Subgingival Scaling Research Articles

The effect of periodontal treatments on endothelial function in degrees of periodontitis patients: A systematic review and meta-analysis.

This article focus on patients with moderate-to-severe periodontitis and periodontitis patients with cardiovascular disease. After they received periodontal initial therapy or antimicrobial drug treatment, was there any improvement in endothelial function during short- and long-term followups? Relevant randomized controlled trials and clinical trials up to 30th June 2024 were identified and retrieved from electronic databases including PubMed, Cochrane Library, Web of Science and CNKI databases, with periodontitis therapy, periodontal disease and endothelial function as the keywords. The weighted (WMD) or standardized mean difference (SMD) was calculated using a fixed- or random-effect model and assessed heterogeneous results. Generally, 14 studies published between 2004 and 2022 were eligible for the meta-analysis, which are all randomised clinical trials. A total of 491 periodontitis patients were screened. All participants received whole-mouth supragingival and subgingival scaling and root planing of the teeth, some trials combined with antimicrobial drug treatment as well as extracting teeth that could not be saved. The outcome indicators were measured by flow-mediated dilatation(FMD) levels. The results of the short term (≤3 months) periodontitis initial therapy group showed positive results (WMD = -3.78,95%CI = [-5.49,-2.07], P<0.0001), while the results of the long term (6 months) periodontitis therapy group exhibited significant difference (WMD = -0.96,95%CI = [-2.06,0.14],P = 0.09). Furthermore, study population were categorized according to the severity of periodontitis, the presence of comorbidities, endothelial dysfunction, and the inclusion of extractions and antimicrobial therapy in the treatment process. The effects of each of these factors on FMD were explored and the results of these subgroups all support periodontitis therapy. The results showed that periodontal treatment enhances endothelial function. Additionally, after subgroup analysis of long-term and short-term follow-up, patients with severe periodontitis, and different periodontal treatments, periodontal therapy was shown to increase FMD levels.

Evaluation and Comparison of the Root Surface Microtopography Following the Use of Gracey Curettes, Piezo-ceramic Scalers, and Piezo-surgery Scalers: An In vitro Study

Abstract Background: Nonsurgical periodontal therapy plays a pivotal role in comprehensive periodontal treatment by effectively removing plaque and calculus through both supragingival and subgingival scaling and root surface debridement. This therapeutic approach encompasses methods aimed at curbing infection, restoring lost tissue integrity, and preserving a healthy periodontium. The ultimate objective of scaling and root planing (SRP) is realized through manual or power-driven scalers. Objectives: This study aims to assess and contrast the microtopography of root surfaces following in vitro SRP using the Gracey curette, Piezo-ceramic ultrasonic scaler, and Piezo-surgery ultrasonic scaler. Materials and Methods: A randomized in vitro investigation was conducted at Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai. Thirty freshly extracted adult human single-rooted teeth, encompassing incisors, canines, and premolars were procured from the Oral and Maxillofacial Surgery outpatient department. The teeth were categorized into three groups: Group A – Gracey curette 7/8 (n = 10), Group B – Piezo-ceramic ultrasonic scaler (Universal insert) (n = 10), and Group C – Piezo-surgery scaler PS1 (n = 10). The evaluation was conducted using electron scanning microscopy (ESEM) and confocal analysis post-SRP. Each tooth was sectioned longitudinally into mesial and distal halves, resulting in 20 samples per group. A demarcation line was established on the middle third of the root surface, distinguishing the test area (T) (coronal) from the control area (C) (apical). In the electron scanning microscopy (ESEM) analysis subset, a notch was created on the upper right corner below the cementoenamel junction in 10 samples from each group. The remaining samples (n = 10 from each group) were not notched for confocal microscopic analysis. Scanning Electron Microscopy analysis was conducted at the Indian Institute of Technology facility in Powai, Mumbai. Results: The overall findings indicated nonsignificant differences among the three groups in the t-test area when examined at × 500 using confocal microscopy and ESEM. However, at × 1000 using ESEM, Group C (Piezo-surgery scaler) exhibited a significantly greater mean surface roughness compared to Group A (Gracey curette) and Group B (Piezo-ceramic ultrasonic scaler) in the t-test area. Conclusion: The Piezo-surgery PS1 root planning tip yields the smoothest root surface following SRP, as indicated by the study’s outcomes.

