One-stage Full-mouth Disinfection Research Articles

The impact of gingivitis reduction on lung function: a randomized trial under intensified oral hygiene

BackgroundPeriodontal disease and lung function impairment were found to be associated with low-grade systemic or local inflammation, and it might be that gingival/periodontal inflammation triggers lung function due to systemic inflammation or the transfer of oral bacteria or its components to the lung. A recent observational study in non-smoking subjects showed that lung volumes and flow rates were significantly reduced by 71–185 ml for severe gingivitis regardless of the adjustment for potential confounders. The result did not show any confounding by smoking, and the association between gingivitis and lower lung function was not modified by systemic inflammation. The designed interventional trial primarily aims to test the hypothesis that gingivitis reduction by optimized daily oral hygiene, professional tooth cleaning and antibacterial chlorhexidine (CHX)-containing mouth rinse improves lung function in terms of forced vital capacity (FVC) by at least 2%. The secondary objective will test the hypothesis that gingivitis reduction improves forced expiratory volume in 1 s (FEV1) and forced expiratory flow at 25–75% of the pulmonary volume (FEF25-75) by at least 2%. Furthermore, the influence of the oral microbiome will be taken into account.MethodsThe study has to include 120 non-smoking subjects aged between 18 and 30 years with biofilm-induced gingivitis. The chosen “waiting control group design” will compare the immediate intervention group with the delayed intervention group, which serves as a control group. Dental and gingival status, lung function and oral microbiome will be recorded. The intensified preventive intervention—professional tooth cleaning, one-stage full-mouth disinfection with CHX and safeguarding an optimal daily oral hygiene by each subject—cannot be blinded, but the outcome measurement in terms of lung function tests is blind.DiscussionThis proposed multidisciplinary study has several strengths. Only one previous intervention study with patients with severe periodontitis (mostly smokers) has been performed. It is novel to include non-smoking subjects with mild and potentially reversible oral inflammation. Furthermore, this research is innovative, because it includes evidence-based interventions for gingivitis reduction, standardized measures of the outcome on lung function and oral microbiome and combines expertise from dentistry, lung physiology, oral microbiology and epidemiology/statistical modelling.Trial registrationGerman Clinical Trial Register DRKS00028176. Registered on February 2022.

Periodontal therapy on the oral health-related quality of life of obese and non-obese individuals.

Oral diseases such as periodontitis can have a more negative influence on the quality of life of obese than in normal-weight patients. The objective of the present study was to assess the impact of one-stage full-mouth disinfection (OSFMD) therapy on the oral health-related quality of life (OHRQL) of obese and non-obese individuals with periodontitis. Fifty-five obese and thirty-nine non-obese patients were evaluated. The questionnaires oral impacts on daily performance (OIDP) and oral health and quality of life (OHQoL) were given to all patients at baseline and 6months after periodontal treatment by the OSFMD protocol. For statistical analysis, Chi-square, the two-factor repeated-measures ANOVA, and correlation tests were used. At baseline, mean global OHQoL and OIDP scores were similar for both groups (p > 0.05). At 6months, OSFMD resulted in OHQoL and OIDP global scores improvements in both groups (p < 0.05), with no significant difference between groups. The most impaired activity at baseline was eating and cleaning teeth for both groups. Periodontal parameters were associated with worse values in the OHQoL and OIDP questionnaires only in obese patients. In conclusion, OSFMD yielded similar improvements in overall OHRQL in both obese and non-obese individuals. Periodontal parameters were associated with a worse quality of life in obese patients. Periodontal treatment can be an important component to improve the OHRQL of obese individuals, and clinicians should expect similar results as those obtained with non-obese patients.

Salivary nitrite and systemic biomarkers in obese individuals with periodontitis submitted to FMD.

