Mechanical Debridement Research Articles

Efficacy of Cissus Quadrangularis (Hadjod) Used Locally, Systemically and combination of both as an Adjunct to Osteon II and PRF in Class II Furcation Defects: A Protocol for Clinical and Radiographic Study

Introduction: When there is significant furcation involvement, mechanical debridement without surgery can cause the disease to progressively worsen. To halt the disease process, surgery allows for odontoplasty, root debridement, osseous recontouring, and periodontal regeneration while preserving periodontal attachment. Need of the Study: In cases of furcation deficiencies, periodontal regeneration with different bone grafts is an effective method to both replace lost bone tissue and slow down the progression of the disease. In osseous abnormalities, the additive actions and features of Cissus Quadrangularis (CQ) demonstrate improved healing. Thus, the purpose of present clinical trial is to determine whether the combination of CQ, when utilised locally and systemically, is efficacious for the management of Class II furcation defects. Aim: To evaluate and compare the efficacy of CQ (Hadjod) used locally, systemically, and in combination as an adjunct to osteon II with Platelet Rich Fibrin (PRF) for the management of Class II furcation defects. Methodology: A randomised clinical trial will be conducted in the Department of Periodontics at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, Maharashtra, India from April 2024 to March 2026. A total 60 systemically healthy individuals with Class II furcation invasions, either buccal or lingual, and moderate to severe chronic periodontitis will be selected. The study population will be categorised into three interventional groups and one control group as follows: Group A: Control group (n=15) will be treated with osteon II + PRF membrane + antibiotic coverage for Class II furcation defects, Group B: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) for Class II furcation defects + antibiotic coverage, Group C: (n=15) will be treated with osteon II + PRF membrane + systemic dosage of CQ for Class II furcation defects + antibiotic coverage, Group D: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) + systemic dosage of CQ for Class II furcation defects + antibiotic coverage. The data will be analysed and calculated using the Student’s t-test, with a significance level of less than 0.05.

Evaluating the potency of laser-activated antimicrobial photodynamic therapy utilizing methylene blue as a treatment approach for chronic periodontitis.

Chronic periodontitis is a ubiquitous inflammatory disease in dental healthcare that is challenging to treat due to its impact on bone and tooth loss. Conventional mechanical debridement has been challenging in eliminating complex subgingival biofilms. Hence, adjunctive approaches like low-level laser antimicrobial photodynamic therapy (A-PDT) utilising methylene blue (MB) have been emerging approaches in recent times. This review evaluates the latest research on the use of MB-mediated A-PDT to decrease microbial count and enhance clinical results in chronic periodontitis. Studies have shown the interaction between laser light and MB generates a phototoxic effect thereby, eliminating pathogenic bacteria within periodontal pockets. Moreover, numerous clinical trials have shown that A-PDT using MB can reduce probing depths, improve clinical attachment levels, and decrease bleeding during probing in comparison to traditional treatment approaches. Notably, A-PDT shows superior antibiotic resistance compared to conventional antibiotic treatments. In conclusion, the A-PDT using MB shows promise as an adjunctive treatment for chronic periodontitis. Additional research is required to standardize treatment protocols and assess long-term outcomes of A-PDT with MB in the treatment of periodontitis.

Management of peri-implantitis using local drug delivery among Indian patients.

It is of interest to compare 0.2% chlorhexidine gel, 0.2% chlorhexidine chip, minocycline microspheres and slow-release doxycycline gel and tetracycline fibers as drug delivery systems in the management of peri-implantitis. The study comprised of 105 Indian participants who had a minimum of one dental implant with a probing depth of 4 mm, along with exudate and/or bleeding upon probing along with the presence of potentially harmful germs. The use of minocycline microspheres and 0.2% chlorhexidine gel resulted in significant improvements in probing depths at 1 month, 3 months and 6 months and all treatments showed decline in the indicator bacteria. Thus, minocycline microspheres and 0.2% chlorhexidine gel is useful as an adjuvant for mechanical debridement in management of peri-implantitis.

