Periodontal Treatment In Patients Research Articles

COMPARISON OF MALACHITE GREEN AND METHYLENE BLUE DYES IN NON-SURGICAL PERIODONTAL TREATMENT IN PATIENTS LIVING WITH HIV/AIDS AND UNDERGOING IMMUNE RECONSTITUTION

The aim of this study was to evaluate the effect of photodynamic therapy (PDT) on non-surgical periodontal treatment in patients failing highly active antiretroviral therapy (HAART). comparing methylene blue (MB) (0.01%) and malachite green (MG) (0.01%) dyes as a therapeutic protocol, measuring the following periodontal clinical parameters: clinical probing depth (CPD), gingival recession (GR), clinical attachment level (CAL), full-mouth plaque index (PI), and full-mouth bleeding index (BI), using polymerase chain reaction (PCR) for identification of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) pathogens. The study was approved by the Research Ethics Committee. Forty-four patients were evaluated, 15 (34.1%) female and 29 (65.9%) male. The mean age was 46 years. In the evaluation of GR, there was a significant difference in the non-resistant group in which MB was used. Resistant patients treated with MG or MB showed significant differences in the decrease of Pg bacteria. PDT associated with MB promoted improvements in CPD and decrease of Aa and Pg bacteria, being an effective therapeutic protocol.

The Use of Statins as an Adjunctive Periodontal Disease Treatment: Systematic Review and Meta-Analysis.

the purpose of this systematic review was to assess the clinical and radiographic effect of subgingival-administered statins as an adjunct periodontal treatment in patients with periodontitis. Electronic literature searches in Medline/PubMed and the Cochrane Library were conducted to identify all relevant articles. Eligibility was based on inclusion criteria which included Randomized Controlled Trials (RCTs) published after 2010, where the periodontal variables were assessed before and after periodontal treatment in combination with a statin administration. The risk of bias was assessed with the ROBINS-2 tool. The outcome variables were probing depth, clinical attachment level, bleeding on probing, and bone fill in systematically healthy patients, patients with type 2 diabetes, and smokers. Out of 119 potentially eligible articles, 18 randomized controlled trials were included with a total of 1171 participants. The data retrieved from the meta-analysis showed the positive effect that statins have as an adjunctive periodontal disease treatment. When comparing the different types of statins, the PD reduction in the Simvastatin group was significantly higher than the Atorvastatin group at 6 months and at 9 months, while no differences between statins were found for the rest of the outcomes. Over 66% of the articles presented an overall risk of bias with some concerns, making this a limitation of this present RCT. The adjunct administration of statins has proven to have a positive effect on the periodontium by improving both clinical and radiographic parameters by a considerable margin.

Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial.

Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers. In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6mg daily, 30days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months. Melatonin (tablet, 6mg daily, 30days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p<0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3months (p<0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3months and IL-1β levels at 6months compared to the control group (p<0.05). However, OPG levels were not affected significantly by the treatments (p>0.05). Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.

Effect of Non-Surgical Periodontal Therapy on Systemic Inflammatory Markers, Glycemic Status and Levels of Proteinuria in Type 2 Diabetic and Non-Diabetic Patients With Chronic Periodontitis.

The present study aimed to evaluate the effect of non-surgical periodontal therapy (NSPT) on systemic inflammatory markers, glycemic status, and levels of proteinuria in Type 2 diabetic and non-diabetic individuals with chronic periodontitis. A total of 120 patients, categorized into three groups of 40 each, were included in this randomized observational study. Group 1 comprised patients with chronic periodontitis; Group 2 had chronic periodontitis with controlled diabetes; and Group 3 represented patients with chronic periodontitis with uncontrolled diabetes based on fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) levels. Periodontal clinical parameters like plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels were evaluated. Blood samples and urine samples were collected and assessed for the levels of FBS, HbA1c, total protein, albumin, globulin, and proteinuria. All parameters recorded at baseline and three months after non-surgical periodontal therapy were analyzed for statistical significance at p <.05 using SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc. A significant reduction in the periodontal clinical parameters within the groups, except for the clinical attachment level in Group 1 patients (p = 0.05), was observed. Glycemic status revealed a significant reduction after non-surgical periodontal therapy (p < 0.001), and on intragroup comparison, the total protein, albumin, globulin, and microprotein blood and urine levels showed significance among the evaluated groups (p < 0.001). Non-surgical periodontal treatment can effectively improve the periodontal and circulating inflammatory status. Results of our study showed improved glycemic control and a reduction in systemic inflammatory markers and proteinuria after performing non-surgical periodontal treatment in patients with type 2 diabetes.