The objective of this 9-month clinical study is to assess the impact of one-stage full-mouth disinfection (FMD) on salivary nitrite levels and systemic biomarkers and its correlation with total subgingival bacterial load in obese and non-obese patients with periodontitis. In total, 94 patients (55 obese and 39 non-obese) were initially evaluated, seven were lost during follow-up, resulting in 87 individuals at the end of the study. Outcomes were assessed at baseline, 3, 6, and 9 months post periodontal treatment by FMD. Salivary nitrite levels were determined using Griess reagent. Blood samples were collected to determine C-Reactive Protein (CRP), alkaline phosphatase and fasting blood glucose. Real-time PCR was used to determine the total subgingival bacterial load. FMD protocol resulted in increased salivary nitrite levels at 6- and 9-months post-treatment in the non-obese group (p<0.05). In obese individuals, FMD treatment led to an increase in salivary nitrite levels at 6 months (p<0.05); however, at 9 months, the nitrite levels returned to baseline levels. For both groups, the highest nitrite values were observed at 6 months. In addition, in both groups, FMD was associated with a decrease in biomarkers related to systemic inflammation and cardiovascular diseases, such as CRP (p<0.05) and alkaline phosphatase (p<0.05), and had no impact on the fasting blood glucose. This study demonstrates that obese patients with periodontitis present similar salivary nitrite levels when compared with non-obese individuals. FMD protocol resulted in increases in salivary nitrite levels and was associated with a positive impact on systemic biomarkers, regardless of obesity status.

Comparative evaluation of the effectiveness of sodium hypochlorite and chlorhexidine in one-stage full-mouth disinfection treatment of patients with generalized aggressive periodontitis: A randomized controlled clinical trial

Background: One-stage full-mouth disinfection (OSFMD) may provide more effective treatment in generalized aggressive periodontitis (GAP) by targeting tissue-invasive bacteria. The present randomized, placebo-controlled, double-masked clinical trial aimed to compare the effectiveness of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) in OSFMD treatment of patients with GAP. Materials and Methods: Twenty-two patients were randomly allotted into two groups: Group 1 (Test): 11 patients receiving OSFMD with NaOCl gel and mouthwash and Group 2 (Control): 11 patients receiving OSFMD with CHX gel and mouthwash. Clinical measurements such as plaque index (PI), modified sulcus Bleeding Index (mSBI), probing depth (PD), and clinical attachment level (CAL) were measured at baseline and 6 months. Results: Both groups showed a nonsignificant difference. At 6 months, mean PI, mSBI, PD, and CAL for the NaOCl group were 0.47 ± 0.23, 0.42 ± 0.15, 2.85 ± 0.61, and 3.06 ± 0.67, respectively, as against 0.35 ± 0.17, 0.30 ± 0.13, 3.04 ± 0.66, and 3.35 ± 0.86, respectively, for the CHX group. Using Student's t-test, patients in Groups 1 and 2 demonstrated no significant difference (P > 0.05) at the end of 6 months. Conclusions: Both treatment modalities seemed to benefit the patients. Although NaOCl is a safe, effective, and inexpensive antiseptic, its short-term use as a mouthwash and gel, at 0.05% concentration, does not contribute to any added clinical benefits in comparison with CHX in GAP patients. Further clinical research is required for testing the longer periods of administration and/or higher concentrations to signify whether this antimicrobial may truly be used as a long-term chemical plaque control.

Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life

Statement of the Problem: Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose:This study sought to compare patients’ perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method:A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results:38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion: Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.

Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life.

Statement of the Problem Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose This study sought to compare patients' perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.

Six-month clinical outcomes of non-surgical periodontal treatment with antibiotics on apoptosis markers in aggressive periodontitis.

Extrinsic and intrinsic pathways of apoptosis are involved in generalized aggressive periodontitis (GAgP). The aim of this study was to evaluate 6-month clinical outcomes relative to apoptosis of one-stage full-mouth disinfection (OSFMD) and systemic antibiotics (SA) in the treatment of GAgP. Twenty-six patients with GAgP were included in this prospective follow-up intervention study. Gingival crevicular fluid (GCF) was collected from patients at baseline and 3 and 6months after periodontal therapy, which consisted of OSFMD and SA (amoxicillin and metronidazole, 500mg each for 7days). The levels of p53, caspase-3, TNF-α, TRAIL, IL-1β, and IL-10 in GCF were measured via ELISA. Periodontal parameters were improved at 3 and 6months compared to baseline (p<0.05). p53 was decreased up to 6months (p<0.05). TRAIL, TNF-α, and IL-10 were similar at baseline and 3 and 6months. Caspase-3 and IL-1β were decreased at 3months (p<0.05), but similar at 6months compared to baseline (p>0.05). Although OSFMD plus SA improves clinical periodontal parameters up to 6months, this treatment protocol differentially regulates the apoptosis markers caspase-3 at 3months and p53 at 6months without influencing TRAIL in GCF.