Probiotic Effect on Periodontal Disease: A Meta-Analysis Study

Periodontal disease remains a major worldwide oral health problem, affecting about 538 million people all around the globe. It is caused by changes in local microflora inhabiting the plaque biofilm from Gram-positive to Gram-negative facultatively anaerobic bacteria, destroying the periodontal membrane and surrounding alveolar bone. Mechanical debridement of biofilm and antibiotics has been used as conventional therapy for gingivitis and periodontitis. However, the uncertain efficacy of the current treatment leads to using probiotics as a promising strategy to combat the periodontal pathogen. An antibiotic application might contribute to antimicrobial resistance and environmental pollution due to non-degradable residue. Probiotics could be an alternative treatment for periodontal disease. This meta-analysis study aims to assess the potential of probiotic bacteria to reduce the magnitude of the inflammatory response, especially in the pro-inflammatory cytokines. Electronic databases such as Google Scholar, Science Direct, and PubMed were used to search for related articles up to May 2021. Randomized Controlled Clinical Trials (RCTs) or controlled clinical trials were included in the study, whereby the concentration of IL-1β and TNF-α were chosen as the main outcome variables. Independent screening resulted in four eligible publications being included in the meta-analysis. However, the overall mean difference for the concentration of IL-1β (MD: -0.32; 95% CI: -1.88, 1.25; P = 0.69) and TNF-α (MD: 0; 95% CI: -0.20, 0.20; P= 0.98) did not show any statistical significance difference between probiotic and placebo groups. Therefore, the study results demonstrated weak evidence to support the usage of probiotics in reducing the magnitude of inflammatory response in patients with periodontal disease. Smaller sample sizes and limited available data may contribute to this conclusion. Hence, future randomized controlled clinical trials with larger sample sizes and a longer intervention period must be considered to evaluate the efficacy of probiotics in periodontal disease.

Fibroblast Viability Through Mechanical and Chemical Root Surface Modifications in Periodontal Healing: An In Vitro Comparative Study.

The wound-healing process incorporates a spectrum of periodontal therapeutic interventions that strive to restore the health and function of the periodontium. Fibroblasts play pivotal roles in tissue repair and regeneration. Extensive research has been focused on mechanical and chemical root surface modifications to enhance fibroblast adhesion, which is crucial for successful wound healing. This study aimed to assess the combined efficacy of mechanical and chemical root surface modifications in promoting fibroblast viability to root surfaces affected by periodontitis in comparison to chemical modifications alone. Root samples were collected from healthy individuals and those with advanced periodontitis. The specimens were prepared, and the experimental groups were categorized based on the type of surface modification with mechanical and/or chemical materials, including hyaluronic acid (HA), ethylenediaminetetraacetic acid(EDTA), enamel matrix derivatives (EMD), and EDTA/EMD. Fibroblasts were seeded onto previously treated root samples. Cell adhesion was assessed using a viability assay. Fibroblast viability was significantly higher on root surfaces treated with chemical agents than on those treated with mechanical and chemical modifications. Long-duration EDTA and short-duration EMD treatments were significantly effective in enhancing cell viability. EDTA/EMD surface treatments resulted in significantly higher cell viability in all groups compared to the periodontitis root surfaces. EDTA, EMD, and their combined application can potentially ameliorate periodontitis-induced surface structural impairments. Mechanical surface debridement can significantly affect the effectiveness of EDTA and EMD root conditioning agents.

Ozonized gels vs chlorhexidine in non-surgical periodontal treatment: A randomized clinical trial.

To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split-mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine-based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone-based gels. After the baseline assessment, the follow-up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine.

Substantiation of tactics of chronic wound bed preparation at various stages of the infectious process on the basis of the analysis of the results of microbiological, clinical and morphological parameters