Evaluation of the adjuvant effect of topic Bach floral in the clinical response to non-surgical periodontal treatment in patients with type 2 diabetes: pilot study

Objective: To evaluate the clinical response of periodontal tissues after periodontal therapy associated with the use of Bach Flower (Rock Rose gel) in participants with type 2 diabetes mellitus. Methodology: This randomized, doble-blind, split-mouth, single-center, placebo-controlled clinical trial selected 20 participants with moderate, severe, or advanced periodontitis (stage II, III, and IV). They were divided into groups, where group 1 received Floral Rock Rose gel and group 2, saline gel. All groups received conventional periodontal treatment characterized by scaling and root planing before gel application. Clinical evaluation was performed using periodontal clinical parameters: Plaque Index (PI), Gingival Index (GI), probing depth (PPD), gingival recession (GR), and Clinical Insertion Level (CAL). Biometric parameters and hematological parameters were also evaluated. All clinical and laboratory parameters were obtained at baseline and after three months. Results: There was an improvement in periodontal clinical parameters before and after treatment in both groups (P&lt;0.05). There was no statistically significant difference between the intervention, control, and floral groups (P&gt;0.05). Conclusion: The periodontal treatment performed with Rock Rose adjuvant gel (Bach Flower) was safe, efficient, and promoted the improvement of periodontal clinical parameters. However, it did not show superior results to conventional periodontal therapy.

Evaluation of Glutathione Levels in Gingival Cervical Fluid in Periodontitis from Stage 1 – Stage 4 among Type 2 Diabetic Patients

Purpose: This study aimed to evaluate if glutathione could be used as a diagnostic biomarker in diabetic patients with stage 1, stage 2, stage 3, and stage 4 periodontitis who were receiving non-surgical periodontal therapy. Material and methods: Twentyeight participants were included, who were separated into four groups, each with seven members. Seven diabetic patients with stage 1 periodontitis were assigned to Group 1, seven diabetic patients with stage 2 periodontitis were assigned to Group 2, and seven diabetic patients with stage 3 periodontitis were assigned to Group 3 and Seven diabetic patients with stage 4 periodontitis were assigned to Group 4. Gingival crevicular fluid (GCF) samples were taken from every individual at baseline (before non-surgical periodontal therapy) and one month after non-surgical periodontal therapy was completed. Results: Glutathione levels in the four groups dramatically improved after non-surgical therapy. Conclusion: Glutathione levels should be considered important indicator for prognosis of the periodontal treatment in patients with periodontal disease.

Digital photometric analysis of gingival response to periodontal treatment

ObjectivesThe color is a major factor in determining inflammation status in most gingival indices. Current indices have limitations mainly due to subjective nature. Digital color analysis can provide objective and accurate measurements. Thus, the present study aimed to assess by digital tool the gingival color in the different stages of an active periodontal treatment. MethodsForty patients (19 males and 21 females) diagnosed with periodontitis (stage III/ IV, grade C) and treated surgically were included in the study. Clinical data (probing depth, bleeding on probing, clinical attachment level, gingival index, and gingival recession) and photographs by digital single-lens-reflex (DSLR) camera were recorded before initial periodontal treatment, which included scaling and root surface debridement (T0); the same parameters were then re-evaluated 6-8 weeks (T1) and 3 months after periodontal surgery (regenerative/resective) (T2). Differences between clinical parameters were calculated. The color space defined by the International Commission on Illumination (CIELab) was used to analyze gingival color. ResultsIn 56 periodontal surgical sites, 168 photographs were taken. The a*-value of the CIELab color system (higher a*- value translate to a stronger red color) was significantly reduced between T0 to T1 and further decreased at T2 (32.01, 29.28, and 27.45 respectively). Significant improvement in clinical parameters were found between T0 to T1 and T1 to T2. Sub-analysis of two distinct surgical interventions revealed that only regenerative procedure improved the a*-value, which was significantly correlated with pocket depth reduction. ConclusionsPhotometric analysis can be used to assess gingival color change during periodontal treatment of patients with periodontitis. Clinical significanceGingival inflammation is a major factor in periodontal assessment; nevertheless, all current gingival inflammation indices are partially subjective and only semi-quantitative. The digital photometric analysis may allow for accurate and objective gingival color assessment during periodontal treatment.