Comparative Evaluation of Two Different One-stage Full-mouth Disinfection Protocols using BANA Assay: A Randomized Clinical Study

The aim of this study was to evaluate and compare two different one-stage full-mouth disinfection protocols in the treatment of chronic periodontitis by assessing dental plaque and tongue coat using BANA assay. The present study was a prospective randomized clinical parallel arm study design including 40 healthy subjects randomly allocated into two groups, i.e., group A (Quirynen's protocol of one-stage full-mouth disinfection) and group B (Bollen's protocol of one-stage full-mouth disinfection). Subjects were assessed at baseline and six weeks using plaque index, gingival index, and sulcus bleeding index. Probing depth and relative clinical attachment level were also recorded at six weeks. Winkel tongue coat index and BANA were recorded at 8 weeks using subgingival plaque and tongue coat sample. Both group A and group B demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, Winkel tongue coat index, reduction in probing depth, and gain in relative clinical attachment level on intragroup comparison. There was no significant difference in BANA assay score of subgingival plaque and tongue coat samples in between group A and group B. From the findings of this study, both Quirynen's protocol and Bollen's protocol of one-stage full-mouth disinfection are effective in plaque reduction and tongue coat reduction and achieve comparable clinical healing outcomes. The difference in duration and mode of use of chlorhexidine as a chemical plaque control agent in the two treatment interventions of Quirynen's and Bollen's protocol of one-stage full-mouth disinfection did not demonstrate statistical significance in reducing sulcus bleeding index scores, reducing probing depths, and gain in relative clinical attachment levels.

Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future.

Background:Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was introduced. Over the years, several modifications to the full-mouth disinfection approach have been suggested.Objective:The purpose of this article is to review the evolution of full-mouth disinfection during the past 20 years, to specify its indications and to consider the prospects for this approach.Materials and Methods:An electronic and manual search of the literature, ending in December 2016, was performed by two independent researchers. Only pivotal studies and randomized controlled clinical trials published in the English language that evaluated a new approach to full-mouth disinfection were selected.Results:According to the studies included in our analysis (21 articles), several modified full-mouth disinfection protocols have been designed including: full-mouth treatment without chlorhexidine, the extension of hygiene methods and an increase in the duration of post-treatment chlorhexidine use, the replacement of chlorhexidine with other antiseptics, supplementation with antibiotics or probiotics, full-mouth antimicrobial photodynamic therapy and one-stage full-mouth disinfection combined with a periodontal dressing.Conclusion:Since 1995, several modifications have been suggested to improve the effectiveness of full-mouth disinfection. The majority of the studies demonstrate that the results obtained with full-mouth disinfection and its variants are equivalent to each other and to those obtained with the conventional quadrant method. Currently, the selection of this technique remains empirical and depends on the preferences of the practitioner and the patient. In the future, a patient-centered approach should be the best indication for the use of this technique.

Evaluation of Clinical Periodontal Indices and Serum Interleukin-27 by One-stage Full-mouth Disinfection and Quadrant Scaling and Root Planing in Periodontitis

One-stage oral disinfection technique has been developed to prevent cross-contamination between the treated and untreated areas between treatment sessions. Considering the role of inflammatory mediators in periodontitis, this study has been designed to compare the effects of one-stage oral disinfection with quadrant scaling and root planing (Q-SRP) on serum interleukin-27 (IL-27) levels in patients with moderate-to-advanced periodontitis. In this study, two groups were considered. One group was treated with one-stage full-mouth oral disinfection (FMD), while the other group was treated with Q-SRP. In each group, 20 patients with chronic periodontitis were randomly selected based on the inclusion criteria. To evaluate the periodontal status, the clinical parameters of bleeding on probing (BOP), clinical attachment level (CAL), and probing depth (PD) were measured before treatment as well as at 2- and 4-month intervals after treatment. At the same intervals, the immunological index of the study (serum IL-27) was measured by special laboratory kits. The data were analyzed using the Statistical Package for the Social Sciences, version 16 (SPSS 16) software. In this study, p-value < 0.05 was considered statistically significant. The results of this study indicate that there has been an elevation in the mean of serum IL-27 after treatment in both treatment groups. There is no significant difference between the levels of IL-27 in the FMD group during the study period (p = 0.20). All periodontal indices (BOP, CAL, and PD) show clinical improvement in each group (p < 0.001). However, no significant difference was observed in the improvement of periodontal indices of CAL and PD (p < 0.05). According to the findings of this study, it can be said that both FMD and Q-SRP improve the periodontal indices and increase the serum level of the inflammatory mediator IL-27 in patients with periodontitis. Considering the benefits of the FMD method, such as patient and dentist comfort, systemic effects, and its cost-effectiveness, use of this method is suggested in patients suffering from periodontitis.