The chronic wounds (CW) bed preparation requires an integrated approach using wound assessment, microbiological and histological analysis, which will avoid skin graft failure.The aim was to evaluate the possibility of using microbiological and morphological parameters of CW assessment to substantiate the choice of tactics of wound bed preparation to skin grafting (SG).Morphological and microbiological indicators of CW (n = 229) at various stages of the infectious process were analyzed. To prepare CW to SG, the following treatment methods were used: dressings, vacuum therapy (VT), mechanical debridement (MD), and ultrasound debridement (UD).The criteria that determine the possibility of CW preparation “under a bandage” in combination with MD are: the absence of inflammation signs and the normal state of granulations (red-pink color, firm and moist), a negative result of wound swabs, the histological result of Si 1/Si 2 and Sp 1/Sp 2. For CW performed with pathologically altered granulations colonized by potential pathogens and having Sp 3, Si 2/Si 3 criteria, the use of 2 UD procedures is indicated (1st in combination with MD, 2nd before SG), between which VT is applied. Critically colonized wounds showing the signs of Sp 3 in combination with Si 1 or Si 2, from which microorganisms are isolated in an amount of ≤105 CFU/ml and are characterized by persistent properties, are an indication for VT, which is performed between two UD procedures. Clinical infection signs, the presence of bright red friable and bulge granulations in the wound, morphological signs of Si 3/Si 2 and Sp 1/Sp 2 are indications for the use of 2 UD procedures in combination with systemic antibiotic therapy based on wound swab culture results.Microbiological and morphological parameters characterize the CW state at various stages of the infectious process (colonization, critical colonization, infection) and are recommended as criteria for choosing tactics for wound bed prepara tion to SG.

The Microbiome of Peri-Implantitis: A Systematic Review of Next-Generation Sequencing Studies.

(1) Introduction: Current evidence shows that mechanical debridement augmented with systemic and topical antibiotics may be beneficial for the treatment of peri-implantitis. The microbial profile of peri-implantitis plays a key role in identifying the most suitable antibiotics to be used for the treatment and prevention of peri-implantitis. This systematic review aimed to summarize and critically analyze the methodology and findings of studies which have utilized sequencing techniques to elucidate the microbial profiles of peri-implantitis. (2) Results: Fusobacterium, Treponema, and Porphyromonas sp. are associated with peri-implantitis. Veillonella sp. are associated with healthy implant sites and exhibit a reduced prevalence in deeper pockets and with greater severity of disease progression. Streptococcus sp. have been identified both in diseased and healthy sites. Neisseria sp. have been associated with healthy implants and negatively correlate with the probing depth. Methanogens and AAGPRs were also detected in peri-implantitis sites. (3) Methods: The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023459266). The PRISMA criteria were used to select articles retrieved from a systematic search of the Scopus, Cochrane, and Medline databases until 1 August 2023. Title and abstract screening was followed by a full-text review of the included articles. Thirty-two articles were included in the final qualitative analysis. (4) Conclusions: A distinct microbial profile could not be identified from studies employing sequencing techniques to identify the microbiome. Further studies are needed with more standardization to allow a comparison of findings. A universal clinical parameter for the diagnosis of peri-implantitis should be implemented in all future studies to minimize confounding factors. The subject pool should also be more diverse and larger to compensate for individual differences, and perhaps a distinct microbial profile can be seen with a larger sample size.

Oxygen‐Free Polycationic Photosensitizers for Treatment of Periodontal Inflammation

AbstractPeriodontal tissue infection is a chronic destructive inflammatory disease caused by bacteria including anaerobes and facultative anaerobes. Traditional mechanical debridement and antibiotic treatments are not effective at removing biofilm from the root surface, resulting in recurrent disease. Antimicrobial photodynamic therapy (aPDT) is a promising bactericidal method, but it is limited by oxygen content. Here, an oxygen‐free cationic polymer (HQRB‐SS‐Dex) containing the photosensitizer rose bengal (RB) and dextran is proposed. It releases both 1O2 and HO•, and it exhibits strong antibacterial efficiency against periodontal pathogenic bacteria under irradiation. The positively charged quaternary ammonium polymer and dextran of HQRB‐SS‐Dex facilitate adherence to the bacterial surface and penetration of the bacterial biofilm to permit efficient use of reactive oxygen species. Disulfide bonds make the complex biodegradable, which improves biosafety. This work presents a unique branched cationic polymer for oxygen‐free aPDT, with potential application to the treatment of periodontal infection.

Decontamination and Repair Protocol Promotes Positive Outcomes in Implants Affected by Peri-implantitis: A Human Case Series.