Management of Endo-Perio lesion in a Tooth with an Unfavorable Prognosis: a Clinical Case Report with an 18-Month Follow-Up

The aim of this case study is to report a successful clinical case of an endo-perio lesion in a tooth with an initially unfavorable prognosis, followed up for 18 months. A male patient, public servant, non-smoker, without a history of diabetes, and married sought dental treatment in 1995 due to periodontal problems. He was then 40 years old and diagnosed with moderate to advanced periodontal disease. The initial treatment consisted of supra and subgingival scaling, followed by the extraction of teeth indicated for removal. After discharge, the patient adhered to a preventive periodic maintenance (PPM) program to control periodontal disease recurrence. In 2021, tooth 43 showed an unfavorable endo-perio lesion during a routine check-up. Despite treatment options, the patient opted for conservative treatment with endodontic and periodontal procedures. Simultaneously, PPM sessions were performed. The patient was monitored every six months, showing regression of periodontal pockets and significant improvement after 18 months. This case highlights the importance of patient adherence to PPM, demonstrating that a conservative approach and proper maintenance can lead to positive clinical outcomes even in cases with an initially unfavorable prognosis.

Effectiveness of Microneedling Technique Using Olive Oil on the Severity of Gingival Inflammation and Plaque Accumulation: A Randomised Controlled Trial.

Gingival inflammation, a hallmark of periodontal diseases, serves as a critical focus in oral health research. Characterized by redness, swelling, and bleeding of the gingival tissues, it reflects the body's response to bacterial biofilms accumulating on the tooth surfaces. This inflammatory process, initiated by the interaction between oral bacteria and the host immune system, can lead to a spectrum of periodontal conditions ranging from mild gingivitis to severe periodontitis. Understanding the efficacy of various methods to treat gingival inflammation is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival inflammation. The objective of the study was to evaluate the efficacy of employing the microneedling technique with olive oil on gingival inflammation and plaque accumulation in individuals with gingivitis. Materials and methods:Twenty-four individuals diagnosed with plaque-induced gingivitis were selected from Saveetha Dental College, Chennai. Participants were randomly assigned to one of two groups: Group A, comprising 12 individuals who received mechanical periodontal treatment only andGroup B, consisting of 12 individuals treated with dermapen and topical olive oil. This involved the creation of microholes in the gingival tissue to enhance the concentration and penetration of the oils through the gingival tissues. Post-intervention assessments of gingival and plaque status were conducted using a gingival index and a plaque index at baseline, one, two, and four weeks. Statistical analysis was done using IBM SPSS Statistics for Windows, version 23 (IBM Corp., Armonk, NY, USA). Intergroup analysis was done using Mann-Whitney test and intra-group analysis was done using Kruskal-Wallis test for all the study parameters.Statistical significance was set at a p-value of less than 0.05. The mean plaque index scores were 2.02 ± 0.12 and 2.29 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively in baseline. The scores were 1.83 ± 0.29 and 0.57 ± 0.16in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of plaque index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*. The mean gingival index scores were 2.09 ± 0.16 and 2.37 ± 0.17 in the subgingival scaling and microneedling with olive oil group in the baseline respectively. The scores were 1.88 ± 0.23 and 0.96 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of gingival index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*. Our research showcased a novel and effective technique, unveiling a significant enhancement in gingival health accompanied by a reduction in both the average gingival index and plaque index.

Cracked tooth and endodontic-periodontal lesion: 2-years follow up of a conservative treatment

This study report diagnosis and management of an endodontic-periodontal lesion in a cracked mandibular tooth after a cyclist’s fall. A 34-year-old female patient with a chief complaint of pain and edema in the region of the mandibular right first molar was evaluated and treated. Patient presented excellent oral health. After clinical, radiographical and tomographic exams, it was diagnosed an acute periapical abscess in stage II combined with tooth cracks and a periodontal involvement (endodontic-periodontal lesion). After emergency dental care it was performed subgingival scaling and root planing, definitive endodontic treatment, indirect definitive restoration (overlay) combined with a reinforcement of the tooth structure with a high-resistance polyethylene tape. Patient was periodically followed up until 24 months and treatment was successful. It can be concluded that a correct diagnosis and a conservative and well-planned and -executed treatment of a compromised tooth by cracks can have good results even endodontic-periodontal lesion is present.