One-stage Full Mouth Disinfection Using 20% Propolis Hydroalcoholic Solution: A Clinico-microbiologic Study.

Background:Propolis is a resinous substance produced by honeybees which has many therapeutic properties because of its unique composition. It has been widely used since many years for different medicinal purposes.Aim:The aim of this study was to investigate the effects of one-stage full mouth disinfection (OSFMD) using 20% propolis hydroalcoholic solution in chronic periodontitis patients.Materials and Methods:Thirty patients diagnosed with chronic periodontitis and presenting three or more nonadjacent teeth with deep pockets were selected for the study. Clinical parameters including gingival index, plaque index, bleeding on probing, probing pocket depth, and clinical attachment level were recorded at baseline in all the patients followed by subgingival plaque sampling. All the thirty patients were randomly allocated into two groups; 15 patients (control group) were subjected to scaling and root planning (SRP) alone, and in remaining 15 patients (test group), SRP was done followed by OSFMD using 20% propolis hydroalcoholic solution after 24 h. All the patients were kept at periodic recall, and clinical and microbiological parameters were again taken at 4 weeks and 12 weeks.Results:There was a significant improvement for all the clinical parameters, with higher probing depth reduction and attachment gain in the test group when compared to the control group. Furthermore, the microbiological counts of the periodontopathogens were found to decrease considerably more in the test group.Conclusion:SRP followed by OSFMD with propolis extract after 24 h was more effective than SRP alone in chronic periodontitis patients.

Effect of non-surgical periodontal treatment by full-mouth disinfection or scaling and root planing per quadrant in halitosis-a randomized controlled clinical trial.

The objective of this study was to compare the effect of one-stage full-mouth disinfection (FMD) and conventional quadrant scaling in four weekly sessions (QS) on periodontal clinical parameters and halitosis among individuals with advanced chronic periodontitis. In this randomized controlled clinical trial, 30 individuals were divided into two groups: FMD (n=15) and QS (n=15). The following data were collected at the baseline and 90days after treatment: plaque index, tongue-coating index (TCI), bleeding on probing, probing depth, and clinical attachment level. Halimetry was performed by the organoleptic method, and the levels of volatile sulfur compounds (H2S and CH3SH) were measured by gas chromatography. The Chi-square, Fisher's exact, the Mann-Whitney, the McNemar, and the Wilcoxon tests were used for statistical analysis. Both groups showed statistically significant improvements in periodontal clinical parameters, reduction in TCI, organoleptic scores, and in CH3SH levels between times. However, major reduction was observed in FMD group. Non-surgical periodontal therapy, regardless of the protocol, was effective in improving periodontal clinical status of individuals, decreasing organoleptic scores and CH3SH levels between times, as well as reducing halitosis. This study contributed to the knowledge that non-surgical periodontal therapy, whether by FMD or QS, was effective in reducing halitosis in individuals with advanced chronic periodontitis.

Scaling and Root Planing per Quadrant Versus One-Stage Full-Mouth Disinfection: Assessment of the Impact of Chronic Periodontitis Treatment on Quality of Life--A Clinical Randomized, Controlled Trial.