This study assessed the effectiveness and predictability of a readily available protocol to treat peri-implantitis utilizing mechanical debridement, chemical antiseptic surface detoxification, and osseous grafting. Nine patients (7 women, 2 men; mean age: 56.5 years) with 15 implants with peri-implantitis were included. Pocket probing depth (PPD), bleeding on probing (BOP), and standardized digital periapical radiographic measurements were taken. Surgical flaps were elevated, and the implant threads were cleaned with a plastic curette. Chemical decontamination was performed by scrubbing solutions of 0.25% sodium hypochlorite (NaClO) and 1.5% hydrogen peroxide (H2O2) around the exposed implant using cotton pellets. Bony defects were filled with a 50/50 mixture of bovine hydroxyapatite and nanocrystalline calcium sulfate (CaSO4). A porcine collagen membrane was placed over the grafted bony defect. Follow-up appointments were scheduled 1 week, 2 weeks, 3 months, 6 months, 9 months, and 1 year posttreatment. Clinical and radiographic parameters were assessed and compared. At baseline, PPD ranged from 5 to 7.5 mm (mean: 6 ± 0.7 mm). At 12 months, PPD ranged from 1.5 to 4.2 mm (mean: 2.5 ± 0.8 mm). The mean PPD reduction of 3.6 mm (59.2%) was statistically significant (P < .001). The number of bleeding sites around each test implant decreased significantly from 4 to 0.4 sites between baseline and 12 months (P < .001). Mean radiographic bone loss decreased from 4.8 ± 1.3 mm to 2.7 ± 1.2 mm (P < .001). The proposed method of mechanical decontamination, chemical detoxification, and bone regeneration is clinically effective and reproducible. Clinical peri-implant parameters and radiographic bone levels were improved and maintained their stability for 1 year using this peri-implantitis treatment protocol.

Mechanical Epithelial Debridement versus Transepithelial Phototherapeutic Keratectomy Followed by Accelerated Corneal Collagen Crosslinking for Progressive Keratoconus.

To compare the visual and topographic outcomes between mechanical epithelial debridement followed by accelerated corneal collagen cross linking (CXL) vs. transepithelial phototherapeutic keratectomy followed by accelerated CXL for treatment of progressive keratoconus. Quasi experimental study. Place and Duration of the Study: Armed Forces Institute of Ophthalmology (AFIO), National University of Medical Sciences, Rawalpindi, Pakistan, from December 2020 to December 2021. On the basis of surgical technique used, patients were divided into two groups, Group A comprising of twenty eyes that underwent mechanical epithelial removal followed by accelerated CXL, and Group B comprising of twenty-two eyes that underwent transepithelial phototherapeutic keratectomy (t-PTK) followed by accelerated CXL. All variables were recorded preoperatively and 6 and 12 months postoperatively and included uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), MRSE (manifest refraction spherical equivalent), and keratometric indices (flat K, steep K, Kmax , mean K, thinnest pachymetry, KPI, K prob, CLMIaa, and I-S). Forty-two eyes of twenty-nine patients were included in the study and were divided into two groups; Group A (mechanical epithelial removal followed by accelerated CXL) and Group B (t-PTK followed by accelerated CXL). The visual acuity improved in both the groups at 6 and 12 months, with more significant improvement in Group B in both UCVA (p=0.005) and CDVA (p=0.004) parameters. Keratometric outcomes showed significant differences in median values for flat K (p=0.048) and thinnest pachymetry (p=<0.001) in Group A, while significant difference in Kmax (p=0.024) and thinnest pachymetry (p=<0.001) in Group B. At 6 and 12 months, the CLMIaa, PPK, and I-S values were significantly lower in Group B (p=0.002 for all three indices). Transepithelial PTK followed by accelerated CXL yielded better outcomes regarding visual acuity and keratomertic indices as compared to mechanical epithelial removal followed by accelerated CXL and did not show any significant decrease in corneal pachymetry. Mechanical, Corneal Collagen Crosslinking (CXL), Transepithelial, Phototherapeutic keratectomy, Keratoconus.