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

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

Evaluate the effect of the metranidazole gel on healing of partial thickness flap in rats (serum TNF-a)

Background: Metronidazole is a broad-spectrum antimicrobial activity against protozoan infections and anaerobic bacteria. In the late 1950s, Metronidazole was first introduced for the treatment of trichomoniasis. At present, the antimicrobial metronidazole is one of the most widely used as antibacterial compounds in the treatment of periodontal disease 9. Beside the periodontal pocket debridement (subgingival scaling and curettage), topical application of metronidazole seems to be very efficacious. Metronidazole efficiently inhibited anaerobic microorganisms in the periodontal pockets 10.&#x0D; Objective: Evaluating the effect of metronidazole gel into surgically healing process of the partial thickness flap, throughout immunological study and comparing it with the chlorhexidine gel&#x0D; Animals and methods: The present study was carried out in Hawler Medical University, Medical research center, College of Dentistry&#x0D; Chemicals and Reagents:- (Rat TNF-a ELISA) kit for estimation of serum tumor necrosis factor (TNF-a), KOMA BIOTECH INC. USA)

Analysis of hospital dental care for patients with special needs in Brazil.

This analytical cross-sectional study aimed to analyze the access of patients with special needs (PSN) in Brazilian municipalities to hospital dental care of the Unified Health System (Sistema Único de Saúde - SUS), based on data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do SUS- SIH/SUS - SIH), from 2010 to 2018. The Kolmogorov-Smirnov normality test was performed; the Poisson regression was used to verify factors associated with the variable total number of hospitalization authorizations with the main procedure of dental treatment for PSN ("Total de Autorizações de Internação Hospitalar" - AIH), the Spearman correlation test with a significance level of 5% was used to characterize the relationships between the Municipal Human Development Index per municipality - (Índice de Desenvolvimento Humano Municipal - HDI) and the Oral Health Coverage in the Family Health Strategy by municipality (Cobertura de saúde bucal na estratégia saúde da família por município - SBSF Coverage), and the relationship of the AIH with SBSF Coverage. A total of 127,691 procedures were performed, of which 71,517 (56%) were clinical procedures, such as restorations, endodontic treatments, supra and subgingival scaling, among others. Municipalities in the Midwest (PR=5.117) and Southeast (RP = 4.443) regions had more precedures than the others. A weak correlation was found between AIH and SBSF Coverage (r = -0.2, p < 0.001) and HDI and SBSF Coverage (r = -0.074, p < 0.001). Population size, region, health coverage, oral hygiene, and number of dentists in hospitals affected the availability of dental procedures in PSN.

Effect of Subgingival Scaling and Root Planing-assisted Occlusal Adjustment Scheme on Periodontitis

Effect of Subgingival Scaling and Root Planing-assisted Occlusal Adjustment Scheme on Periodontitis

Long Term Outcomes of Implant Treatment in Patients with a History of Moderate Periodontitis and With Type 2 Diabetes Mellitus

Purpose: The aim of this study was to evaluate the long-term outcome of implant treatment in patients with previous tooth loss due to a history of moderate periodontitis and with type 2 diabetes mellitus. Materials and methods: The study included 42 patients with partially edentulous, with a history of moderate periodontitis and with type 2 diabetes mellitus using 134 dental implants over the period from 2021 to 2023. It the baseline and at 3 month intervals bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL) were recorded. All patients prior implant surgery periodontal therapy were treated, which included the following: supragingival and subgingival scaling and root debridement were performed with an ultrasonic device, magnetic laser irradiation, local use of antibacterial agents. Results: Implant surgery was performed 3 months after periodontal therapy, when PPD &lt;4 mm and BOP &lt;10%, with stable clinical index. After 12-month in patients mean MBL 0.76±0.6 mm, after 5 years MBL was 1.34 ± 0.25 mm (P&gt; 05), after 10 years MBL was 1.56 ± 0.28 mm (P&gt; 05). Survival rate of implants 5 years after was 96.4% implants 10 years after was 93.6%. Conclusions: This study confirmed that implant therapy can be successfully used in patients diagnosed with moderate periodontitis and with type 2 diabetes mellitus who have received individualization supportive periodontal therapy, regular periodontal maintenance and if their HbA1c level was &lt;7.2% or less than 154 mg/dL.

