodontic invasion with fibrotomy. Keywords: orthodontic and periodontal treatment, outcome, bone implantation, Periodontal disease

Efficacy of the Adjunct Use of Povidone-Iodine or Sodium Hypochlorite with Non-Surgical Management of Periodontitis: A Systematic Review and Meta-Analysis.

This systematic review sought to assess the efficacy of combining either sodium hypochlorite or povidone-iodine as disinfection solutions with non-surgical treatment of periodontitis. An electronic search was conducted through PubMed, Scopus, Web of Science, CENTRAL, and Google Scholar from inception until 10 September 2022. Outcomes included clinical outcomes (probing pocket depth, plaque index, clinical attachment level, relative-horizontal attachment level, bleeding on probing, gingival recession, the position of gingival margin) and biochemical (BAPNA level) properties. A subgroup analysis was conducted according to the assessment timepoint. Ten studies reporting the use of povidone-iodine and five studies reporting the use of sodium hypochlorite were included in this review. Overall, in the meta-analysis of povidone-iodine, no significant changes were noted in any of the assessed outcomes; however, minor changes were noted in probing pocket depth and clinical attachment level at a specific timepoint. Regarding sodium hypochlorite, a significant reduction in all clinical outcomes, except for bleeding on probing, was noted. In conclusion, the use of povidone-iodine does not result in an improvement in clinical outcomes, whereas sodium hypochlorite has promising properties that result in significant improvement in probing pocket depth and clinical attachment level. However, more studies are needed to confirm these observations.

Differences in periodontal parameters between SPT patients who regularly and irregularly visited the dental clinic analyzed at tooth level: a 14-year retrospective cohort study.

The purpose of this study was to evaluate the periodontal status of patients who routinely did SPT, when compared to patients that did not SPT. This retrospective cohort study was conducted at a general dental office from 2001 to 2019. Patients aged 18 to 81years who visited the dental office over a 10-year period were assigned into two groups: an SPT group, which included patients who continually visited the dental office for SPT one or more times every year, and an irregular group, consisting of patients who did not visit the dental office at least once a year. A total of 7307 teeth (SPT group) and 4659 teeth (irregular group) were evaluated, and the periodontal conditions were compared between the first and latest visits. Multiple regression analysis was used to analyze the results. The mean follow-up time was 13.74years. The risk factors for improvements in probing pocket depth included age, sex, smoking, diabetes mellitus, molar tooth, and irregular SPT group (p < 0.001), and that for a positive bleeding on probing site was the irregular group (odds ratio 2.94; 95% confidence interval 2.63-3.29). This study showed that lack of routine in attending the SPT program significantly decreased the periodontal parameters, thus highlighting the importance of continuing with the program to maintain the periodontal health.

Effects of artificial intelligence-assisted dental monitoring intervention in patients with periodontitis: A randomized controlled trial.

To evaluate the effects of an at-home artificial intelligence (AI)-assisted dental monitoring application on treatment outcomes in patients with periodontitis. Participants with periodontitis were recruited and randomly assigned to an AI (n=16), AI and human counselling (AIHC; n=17), or control (CG; n=20) group. All participants received non-surgical periodontal treatment. We employed an AI-assisted tool called DENTAL MONITORING® (DM) intervention, a new technological AI monitoring product that utilizes smartphone cameras for intra-oral scanning and assessment. Patients in the AI and AIHC groups received additional (a) DM or (b) DM, respectively, with real-person counselling over 3 months. Periodontal parameters were collected at baseline and follow-ups. A mixed-design model analysed the follow-up effects over time. The AI and AIHC groups, respectively, exhibited greater improvement in probing pocket depth (PPD) (mean diff=-0.9 ± 0.4 and -1.4 ± 0.3, effect size [ES]=0.76 and 1.98), clinical attachment level (mean diff=-0.8 ± 0.3 and -1.4 ± 0.3, ES=0.84 and 1.77), and plaque index (mean diff=-0.5 ± 0.2 and - 0.7 ± 0.2, ES=0.93 and 1.81) at 3-month follow-up than the CG did. The AIHC group had a greater reduction in PPD (ES=0.46) and clinical attachment level (ES=0.64) at the 3-month follow-up compared with the AI group. Using AI monitoring at home had a positive effect on treatment outcomes for patients with periodontitis. Patients who received AI-assisted health counselling exhibited better treatment outcomes than did patients who received AI monitoring alone.

Comparative Evaluation of 980-nm Diode Laser Therapy as an Adjunct to Scaling and Root Planing Versus Scaling And Root Planing Alone In Diabetic Patients With Chronic Periodontitis

Background The objective of the current study was to evaluate the clinical effects of multiple applications of a 980nm diode laser with scaling and root planing treatments SRP versus the effects of SRP alone in diabetic patients.Methods Thirty patients with moderate chronic periodontitis and fasting blood sugar levels above 140 mmol dl were selected for the split-mouth clinical study. After SRP quadrants were equally divided between the right and left sides. SRP was done in two control quadrants control groups CG and the diode laser was used adjunctively with SRP in two contralateral quadrants laser groups LG on the 1st 3rd and 7th day. Clinical parameters including plaque index PI sulcus bleeding index SBI probing pocket depth PPD and clinical attachment level CAL were recorded at baseline 6 and 12 weeks after the treatment.Results Both groups showed highly significant results in all the clinical parameters at day 1 to 6 weeks P lt0.001 and day 1 to 12 weeks P lt0.001 period. A significant difference in probing pocket depth was observed from baseline to 12 weeks Plt0.05 in the laser group compared to the control group.Conclusion The current study showed significant improvement in probing pocket depth in diabetic patients treated with SRP and laser when compared to SRP alone