PAEDIATRIC-02 ROLE OF INTRAOPERATIVE INTRATUMORAL HYDROGEN PEROXIDE IN RESECTION OF SOLID BRAIN TUMORS: CASE SERIES AND BRIEF REVIEW OF LITERATURE

Abstract INTRODUCTION The use of Hydrogen peroxide (H2O2) has been reported in surgical literature as one of the best agents for irrigation during neurosurgical procedures for many years due to its purported effects on mechanical debridement and its antiseptic and haemostatic properties although its use has been similarly surrounded by persistent controversy. METHODS We report the intraoperative use of hydrogen peroxide injection in tumour resection among four paediatric patients with different solid brain tumours which included tuberculoma, diffuse B cell lymphoma, pilocytic astrocytoma and medulloblastoma. Following open craniotomy, 3mls of diluted 6% hydrogen peroxide were injected into the exposed solid tumour. The tumour became firmer and evidently more devascularized and this was followed with meticulous bipolar cauterization-resection of the tumour with the aim to achieve total resection. RESULTS Total tumour resection was achieved and the patients recovered uneventfully without any complications. None of the patients in our series developed gas embolism, dysrhythmias nor pneumocephalus. DISCUSSION Hydrogen peroxide irrigation is commonly utilised in neurosurgical procedures for its bactericidal and haemostatic effects. Although several authors have reported adverse complications in literature, we report the judicious safe use of H202 in tumour resection without adverse effects. CONCLUSION The authors report the safe use of intratumoral hydrogen peroxide in resection of solid tumours with aiding control of blood loss and improving resectability. Close observation by the anaesthesiology team is paramount for early detection of gas embolism to avoid adverse outcomes

Efficacy of phthalocyanine dye in antimicrobial debridement by photodynamic therapy as an adjunct to mechanical management of peri-implantitis: an in vitro study

Objective: The aim of the present in vitro study was to evaluate the efficacy of phthalocyanine dye in photodynamic therapy (PDT) as an adjunct to mechanical debridement in the management of peri-implantitis. Methods: S. aureus, F. nucleatum, and P. gingivalis were coated on titanium (Ti) discs and divided into control and test groups. In the control group, mechanical debridement + laser was performed, while in the test group, PDT with hydroxyaluminium phthalocyanine (AIPcOH) dye as photosensitizer was used. Bacterial colony counts and surface hardness were assessed post-operatively. Results: There was a significant difference in the bacterial count reduction at different time intervals in the test group (p=0.01) compared to the control group; no significant difference was observed in surface hardness (p=0.7). Conclusion: This present in vitro study concluded that PDT with AIPcOH dye was effective in eradicating S. aureus, F. nucleatum, and P. gingivalis on Ti discs. This study also concluded that PDT with a photosensitizer can be used as an adjunct in the management of peri-implantitis.

Anti-infective Efficacy of Mechanical Debridement with Adjunctive Modalities on Clinical and Cytokine Parameters in Treatment of Chronic Periodontitis: Randomized Controlled Clinical Trial.

Periodontal debridement involves conventional scaling and root planing (SRP) along with variant forms of adjunctive therapies. In the present clinical trial, we investigated if the adjunctive use of HybenX gel or diode laser along with SRP could provide a favorable outcome for the treatment of chronic periodontitis. The present study involved 60 subjects diagnosed with chronic periodontitis who were randomly assigned as test groups (laser or HybenX) or control group (SRP alone). The primary outcomes of the clinical trial were pocket probing depth (PPD) and clinical attachment level (CAL), which was evaluated at baseline and at third-month time interval. Additionally, secondary outcomes included estimation of reduction in inflammatory mediators interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in gingival crevicular fluid using enzyme-linked immunosorbent assay at baseline and third-month intervals. Normality determination was checked using Shapiro-Wilk test. Since the data was not normally distributed, nonparametric tests were applied. The comparison of clinical parameters between the groups was analyzed with Kruskal-Wallis test. Wilcoxon sign rank test was used to compare the pairwise comparison of clinical parameters among the groups from baseline to third-month follow-up. The inflammatory mediators at various time points were compared using a One-way analysis of variance test, and the inflammatory mediators in each study group were compared using a paired t-test. Both the test groups demonstrated a decrease in PPD and CAL. However, the HybenX group exhibited statistically significant reduction at the end of the third-month study interval compared to the laser group and SRP alone. Further, the secondary outcome IL-1β and TNF-α analysis exhibited statistically significant reduction in all the groups posttherapy. The adjunctive application of HybenX gel yielded an advantage compared to laser and SRP for the treatment of chronic periodontitis. Adjunctive use of the oral tissue desiccant (HybenX gel) combined with SRP improved the periodontal pocket disinfection process and enhanced tissue healing devoid of adverse effects.

Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis

BackgroundType 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes.MethodsPublications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected.ResultsTwo randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I2 = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I2 = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I2 = 0.00%, p = 0.47).ConclusionGiven that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.

The Impact of Mechanical Debridement Techniques on Titanium Implant Surfaces: A Comparison of Sandblasted, Acid-Etched, and Femtosecond Laser-Treated Surfaces.

This study evaluated the effects of various mechanical debridement methods on the surface roughness (Ra) of dental implants, comparing femtosecond laser-treated surfaces with conventionally machined and sandblasted with large-grit sand and acid-etched (SLA) implant surfaces. The fabrication of grade 4 titanium (Ti) disks (10 mm in diameter and 1 mm thick) and the SLA process were carried out by a dental implant manufacturer (DENTIS; Daegu, Republic of Korea). Subsequently, disk surfaces were treated with various methods: machined, SLA, and femtosecond laser. Disks of each surface-treated group were post-treated with mechanical debridement methods: Ti curettes, ultrasonic scaler, and Ti brushes. Scanning electron microscopy, Ra, and wettability were evaluated. Statistical analysis was performed using the Kruskal-Wallis H test, with post-hoc analyses conducted using the Bonferroni correction (α = 0.05). In the control group, no significant difference in Ra was observed between the machined and SLA groups. However, femtosecond laser-treated surfaces exhibited higher Ra than SLA surfaces (p < 0.05). The application of Ti curette or brushing further accentuated the roughness of the femtosecond laser-treated surfaces, whereas scaling reduced the Ra in SLA surfaces. Femtosecond laser-treated implant surfaces, with their unique roughness and compositional attributes, are promising alternatives in dental implant surface treatments.

Effect of Adjunctive Use of Probiotics in the Treatment of Peri-Implant Mucositis: A Systematic Review and Meta-Analysis

This review was performed to analyze evidence from the scientific literature of the adjunctive effect of probiotics in the treatment of peri-implant mucositis (PiM). Only randomized clinical trials evaluating the effect of probiotics as an adjunct to mechanical debridement in PiM were included. A search was performed in PubMed/MEDLINE, LILACS, ScienceDirect, and Web of Science to identify articles published in English up to January 2023. The quality of the studies was evaluated using the JADAD scale, and the risk of bias was assessed with the Cochrane Collaboration assessment tool. Of the 159 potentially relevant studies, only 9 studies were included. The most commonly used strain was Lactobacillus reuteri, and the meta-analysis was conducted on studies with a follow-up period of 3 to 6 months, observing an overall effect on the reduction of bleeding on probing (BOP) at 3 and 6 months (WMD = −1.13, 95% CI = −1.95 to −0.30, p = 0.007; and WMD = −1.32, 95% CI = −2.15 to −0.48, p = 0.002), plaque index (PI) at 3 months (WMD = −1.22, 95% CI = −2.25 to −0.19, p = 0.02), and probing pocket depth (PPD) at 3 and 6 months, which was statistically significant in favor of the probiotic group (WMD = −1.34, 95% CI = −2.42 to −0.25, p = 0.02 and WMD = −1.36, 95% CI = −2.61 to −0.11, p = 0.03). On the other hand, there were no significant changes in the subgingival microflora around the implants with the use of probiotics. Probiotic therapy, as an adjunct to mechanical debridement, promotes a greater reduction in BOP, PPD, and PI, in relation to the control group without probiotics.