Day one core competencies in veterinary dentistry.

This article describes the core competencies recommended for inclusion in the veterinary curriculum for all veterinary graduates based on the American Association of Veterinary Medical Colleges Competency-Based Veterinary Education document. General practice companion animal veterinarians are frequently presented with patients having dental, oral, or maxillofacial pathology, and veterinary graduates will be relied upon for recommendations for the maintenance of oral health, including the prevention of periodontal disease, identification of endodontic disease, and knowledge of developmental defects. These recommendations should be made for all veterinary patients starting at a young age. These core competencies can apply to many companion species, but mainly are focused on the dog and cat. Because periodontal disease is the most common abnormality observed in dogs and cats, the first key step is taking a few seconds during examination of every patient of any age presented for any reason to examine the oral cavity. Although dental, oral, and maxillofacial pathology is often diagnosed after imaging and evaluation under anesthesia, the first step is observation of dentition and gingivae during the conscious exam to assess periodontal health status. The physical exam of the oral cavity may reveal oral behavior (eg, observation of uncomplicated crown fractures due to chewing on hard objects), which will permit recommendations for enhanced prevention by daily oral hygiene or professional treatment. There are now many involved dental and surgical treatments available, some of which require specialist-level instrumentation and expertise. General practitioners should be able to competently perform the following immediately upon graduation from veterinary school: For patients for whom the owner's reason for the veterinary visit is not dental, oral, or maxillofacial disease, obtain a brief (1 or 2 questions) history of the oral health of the patient. On lifting the lip of every patient, recognize presence or absence of accumulated dental plaque or calculus on the crowns of the teeth, presence or absence of gingival inflammation or ulceration, and presence or absence of other dental, oral, and maxillofacial pathology. On anesthetized patients that have dental, oral, and maxillofacial pathology for which professional treatment is indicated, be able to obtain and interpret appropriately positioned and exposed dental radiographs. When the presence of dental, oral, and maxillofacial pathology is recognized, determine whether each tooth present in the mouth does or does not require professional treatment beyond dental subgingival and supragingival scaling and polishing. List the indications for tooth extraction, know indications for potential oral/dental treatments beyond subgingival and supragingival scaling and polishing or extraction, and determine whether the professional treatment that may be indicated, such as root canal treatment or mass resection of oral tissues, requires referral for specialist-level expertise and instrumentation. Complete a thorough periodontal evaluation and therapy with periodontal probing, including professional subgingival and supragingival ultrasonic scaling with polishing under anesthesia. Demonstrate the ability to extract teeth indicated for extraction, using gentle and appropriate techniques that will risk minimal injury to the jaws and oral soft tissues and reduce postoperative patient pain. Provide appropriate postoperative care, including recognition of when postoperative analgesia and possibly antibiotic administration are indicated.

Long-Term Stability of Er:YAG Laser Non-Surgical Periodontal Treatment

Background: Nonsurgical periodontal therapy is the first step of periodontal diseases treatment. It could be performed with various instruments and in recent years lasers have been tested too. The aim of the present study is to evaluate the long-term clinical effectiveness of Er:YAG laser monotherapy in the treatment of moderate chronic periodontitis. Methods: 451 teeth (1099 periodontal pockets) from 30 patients with moderate chronic periodontitis are allocated for subgingival scaling and root planing into two groups—hand instrumentation (control) and Er:YAG laser instrumentation with 100 mJ/15 Hz (test). Patients are examined for probing pocket depth, gingival recession, clinical attachment level, bleeding on probing, plaque presence at baseline, 1, 3, 6 and 12 months after instrumentation. Results: One year after therapy significant reduction of all clinical parameters examined is observed. The pocket depth decreases with 1.55 mm for the control group and 1.70 mm in the test group. The attachment level gain reveals 1.09 mm for hand instrumentation and 0.59 for laser instrumentation. The bleeding on probing reduces more significantly in the test group, where one year after treatment the index is 19.1%, whereas in the control group, it is 33.8%. Conclusions: The Er:YAG laser demonstrates similar clinical effectiveness to hand instrumentation in the non-surgical periodontal treatment. Better long-term stability is observed in the test group.