Periodontal Treatment in Patients with Perio-Endo Lesions: A Case Report

Background: Periodontal tissue and pulp are interconnected anatomically. In some circumstances, the inflammation may extend from the periodontal region to the pulp or vice versa. In perio-endo lesions, an appropriate treatment plan is required to obtain a predictable and reliable treatment prognosis. The development and progression of these perio-endo lesions can be influenced by many factors such as bacteria, fungi, viruses, trauma, root resorption, perforation and dental malformations. An appropriate treatment plan for perio-endo lesions can provide a good prognosis.&#x0D; Objective: To describe periodontal treatments performed in patients with perio-endo lesions.&#x0D; Case Report: A 39-year-old man presented to Hasanuddin University Dental and Oral Hospital with a chief complaint of uncomfortable left posterior maxillary teeth during mastication. Clinical examination showed vital, non-caries, pocket depth of ±9mm on tooth 26. Radiographic examination showed a radiolucent lesion that extended to the apically. Regenerative periodontal treatment was performed using a combination of platelet-rich fibrin (PRF) with demineralized freeze-dried bone xenograft (DFDBX).&#x0D; Results: During the observation period, pocket depth was reduced, and the pain was absent.&#x0D; Conclusion: Periodontal inflammation that extends to the pulp tissue can be prevented by regenerative periodontal treatment using a combination of PRF and DFDBX, which shows promising results.&#x0D; Keywords: endo-perio lesions, periodontal regenerative, periodontal surgery

Effects of Periodontal Treatment in Patients with Periodontitis and Kidney Failure: A Pilot Study

Periodontitis and chronic kidney disease are both chronic inflammatory diseases and share some common risk factors. This 3-month pilot study aimed to clarify whether non-surgical periodontal therapy is beneficial in clinical, biochemical, and microbiological conditions in patients with periodontitis and kidney failure. Kidney failure patients with moderate to severe periodontitis were recruited from two hospitals. Treatment group received non-surgical periodontal therapy, and control group received oral hygiene instruction only. Outcome assessments were conducted 1 and 3 months after treatment. Non-parametric tests were used to analyze the patient-level data. Periodontal site-level assessments were analyzed by Student t-test and paired t-test. Statistical significance was set at p-value < 0.05. A total of 11 subjects completed the study. There was no significant difference between groups in all-cause mortality, cardiovascular events, infection events, systemic parameters, and serum biomarkers. Comparing to control group, clinical periodontal parameters, gingival crevicular fluid interleukin-1β (IL-1β) level and periodontal pathogens showed significant improvement in the treatment group. Non-surgical periodontal treatment did not change systemic outcomes in kidney failure patients, but changed the local micro-environment.

Total Salivary Immunoglobulin A Determination Before and After Non-Surgical Periodontal Treatment in Patients with Aggressive Periodontitis

Total Salivary Immunoglobulin A Determination Before and After Non-Surgical Periodontal Treatment in Patients with Aggressive Periodontitis

Parametric assessment of lactoferrin activity in experiment and clinical application

The possibilities of using lactoferrin preparations for the destruction of microbial biofilms as the leading factors in the development of oral diseases are considered.&#x0D; Materials and methods. As part of the experiment, a microbiological diagnostic technique was used using a system for the automatic cultivation of microbial populations. A pre-prepared bacterial suspension was inoculated into the nutrient broth and the studied lactoferrin samples were added, followed by cultivation and analysis of the possible antibacterial effects of transferrin protein. The infrastructure of the Unique scientific installation “Transgenbank” was used in the work. The assessment of the growth control of the corresponding type of bacteria was reflected in the change in the optical density parameters, on the basis of which the curve was constructed.&#x0D; Results. According to the results of an experimental study of the growth curves of bacterial populations, statistically significant differences in the number of viable cells in different phases of the growth curves were noted. The analysis of growth dynamics revealed differences in the onset of maximum reproduction and its inhibition under the influence of various aggravating factors during cultivation. The bacteriostatic effect of lactoferrin is realized by binding iron ions, depriving bacteria of this trace element, causing inhibition of their development.&#x0D; Conclusion. With local application of lactoferrin-containing drug in the complex periodontal treatment of patients, normalization of the clinical picture of periodontitis was established, a statistically significant decrease in the indices of OHI-S, PHP, PMA, PBI and SBI indices in the dynamics of clinical observation, which remained optimal for 1 year. The used bioreactor allows to obtain reproducible results, is available for wide use and can be recommended for obtaining objective, comparable, reliable information about the antimicrobial properties of various samples of the bactericidal protein lactoferrin produced by the domestic pharmaceutical industry.

Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report

BackgroundAplastic anemia is an intractable disease characterized by pancytopenia, susceptibility to infection, and difficulty in achieving hemostasis. In patients with severe periodontal disease and aplastic anemia, spontaneous bleeding from the gingival tissue due to thrombocytopenia and during brushing is common, which may further exacerbate dental issues. Comprehensive periodontal treatment for patients with aplastic anemia is highly challenging and requires collaboration with a hematologist. Here, we discuss the case of a patient with aplastic anemia and severe periodontitis who was successfully treated in collaboration with our hematology department.Case presentationA 36-year-old Japanese woman with chief complaints of spontaneous gingival bleeding, pain, and increasing tooth mobility consulted our department. She had developed pancytopenia at age 11 years and was later diagnosed with aplastic anemia, making her susceptible to infection due to leukopenia. The results of the initial periodontal examination led to a diagnosis of severe generalized periodontitis (generalized stage IV grade C periodontitis) caused by leukopenia and poor oral hygiene. We adopted a comprehensive treatment plan, including invasive dental procedures. The patient exhibited no postoperative bleeding due to aplastic anemia-induced thrombocytopenia and experienced a good outcome.ConclusionsBoth physicians and dentists should be aware that immunocompromised patients with aplastic anemia are at risk of developing severe periodontitis with severe alveolar bone resorption if the condition is combined with poor oral hygiene. Even in the presence of aplastic anemia, patients with severe periodontitis can undergo comprehensive dental treatment, including dental extraction and periodontal surgery, if bleeding and susceptibility to infection are controlled. This requires the cooperation of the patient and hematologists and can ultimately contribute to improving the patient’s quality of life.

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis.

BACKGROUNDSevere periodontitis is a major oral health concern today as it can lead to loss of teeth. Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIMTo investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β (IL-1β) and IL-10 in gingival crevicular fluid (GCF) in patients with severe periodontitis.METHODSEighty-six patients with severe periodontitis were randomly divided into a research group (n = 43) and a control group (n = 43). The control group was treated with simple periodontal therapy, and the research group was treated with dental pulp periodontal therapy. The total effective rates of the treatments; periodontal status before and after treatment through the measurement of the periodontal pocket probing depth (PPD), gingival sulcus bleeding index (SBI), mobility (MD), and plaque index (PLI); the levels of inflammatory factors IL-1β and IL-10 in the GCF; and the incidence of complications were calculated for both groups and compared using the Student’s t test and the χ2 test.RESULTSThe total effective rate of treatment in the study group (93.02%) was higher than that in the control group (76.74%; P < 0.05). While before treatment, there was no significant difference in the PLI, MD, SBI, or PPD between the two groups, the post-treatment values of PLI, MD, SBI, and PPD (4.71 ± 0.16 mm, 0.61 ± 0.09 mm, 0.96 ± 0.17 mm, and 0.76 ± 0.26 mm, respectively) were significantly lower (P < 0.05) in the research group than in the control group (5.35 ± 0.24 mm, 0.93 ± 0.15 mm, 1.35 ± 0.30 mm, and 1.04 ± 0.41 mm, respectively). There was no significant difference in the level of IL-1β or IL-10 in the GCF before treatment between the two groups; after treatment, the IL-1β level in the research group (139.04 ± 15.54 pg/mL) was significantly lower than that in the control group (156.35 ± 18.10 pg/mL), and the level of IL-10 in the research group (7.98 ± 1.01 ug/L) was higher than that in the control group (5.56 ± 0.96 ug/L) (P < 0.05). The incidence of complications in the study group (4.65%) was significantly lower than that of the control group (18.60%; P < 0.05). CONCLUSIONEndodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction. In addition, it can improve the periodontal condition and the overall treatment effect, reduce the risk of complications, and ensure the safety of treatment.