Dental Drug Delivery System used in Periodontitis

Periodontitis, a condition affecting the teeth’s supporting structures, affects people of all ages, ethnicities, races, and genders. There is a well-established link involving microbial infection and the progression of gum diseases and tooth cavities. There are different types of periodontal diseases caused by microbial infection. Aggressive periodontitis can be localized or generalized. Periodontal infection has been successfully treated with antibacterial medicines. The effectiveness of mechanical plaque debridement and regular use of topical and systemic medicines is limited due to a lack of access to infecting organisms into the periodontal tissues. Systemically administered drugs achieve effective concentration at the infected area, but only for a small period, necessitating multiple doses over extensive periods of time. Antimicrobials delivered locally have being studied to see if they can overcome the limits of conventional therapy. Anti-bacterial is delivered using prolonged release formulations. Anti-bacterial is increasingly being delivered at the infection site (periodontal pocket) through sustained release formulations. This review discusses the main drug delivery system used in periodontal disease, their advantages and evaluations. The usage of collagen dental cones after an infected tooth has been extracted is also discussed in this review. Periodontal regeneration, soft-tissue restoration, and wound healing are all aided by dental cones containing antibacterial and biodegradable polymers.

Microenvironment-Responsive Metal-Phenolic Nanozyme Release Platform with Antibacterial, ROS Scavenging, and Osteogenesis for Periodontitis.

Periodontitis is a chronic inflammatory disease deriving from dental plaque, characterized by the excessive accumulation of reactive oxygen species (ROS), matrix metalloproteinase (MMP) and other substances, resulting in the destruction of periodontal tissues. At present, the main therapeutic modalities, such as local mechanical debridement and antibiotic delivery, are not only difficult to solve the intractable bacterial biofilm effectively but also tricky to ameliorate the excessive inflammatory response as well as regenerate the impaired periodontal tissues. Herein, we have proposed the TM/BHT/CuTA hydrogel system formed by the self-assembly of the copper-based nanozyme (copper tannic acid coordination nanosheets, CuTA NSs) and the triglycerol monostearate/2,6-di-tert-butyl-4-methylphenol (TM/BHT) hydrogel. The negatively charged TM/BHT/CuTA can retain at the inflammation sites with a positive charge through electrostatic adsorption and hydrolyze in response to the increasing MMP of periodontitis, realizing the on-demand release of the CuTA nanozyme. The released CuTA nanozyme has antibacterial and antiplaque properties. Meanwhile, as a metal-phenolic nanozyme, it can scavenge multiple ROS by simulating the cascade process of superoxide dismutase (SOD) and catalase (CAT). Further, the CuTA nanozyme can modulate the macrophage polarization from M1 phenotype to M2 phenotype through the Nrf2/NF-κB pathway, which reduces the pro-inflammatory cytokines, increases the anti-inflammatory cytokines, and promotes the expression of osteogenetic genes successively, thus relieving the inflammation and accelerating the tissue regeneration of periodontitis. Altogether, this multifunctional nanozyme on-demand release platform (TM/BHT/CuTA) provides a desirable strategy for the treatment of periodontitis.

Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study.

This retrospective study was designed to investigate the effectiveness of using a toothbrush, which is commonly used in our daily life, for biofilm removal and infection control in the treatment of spinal infections occurring after spinal fusion surgery. Currently, a biofilm is thought to form on the surface of the metal inserted during spine fusion surgery. We aim to determine the differences in clinical outcomes between using and not using a toothbrush to remove biofilm while performing conventional drainage, curettage, and debridement. A total of 1081 patients who underwent anterior or posterior spinal fusion surgery between November 2018 and October 2022 were screened. The study included 60 patients who developed surgical site infection and underwent incision and drainage surgery either with a toothbrush (n = 20) or without a toothbrush (n = 40). Failure of infection control that requires revision surgery occurred in 2 patients (10%) in the Toothbrush group and in 14 patients (35%) in the No-Toothbrush group (p = 0.039). Thus, the rate of additional surgery was significantly lower in the Toothbrush group. Additionally, normalization of c-reactive protein levels occurred significantly faster in the Toothbrush group (p = 0.044). Therefore, using a toothbrush to treat spinal infections following spinal fusion surgery appears to have beneficial mechanical debridement effects, resulting in improved clinical results, which were also confirmed based on the electron microscopic images.