CLINICAL APPLICATIONS OF INJECTABLE PLATELET RICH FIBRIN (IPRF) IN ADJUVANT THERAPY FOR PERIODONTITIS: A CASE SERIES

The purpose of this study is to evaluate the clinical outcomes of non-surgical periodontal therapy using injectable Platelet Rich Fibrin (iPRF). Materials and Methods: In the present study, analyzed the results of treatment in 82(43 men and 39 women, aged 36 to 63 years) patients in the period from 2018 to 2023 years with periodontitis stages I–II were included. The following clinical parameters were recorded at the beginning of the study (before and treatment), after 1 month (after iPRF therapy), at the end of the 3-month (after iPRF therapy). The diagnosis of periodontitis was established taking radiological signs of bone loss and indicators of bleeding on probing (BOP), probing depth (PD), Clinical attachment level (CAL). All patients subjected to the complex periodontal treatment included supragingival and subgingival scaling and root debridement with an ultrasonic device, antibacterial therapy. After 4 weeks, only those patients underwent I-PRF therapy who maintained optimal oral hygiene. I PRF was injected into the gum area. The number of plasma-based sessions is strictly individual and depends on the severity of the inflammatory process (4-6 sessions break between sessions 1 week). Results: The postoperative periods in all patients passed without complications, there were no serious intraoperative or immediate postoperative complications. After a course of I-PRF therapy, patients noted elimination of pain, bleeding and swelling of the gums, tooth mobility became less bad breath disappeared, loss of bone tissue stopped. The first changes in the gums are noticeable on the 7th-10th day. The clinical picture and diagnostic parameters were comparable at baseline and after treatment. The clinical periodontal parameters (BOP, PPD, CAL) were shown a reduction in their mean values after 3 months from the treatment with the PRP, with a highly significant difference no complications had been observed. The mean value BOP before treatment was 2.6 ± 0.32, after 1month treatment the mean BOP 1.8 ± 0.2, after 3 months treatment the mean BOP 1.4 ± 0.15. The mean value PPD before treatment was 5.41 ± 0.77 mm, 1 month after therapy it was 4,27 ±0.38 mm and 3 month after therapy it was 2.46 ± 0.42 mm. The mean value CAL before treatment was 5.84 ± 0.79 mm, 1 month after therapy it was was 4.92 ± 0.71 mm. and 3 months after therapy it was 3,4 ± 0,7 mm. Conclusion: This study confirmed that iPRF periodontal therapy can be successfully used in patients diagnosed with I-II periodontitis who have received individualization supportive periodontal therapy and regular periodontal maintenance. The use of iPRF in periodontal therapy represents a valuable minimally invasive adjunct to complex conservative therapy.

Oral streptococcal infective endocarditis among individuals at high risk following dental treatment: a nested case-crossover and case-control study