There are few randomized, controlled clinical trials about the effect of non-surgical periodontal treatment on oral health-related quality of life (OHRQL). This study aims to compare the effects of two different forms of non-surgical periodontal therapy, scaling and root planing (SRP) per quadrant and one-stage full-mouth disinfection (FMD), on periodontal clinical parameters and OHRQL of patients with chronic periodontitis. In this randomized, controlled clinical trial, the questionnaires Oral Impacts on Daily Performance (OIDP) and Oral Health and Quality of Life (OHQoL) were given to 90 patients divided into two groups: SRP (n = 45) and FMD (n = 45). Periodontal clinical parameters recorded included probing depth, clinical attachment level, plaque index, and gingival index. For statistical analysis, χ(2) test, Fisher exact test, Mann-Whitney U test, and Wilcoxon test were used. Intention-to-treat analyses were performed at T0 (baseline) for periodontal clinical parameters, T1 (30 days after treatment) for questionnaires, and T2 (180 days after treatment) for both. No significant differences were identified between the SRP and FMD groups in regard to OHQoL and OIDP scores when comparing the data of T1 and T2. Patients treated by both SRP and FMD showed improvement in all periodontal clinical parameters and OHRQL, with no significant differences between treatment groups.

Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial.

Conflicting data about the protocol of choice for non-surgical periodontal therapy with adjuvant use are still reported. This study aims to evaluate, through clinical and microbiologic parameters, the systemic use of azithromycin (AZ) and chlorhexidine (CHX) as adjuvants to non-surgical periodontal treatment performed by one-stage full-mouth disinfection (FMD) within 24 hours or conventional quadrant scaling (QS) in four weekly sections. In this randomized controlled trial, 85 patients diagnosed with chronic periodontitis underwent different treatment protocols, in six groups: three FMD groups and three QS groups, each with no adjuvants, with CHX, and with AZ. Clinical periodontal parameters were recorded, and total and quantitative bacterial counts of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Streptococcus oralis were measured with real-time polymerase chain reaction at baseline and 90 and 180 days after treatment. In all groups, a significant reduction was observed in the percentage of periodontal diseased sites, gingival index, plaque index, and clinical attachment level gain at 90 days, demonstrating effectiveness of the treatment, independently of the adjuvant. The FMD with CHX group showed higher reduction in probing depth and percentage of periodontal diseases sites, as well as lower total bacterial count, than all the other groups at 180 days. The adjuvant use of AZ did not provide any significant benefit, independently of the treatment protocol. The adjuvant use of CHX showed a more expressive and significant improvement in clinical and microbiologic parameters, especially in the FMD protocol, followed by QS.

Pre‐ and post‐treatment experiences of fear, anxiety, and pain among chronic periodontitis patients treated by scaling and root planing per quadrant versus one‐stage full‐mouth disinfection: a 6‐month randomized controlled clinical trial

To relate the clinical effects of two different forms of non-surgical periodontal therapy - scaling and root planing per quadrant (SRP-Q) and one-stage full-mouth disinfection (FMD) - to patient-based outcomes such as fear, anxiety, and pain of moderate chronic periodontitis patients. Dental Fear Survey (DFS) and Dental Anxiety Scale (DAS) questionnaires and Visual Analogue Scale (VAS) were applied to 78 patients randomized into two groups: SRP-Q (n=37) and FMD (n=41). Periodontal clinical parameters: probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI) were monitored at baseline and 6months after treatment. Data were statistically analysed by chi-square, Fisher's exact, Mann-Whitney, Wilcoxon tests, Pearson's correlation, and Cluster analysis. All periodontal clinical parameters improved from baseline to 6months. Patients with higher fear and anxiety showed a worse clinical periodontal status before and after treatment (mean CAL, PI, and GI). After both types of treatment, fear and anxiety decreased (FMD: p=0.019; SRP-Q: p=0.043) with no differences between the groups. Pain did not differ between groups (FMD: 20.6±19.0 and SRP: 20.7±20.0; p=0.930). In moderate chronic periodontitis patients, SRP-Q and FMD provided periodontal clinical improvements and similar experiences of fear, anxiety, and pain.