The Effect of Adiposity on the Outcome of Non-Surgical Periodontal Therapy

Background: Non-surgical periodontal therapy constitutes the first step in controlling periodontal infections, and its outcome is affected by the presence of other systemic diseases and conditions. Obesity is a modifiable risk factor for periodontitis and its effect on the outcome of non-surgical periodontal therapy has not been clearly determined. Aim: To determine the impact of central adiposity on the outcome of non-surgical periodontal treatment in patients with periodontitis. Methodology: This prospective interventional study included 39 obese patients with periodontitis (Group A) and 39 normal?weight patients with periodontitis (Group B). The waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR), Simplified oral hygiene index (OHIS), bleeding on probing (BOP), probing pocket depth (PPD), number of sites with PPD ≥ 4 mm, and clinical attachment loss (CAL) were measured at baseline and 3 months after non-surgical periodontal treatment. Chi-square test was used to compare categorical variables between the groups. Independent samples t-tests and paired t-test were used to analyse the numerical intergroup and intragroup data, respectively. Pearson’s correlation coefficients and multiple regression analyses were used to assess the strength and impact of central adiposity on periodontal treatment outcomes. Data were analysed using the IBM Statistical Package for Social Sciences version 20.0 and statistical significance was set at P &lt; 0.05. Results: At baseline, the mean PPD and CAL were comparable in both Groups A and B; while the mean percentage of sites with gingival BOP and percentage of sites with periodontitis were significantly higher in Group A. All periodontal parameters significantly improved after treatment in Groups A and B. However, participants in Group B had a better improvement in sites with gingival BOP and percentage of sites with periodontitis after treatment compared to Group A. Multiple regression analysis showed that central adiposity had a significant (P &lt; 0.05) negative impact on the treatment outcome of gingival BOP, PPD and percentage of sites with periodontitis (PPD ≥ 4 mm) after adjusting for age, sex and socio-economic status. Conclusions: The findings indicated that central adiposity has a negative impact on gingival bleeding on probing, probing pocket depth and percentage of sites with periodontitis.

ANTIBIOTIC SENSITIVITY ISOLATION EVALUATION OF MAJOR MICROORGANISMS IN PERIODONTAL TISSUE PATHOLOGY

Relevance of research The loss of effectiveness and activity of antibiotics is caused by their irrational and inappropriate use (especially in self-medication). The risk of antibiotic-resistant mikrobiom potentially be associated not only with time proceeding systemic antibacterial component in the protocol complex treatment of periodontitis but with specific combinations of different used drugs duration, efficiency previously performed mechanical treatment by open or closed curettage, especially the dosing of selected antibiotics middlemen. In – depth study and development of or personalized approaches to treatment is relevant periodontitis by individualizing the choice of appropriate antibiotics for incorporation into the algorithm of complex therapy, or universal approaches, the possibility of implementation of which depends on arguing the effectiveness of a particular combination of antibacterial agents for the vast majority of patients according to studies with sufficient samples. Study Goal is to assess the levels of antibiotic resistance and antibiotic sensitivity of isolates of major microorganisms in periodontal tissue pathology. Materials and methods of research. The research was conducted on the basis of the University Dental Clinic and private dental clinics in Uzhhorod. Determination of levels antibiotic sensitivity was carried out using a disco-diffusion method with the advice and algorithm identified by order MOH Ukraine 05.04.2007 № 167 "On Approval of guidelines" Determination of the sensitivity of microorganisms to antibiotics and in accordance with the recommendations EUCAST (Eurepean Committee on Antimicrobial Susceptibility Testing). During the testing, standard sets of discs with antibiotics and appropriate test cultures were used, which were seeded with microorganisms obtained from patients with generalized periodontitis of varying severity. Research results and their discussion. During the microbiological analysis of smears obtained from periodontal pockets of whole patients study group, microorganisms were identified, which were characterized by relatively high levels of prevalence, among them: P. gingivalis, T. forsythia, F. nucleatum, P. intermedia, A. actinomycetemcomitans, K. pneumoniae, E. coli, E. cloaceae, S. aureus, S. haemolyticus, S. viridans, S. pyogenes. A detailed analysis of the distribution of mean levels of prevalence of antibiotic sensitivity and antibiotic resistance among the analyzed isolates was performed. The results of antibioticograms differ depending on the qualitative and quantitative composition of the isolated microorganisms, their levels of antibiotic sensitivity and antibiotic resistance. This distribution of results indicates the feasibility of a patient-centered approach to treatment, based on the preliminary identification of microorganisms isolated from periodontal pockets of patients, as well as determining the levels of their antibiotic sensitivity and antibiotic resistance. Conclusion. The application of the approach with preliminary determination of antibiotic sensitivity to microorganisms cultured from the oral cavity is characterized by the relevant biological principles of conducting. Prospects for further research. The analysis of the effectiveness of adjuvant antibiotic therapy in the process of complex treatment of periodontal patients and the development of personalized approaches to the treatment of periodontitis are promising.

Peptidomic changes of saliva after non-surgical treatment of stage I/II generalized periodontitis.