It is not clear whether Viridans Group Streptococcal Infective Endocarditis (VGS-IE) among individuals at high risk is more frequent following bacteraemia caused by invasive dental procedures (IDPs) than after daily bacteraemia caused by chewing and tooth brushing. The aim of this nested study was to assess if VGS-IE was temporally associated with IDPs in a national cohort of individuals at high risk. This nested case-control and case-crossover study was based on a Swedish national cohort study of 76,762 individuals at high risk of IE due to complex congenital heart disease, prosthetic heart valve or previous IE. Participants were living in Sweden between July 1st, 2008 and January 1st, 2018. The frequency of IDPs during the 3 months before VGS-IE was calculated and compared to controls (sampled 1:10). A case-crossover study was conducted to account for residual confounders. Participants were identified using the national patient register, and IDPs were identified using the national dental health register. 98,247 IDPs were carried out in the cohort during the study period: 624 occasions of oral surgery, 44,190 extractions and 53,433 sessions of subgingival scaling. The study could not confirm that IDPs were more common among cases (4.6%) than controls (4.1%), OR=1.22 [95% Confidence Interval (CI) 0.64-2.3], or during case- (3.3%) than reference periods (3.8%), OR=0.89 [95% CI: 0.68-1.17]. Restricting the analysis to the period when cessation of antibiotic prophylaxis for the prevention of IE in Swedish dentistry was recommended, from the 1st of October 2012 to the 1st of January 2018, did not alter the results of the case-control study: OR 0.64, 95% CI: 0.20-2.09, or the case-crossover study: OR 0.58, 95% CI: 0.15-2.19. The study could not confirm that VGS-IE is associated with IDPs among individuals at high risk. A study with larger sample size could clarify whether there is a lack of association. The finding of a small (<5%) proportion of cases temporally associated with IDPs is similar to that of the previous large-scale study on IDPs and VGS-IE. Funding was provided by the Board of doctoral education at Karolinska Institutet, the Public Health Agency of Sweden, Folktandvården Stockholm AB, Steering Group for Collaborative Odontological Research at Karolinska Institutet and Stockholm City County, and the Swedish Dental Association.

The efficacy of subgingival air polishing and subgingival debridement in periodontal support therapy: a meta-analysis.

To assess whether there is sufficient evidence of a difference in efficacy between subgingival air polishing (SubAP) and subgingival debridement as periodontal support treatment. The systematic review protocol was registered in the PROSPERO database under no. CRD42020213042. A comprehensive search was conducted using eight online databases to develop straightforward clinical questions and search strategies, from their inception to 27 January 2023. The references of identified reports were also retrieved for inclusion in the analysis. The risk-of-bias of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool (RoB 2). A meta-analysis was performed on five clinical indicators using the Stata 16 software. Twelve randomized controlled trials were ultimately included, and most included studies had varying degrees of risk-of-bias. The results of the meta-analysis indicated that there was no significant difference between SubAP and subgingival scaling in terms of improving probing depth (PD), clinical attachment loss (CAL), plaque index (PLI), and bleeding on probing% (BOP%). The results of the visual analogue scale score analysis indicated that SubAP produced less discomfort than did subgingival scaling. SubAP can provide better treatment comfort than subgingival debridement. There was no significant difference in the efficacy of the two modalities in improving PD, CAL, and BOP% in supportive periodontal therapy. Currently, evidence for assessing the difference in the efficacy of SubAP and subgingival debridement in improving the PLI is insufficient, and further high-quality clinical studies are needed.

Multisensory Preclinical Training Strategy of Periodontal Scaling for Undergraduates

BackgroundInvisibility of subgingival scaling is the most important negative factor affecting the performance of periodontal treatment. A multisensory teaching strategy is used in the preclinical training of undergraduates in order to increase the haptic-auditory-visual feedback, aiming to overcome the invisibility and achieve minimal postoperative complications, improving patients’ treatment experience. MethodsOne hundred undergraduate dental students in grade 5 were divided into a multisensory teaching strategy group (MTS: n = 50) and a conventional training pattern group (CTP: n = 50). All participants attended a lecture on using an ultrasonic subgingival scaler (USS) and Gracey curettes (GRA), followed by a 3-week training programme. Students in the MTS group were trained in a haptic/auditory-visual feedback manner, whereas students in the CTP group were trained conventionally. After the training phase, paired students in the 2 different groups performed subgingival scaling in paired patients with equivalent teeth of periodontitis using USS and GRA. Objective and subjective postoperative evaluations were recorded. Probing depth (PD) and gingival index (GI) were evaluated before and 4 weeks after scaling by the same periodontal specialist. ResultsMTS significantly reduced treatment time and ameliorated postoperative complications (gingival injury, haemorrhage and root surface roughness; P < .05). Postoperative sensitivity was reduced in the MTS group from day 1 to day 7 (D1–D5: P < .001; D6: P = .002; D7: P = .003), whereas postoperative pain was reduced on day 1 (P = .006), compared with that in the CTP group. The PD reduction was not significant between the groups (MTS: 3.17 ± 0.95 mm vs CTP: 3.07 ± 0.97 mm, P > .05), whereas the GI change showed a significant difference between the groups (MTS: 1.71 ± 0.41 vs CTP: 1.67 ± 0.41, P < .05). ConclusionsMultisensory teaching strategies in the preclinical periodontal training of undergraduates can reduce postoperative complications (gingival injury, postoperative haemorrhage, and root surface roughness) and provide a better treatment experience (decreased treatment time and postoperative pain and sensitivity) for patients.