English

The objective of this study was to test the hypothesis that the application of a chlorhexidine-based decontamination protocol during two weeks prior to scaling root planing (SRP) would reduce bleeding on probing (BoP) at the time of SRP. Secondary outcomes were other clinical parameters. Another secondary aim was to assess whether the improvement of periodontal conditions, if any, would have a benefit up to 3 months later. In this mono-centre, parallel, single blind, randomised, controlled clinical study, thirty subjects affected by chronic periodontitis were randomly allocated 1:1 to either a control group (n=15, individuals subjected to a standard one-stage full-mouth disinfection procedure fifteen days after inclusion), or a test group (n=15, individuals had to apply a decontamination protocol consisting of tongue brushing and mouth rinsing with chlorhexidine-based products during the fifteen days intervening between inclusion and SRP. BoP, probing depth (PD), plaque index (Pl.I) and clinical attachment loss (CAL) were measured at the inclusion and at tSRP=baseline, when individuals were subjected to SRP, and after 30 and 90 days. Immediately before SRP, BoP was significantly reduced in test (68.31&plusmn;14.70) with respect to control group (29.54&plusmn;11.97, p&lt;0.0001). The other clinical parameters (except for CAL) were significantly reduced, with comparable improvements between the two groups after 30 and 90 days. Although investigations on a larger sample are desirable, the early application of a disinfection procedure improves the condition of patients undergoing full-mouth therapy. This leads to marked advantages both for patients, who exhibit reduced bleeding, swelling and pain, and the operator, who is less operatively limited during the hygiene session. &nbsp; Key words: Full-mouth disinfection, scaling and root planing, periodontitis, periodontal therapy.

Evaluation of different periodontal treatments modes for patients with type 2 diabetes mellitus

Aim The type 2 diabetes (DM2) is a risk factor for periodontal disease, while, on the other hand, periodontitis worsens glycemic control. The treatment of periodontal disease reduces glycemia; however, there is no consensus on which is the best periodontal treatment for diabetic patients. This study aims to evaluate different modalities of periodontal therapy in diabetic patients, i.e., conventional periodontal treatment using scaling and root planning (RAR); and the one-stage full-mouth disinfection (FMD).

One-stage full-mouth disinfection combined with a periodontal dressing: a randomized controlled clinical trial

To compare the clinical benefit of a periodontal dressing applied after a one-stage full-mouth disinfection (OSFMD) in patients with chronic periodontitis up to 3months after therapy. This randomized, controlled split-mouth study included 24 patients. After OSFMD, a test and a control side were selected by means of a computer-generated randomization list. Test sides received a periodontal dressing (Coepak(®) ) for 7days and the control sides received no periodontal dressing. After 7days the periodontal dressing was removed and the pain experience was recorded. After 3months, the clinical periodontal parameters were recorded. The periodontal dressing group showed a significant (p<0.05) additional pocket depth reduction and additional clinical attachment gain for the moderate pockets of single- and multi-rooted teeth compared with the control group. A significant (p<0.05) lower percentage of sites with probing pocket depth ≥5mm were shown for the periodontal dressing group compared with the control group (2.7±16.3% versus 4.8±21.4%). The pain intensity was significantly reduced when using a periodontal dressing (5.13±0.89 versus 3.42±1.27). The use of a periodontal dressing for 7days after a OSFMD offers an additional short-term clinical improvement and lowers the pain intensity.

One-stage full-mouth disinfection and basic periodontal treatment in patients with diabetes mellitus

The objective of this study was to evaluate the effectiveness of two modalities of treatment through clinical periodontal parameters in glycemic control of patients with diabetes mellitus and periodontal disease. 40 patients, who had not been submitted to conventional periodontal scaling and root planning, were selected and divided into two groups: (1) conventional periodontal treatment with scaling and root planning plus mechanical control, and (2) periodontal treatment (one-stage full-mouth disinfection) plus mechanical control. The analysis was carried at 0, 3 and 6 months, including probing depth, level of clinical attachment and bleeding on probing with evaluation of glycated hemoglobin. Only group 1 showed a significant reduction in bleeding on probing, while only group 2 showed a significant reduction in probing depth. The level of clinical attachment showed improvement in both the groups after 6 months. In the glycated hemoglobin test, only group 1 significantly reduced after 6 months, while for group 2 there was a reduction after 3 months and a significant increase after 6 months. We suggest that after a period of 6 months, the basic periodontal treatment is more efficient for glycemic control in patients with type 2 diabetes with periodontal disease.

Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo‐controlled study

Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol 2013; 40: 1025–1035. doi: 10.1111/jcpe.12155.AimThe aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP).Material and MethodsThirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks.ResultsAt week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.ConclusionsThe results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.