Influence of aging on periodontal regenerative therapy using enamel matrix derivative: A 3‐year prospective cohort study

To investigate the influence of chronological aging on periodontal regenerative therapy (PRT) outcomes with enamel matrix derivative (EMD). In total, 253 intra-bony defects (151 patients) including 44 furcation involvement were prospectively investigated for 3 years after regenerative therapy with EMD by evaluating probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone defect depth (RBD). The influence of age on these outcomes was assessed using multilevel regression analyses adjusting for confounders. Participants' mean age was 55.9 ± 12.3 years (range: 22-85). Baseline PPD, CAL, and RBD were 6.14 ± 1.82, 7.22 ± 2.14, and 5.08 ± 2.04 mm, respectively. Significant improvement was observed with PPD reductions of 2.84 ± 1.73 and 2.87 ± 1.87 mm, CAL gains of 2.40 ± 1.87 and 2.47 ± 1.89 mm, and RBD gains of 1.76 ± 1.98 and 2.39 ± 2.41 mm at 1- and 3-year examinations, respectively. At the 1-year examination, multivariate analysis revealed a significant negative association between age and improvement in PPD and CAL (coefficients: -0.13, -0.23 mm per 10 years). However, by the 3-year examination, no significant association was noted between age and improvement in PPD, CAL, or RBD. Although the statistical difference was detected with age at 1-year examination, PRT with EMD significantly improved clinical outcomes on long-term observation, irrespective of the patient's age. UMIN000039846.

Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis.

This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes. PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen's kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta-analysis. The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16mm, p<0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non-significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients. Erythritol powder air-polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation. Erythritol powder air-polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.

Efficacy of Erbium:YAG Laser for Regenerative Surgical Treatment of Peri-implantitis: Clinical, Microbiological, and Biomarker Analyses.

This paper reports on a study undertaken to ascertain the efficacy of the erbium:YAG laser (EYL) for peri-implantitis treatment. A total of 12 patients with bone loss resulting from peri-implantitis were involved in this study. The treatment protocol consisted of using the EYL for implant surface debridement and deproteinized bovine bone mineral (DBBM) for bone grafting. The following parameters were analyzed: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), bone levels (BLs), and the lipopolysaccharide levels before and after debridement with the EYL. This study found a statistically significant improvement in PPD, CAL, BOP, and BL at 3 and 12 months postoperative. Furthermore, a statistically significant decrease in implant-surface LPS levels was observed following debridement with the EYL. These findings show that using the EYL for debridement in peri-implantitis cases is effective in decreasing LPS levels. Moreover, after partial reconstruction with DBBM grafting, BLs were restored for at least 12 months. It was shown in one case that BLs had remained stable over 6 years, which also attests to the efficacy of this treatment. The combined use of EYL and DBBM could be effective for regenerative surgical peri-implantitis treatment.

Effects of adjunctive light-activated disinfection and probiotics on clinical and microbiological parameters in periodontal treatment: a randomized, controlled, clinical pilot study

ObjectivesThe aim of this pilot study was to evaluate the clinical and microbiological outcomes of light-activated disinfection (LAD) alone or combined with probiotics as an adjunct to non-surgical periodontal treatment.Materials and methodsIn this single-blinded, randomized, controlled clinical pilot study, 48 patients (28 females and 20 males) with untreated periodontitis (stages II and III, grade B) were included. Using a parallel-group design, patients were randomly assigned into 3 groups to receive subgingival debridement (SD) alone (group 1, n = 16), SD with LAD (group 2, n = 16), or SD with LAD plus probiotic treatment (group 3, n = 16). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), gingiva-index simplified (GIs), plaque-control record (PCR), and subgingival microbiological samples were analyzed at baseline, 3 months, and 6 months of follow-up.ResultsAll treatment modalities demonstrated clinical improvements in PPD and CAL at 6 months compared to baseline but without a statistical significant difference between the groups. The combination of SD + LAD + probiotic treatment (group 3) demonstrated significantly greater reductions in BOP, GIs, and red complex bacteria P. gingivalis and T. forsythia compared with other groups at 6 months (p < 0.05).ConclusionsA single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone. The combination of SD + LAD + probiotic treatment in group 3 led to further improvements of the inflammatory parameters.Clinical relevanceThe additional use of probiotics in periodontal treatment can be a useful approach to support inflammation and infection control of periodontal tissues. Further studies are necessary to determine the extent of added benefit for this treatment approach.

Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial

BackgroundThe aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis.MethodsForty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated.ResultsAll 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups.ConclusionThe use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.Trial registrationNCT02839408, 10/28/2017, Clinicaltrial.gov.