Comparative evaluation of conventional and diode laser-assisted gingival curettage in shallow suprabony periodontal pocket – Three months follow-up of a randomized clinical trial

Background: Chronic periodontitis is one of the most common forms of periodontal disease in adults. The primary goal of periodontal therapy is to remove dental plaque and bacteria to restore and maintain gingival tissue health. Subgingival scaling, root planning, and curettages are aimed at removing dental plaque, calculus, and necrotic cementum. Aim and Objectives: The main aim of our present randomized control clinical trial was to evaluate the clinical effectiveness of diode lasers compared to conventional curettage using hand instruments in patients with chronic periodontitis having shallow suprabony pockets. In addition, the pain sensation during conventional and laser-assisted curettage was compared during the procedure using Visual Analog Scale. Materials and method: Subjects with shallow pockets were divided into two groups and treated with either conventional curettage (Control group) with hand instrument or with diode laser (Test group). The data obtained were fed into Microsoft Excel 2000 package, and statistical analysis was carried out using SPSS software version 20.0 for Windows. Results: The control group elicited a reduction in probing pocket depth (PPD) from baseline to 1 month after treatment (6.60 ± 0.99 vs. 3.87 ± 0.64, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 2.43 ± 0.50, which was also statistically significant (P &lt; 0.05). The reduction between the 1 and 3 months after treatment (3.87 ± 0.64 vs. 2.43 ± 0.46, respectively), was also statistically significant (P &lt; 0.05). The test group elicited a reduction in PPD from baseline to 1 month after treatment (6.80 ± 0.86 vs. 4.00 ± 0.76, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 3.53 ± 0.48, which was also statistically significant (P &lt; 0.05). There was a marginal reduction of postoperative scores between the 1 and 3 months after treatment (4.00 ± 0.76 vs. 3.53 ± 0.48, respectively), which was nonsignificant (P = 0.53). The mean PPD at baseline between Control group versus Test group (6.60 ± 0.99 vs. 6.80 ± 0.86, respectively) was nonsignificant (P = 0.56). The PPD at 1 month also revealed nonsignificant reduction, i.e. Control group versus Test group (3.87 ± 0.64 vs. 4.00 ± 0.76, P = 0.60). The postoperative reduction of PPD at 3 months was statistically significant (P &lt; 0.05), i.e. Control group versus Test group (2.43 ± 0.46 vs. 3.53 ± 0.48). Conclusion: Within the limit of our study, it can be proved that both hand instrument-guided curettage and laser-assisted curettage can effectively reduce shallow pockets to a healthy gingival sulcus.

Modern understanding of endoscopy technology at a periodontal appointment: a systematic review