To explore the changes of peptidome profiles of saliva, serum, and gingival crevicular fluid (GCF) before and after non-surgical periodontal treatment in patients with generalized periodontitis (stage I/II). Saliva, serum, and GCF samples were collected from 17 patients at baseline (T0 ), one week after ultrasonic supragingival scaling (T1 ) and eight weeks after subgingival scaling and root planning (T2 ). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was carried out to detect changes in peptidomic profiles. Then, nano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify potential peptide biomarkers. Most of the peptides from the patients exhibited a decreasing trend from the time point of pretreatment to that of post-treatment. Cluster analysis and scatter plots using these peptides indicated that salivary peptidome has an acceptable capability of reflecting the status of stage I/II generalized periodontitis. Seven of these peptides were successfully identified as α-1-antitrypsin, immunoglobulin κ variable 4-1, haptoglobin, and immunoglobulin heavy constant γ2. Certain peptides in saliva, serum, and GCF were down-regulated after non-surgical periodontal treatment, demonstrating the application prospects of saliva in monitoring and surveillance of periodontal diseases in both clinical settings and communities.

Effect of periodontal therapy on COPD outcomes: a systematic review

BackgroundLatest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients.MethodsA systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects which were published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation working group methodology.ResultsOut of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Significant methodological differences were noted amongst included studies, while very low-to-moderate overall quality of evidence was demonstrated.ConclusionsAlthough it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes.Trial Registration: PROSPERO 2020 (CRD42020158481). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158481

Evaluation of Oxidative Stress before and after Using Laser and Photoactivation Therapy as Adjuvant of Non-Surgical Periodontal Treatment in Patients with Rheumatoid Arthritis.

(1) Background: The aim of this split-mouth design study was to analyze the clinical periodontal indexes and oxidative stress markers in gingival crevicular fluid modifications after three periodontal disease treatment possibilities (scaling and root planning—SRP; SRP and diode laser—L; SRP and photodynamic therapy—PDT). (2) Methods: The study was conducted on 52 patients: systemically healthy subjects with periodontal disease—non-RA (n = 26); and test group (n = 26) subjects with rheumatoid arthritis and periodontal disease—RA. Clinical periodontal measurements (probing depth—PD; Löe and Silness gingival index—GI; papillary bleeding index—PBI; and periodontal community index of treatment needs—CPITN) and oxidative stress markers (8-hydroxy-2’-deoxyguanosine (8-OHdG) and 4 hydroxynonenal (4-HNE)) were analyzed at baseline (T0), after three sessions of periodontal treatment (T1), and 6 months after treatment (T2). (3) Results: Periodontal therapy improved clinical periodontal measurements and oxidative stress markers in both analyzed groups, with supplementary benefits for laser- and PDT-treated periodontal pockets. (4) Conclusions: The analyzed oxidative stress markers decreased significantly following non-surgical periodontal therapy in both rheumatoid arthritis and systemically healthy patients. All the periodontal disease treatment possibilities analyzed in this study offered clinical and paraclinical improvements; however, the association of laser with SRP and photodisinfection with SRP yielded the best clinical and paraclinical outcomes when compared to SRP alone.

Effect of adjunctive diode laser in the non-surgical periodontal treatment in patients with diabetes mellitus: a systematic review and meta-analysis.

This study aimed to systematically review and analyze the present randomized clinical trials (RCTs) regarding the clinical efficacy of a diode laser (DL) adjuvant to scaling and root planning (SRP) in patients with chronic periodontitis (CP) who have diabetes mellitus (DM). Five databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trails, Web of Science, and Chinese BioMedical Literature Databases) were searched. A meta-analysis was implemented to evaluate periodontal parameters including probing depth (PD) and clinical attachment level (CAL) as primary outcomes. Hemoglobin A1c (HbA1c), plaque index (PI), and the gingival index (GI) were also observed as secondary outcomes. Independent scanning of 239 papers resulted in 9 RCTs. Moderate evidence demonstrated that the test groups showed significant benefits for PD reduction, CAL gain, and HbA1c reduction after 3 and 6months. Significant differences in PI and GI reduction were not found except for GI reduction within 1month. The collective evidence suggested that the DL with SRP had significant improvements in clinical results compared to SRP alone. Based on our results, the DL could be a recommended therapy for patients with CP who have DM.

Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial

BackgroundThis study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis.MethodsFourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons.ResultsIn both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group.ConclusionsSubgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only.Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery.Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.