Relevance. Periodontitis is a common chronic infectious and inflammatory disease. Multiple microorganisms, including periodontal pathogens in the dental biofilm, are the principal reason for inflammatory periodontal diseases. The initial stage of periodontitis treatment involves the mechanical removal of dental deposits from the tooth surface. Subgingival scaling is technically complex due to the limited visualization. An experienced clinician does not always have a chance to thoroughly treat all roo ts’ surfaces and remove all plaque and tartar.Modern technology, e.g., Perioscopy, enables illumination and visualization of periodontal pockets and their content. Thus, dental endoscopy technology practicability determination requires the study of the systematization of a large initial data array.Materials and methods. Publications were searched and studied in seven electronic databases PubMed, Google Search, Embase, Web of Science, ScienceDirect, and SciELO II eLibrary. The study reviewed the articles published from 2000 to 2022, available in full text, and assessed for relevance. The search resulted in 119 selected publications. Based on the inclusion criteria, we selected 44 articles, which included 42 clinical trials and two reviews. The study methodology meets the requirements for systematic reviews (PRISMA).Results. High-quality visualization allows for the operating field control enabling access to hard-to-reach areas and improves periodontal treatment outcomes. Closed periodontal scaling, the most commonly used non-surgical inflammatory periodontal disease treatment technique, is based on the dentist’s tactile sensations and experience. Due to the lack of visual control, even an experienced practitioner may not always effectively treat all surfaces or remove all plaque and tartar. The examination with the endoscope (Perioscopy) after the instrumentation reveals areas of tartar and biofilm remains, which may lead to further periodontal destruction and future surgical treatment. The article presents the studies proving the sufficient effectiveness of a dental endoscope for periodontal disease treatment. It is of note that the endoscope significantly increases the treatment quality in cases with deep pockets and severe periodontitis.Conclusion. Endoscopic imaging of dental deposits and pocket content indirectly reduces the risk of recurrence and complications of inflammatory periodontal diseases. The treatment of patients with moderate and severe periodontitis requires the development of algorithms for the management of such patients with the mandatory use of an endoscope.

ENDODONTIC-PERIODONTAL LESION

Introduction: Periodontal and pulp tissues are closely related through communication pathways present in the periodontium. This interrelation supports the emergence of endo-periodontal lesions, caused by infectious and irritating products, triggering an inflammatory response Objective: The present study aim to report the treatment of a case of endo-periodontal lesion where endodontic treatment was performed prior to periodontal treatment. Case description: On clinical and radiographic examination, the patient was diagnosed with an endo-periodontal lesion on element 48. The proposed treatment plan was endodontics followed by subgingival scaling. Conclusion: Endodontic treatment associated with periodontal treatment led to the resolution of the case, being observed the absence of pain, absence of abscess/fistula, decreased probing depth and tooth mobility, in addition to bone gain seen radiographically.

Comparative Evaluation of Effectiveness of Triphala and Chlorhexidine in One Stage Full Mouth Disinfection Treatment of Stage-II and III Periodontitis in Type-II Diabetes Mellitus Patients- A Research Protocol

Introduction: The idea of Full-Mouth Disinfection (FMD) was presented in the early 1990s, the traditional method of treating periodontal disease, quadrant by quadrant over several visits. The FMD method has been recommended with a number of changes over time. Triphala, Ayurvedic medicinal herbal formulations is also useful in dentistry as antiplaque, antimicrobial, antioxidant, analgesic, antipyretic and antiinflammatory agent. As Chlorhexidine (CHX) is used from past years for full mouth disinfection, there is need to evaluate the efficacy of CHX as well as Triphala in diabetic mellitus patients. Need of the study: As CHX has been used for years to disinfect the entire mouth, a study comparing the effectiveness of CHX and Triphala in individuals with Diabetes Mellitus (DM) for full mouth disinfection will be done. Aim: To evaluate and compare the efficacy of triphala and CHX in the treatment of Stage-II and III periodontitis with one stage complete mouth disinfection in Type-IIDM patients. Materials and Methods: This experimental study will be done in Sharad Pawar dental College, department of Periodontics after obtaining the ethical clearance during September 2021 to September 2022. About 24 type 2 diabetic subjects with StageII and Stage-III periodontitis, will be randomly divided into test Group-And control group with 12 in each group. In Group-A, Full mouth disinfection will be done using CHX and in Group-B full mouth disinfection will be done using Triphala. After full mouth subgingival scaling and root planning, patient will brush the dorsum of the tongue for one minute with gel, the mouth will be rinsed two times with mouthwash for one minute, the pharynx will be cleaned with a spray, and all periodontal pockets will be irrigated (thrice within 10 minutes) with a gel. Clinical parameters will be evaluated at baseline and six months. The clinical parameters are Probing Pocket Depth (PPD), Plaque Index (PI), Clinical Attachment Level (CAL), Papillary Bleeding Index (PBI). Paired t-test will be used to compare data within group for before and after treatment and unpaired t-test will be used to compare between the groups.