Subgingival Scaling Research Articles

ANALYSIS OF PERIODONTAL TISSUE STATUS OVER TIME DURING THE LOCAL TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS

The objectives of the study was to evaluate the changes in the special indicators of periodontal tissue damage during the local treatment among patients with generalized periodontitis. Materials and methods. At private medical institution specialized in periodontal treatment, 30 patients (15 men and 15 women, aged 40.23 ± 8.76 years (M = 39.00)) with generalized periodontitis were treated according to the standard treatment protocol. Protocol included ultrasonic removal of tartar and other dental sediments, segmental subgingival scaling, air-abrasive polishing and giving recommendations on hygienic care of the oral cavity. All patients obtained the control of the maximum depth of periodontal pockets, the level of the indices of PMA, CPITN and Green–Vermilion (OHI-S) on at the start of treatment, after 6 months and one year later during follow-up. Results. Periodical observation and clinical examination showed a partial restoration of the marginal periodontium (gingival) attachment among patients – that was observed by periodontal pocket depth decrease from 9.60 ± 2.07 (M = 10.00) mm to 7.23 ± 1.40 (M = 7.00) mm after 6 months, and to 4.98 ± 0, 88 (M = 5.00) mm a year after the start of treatment. The reduction of the indicator was 4.63 ± 1.43 (M = 4.50) mm. Amnog males recovery took place more intensively which was statistically significant. Initially, PMA index level was 66.38 ± 13.71 (M = 67.50)%, six months later – 32.63 ± 7.48 (M = 32.50)%. A year later – 28.90 ± 8.10 (M = 28.00)%. The reduction of the PMA index was 37.48 ± 9.05 (M = 37.00)%. At the end of the observation period, the reduction in the level of periodontal tissue inflammation among males was 1.2 times more intense than among females which was statistically significant to. At the beginning of observation, the CPITN index was 5.21 ± 0.95 (M = 5.00) with a range of 3.30 to 6.90. After six months – 2.63 ± 0.69 (M = 2.40), after a year – 2.63 ± 0.71 (M = 2.55). Reduction of the CPITN index was 2.59 ± 0.48 (M = 2.50), no gender difference was found. At the beginning of the observation, the OHI-S level was 4.40 ± 0.54 (M = 4.45) and the range was from 3.00 to 5.60. Six months later – 1.80 ± 0.40 (M = 1.80), one year later – 1.79 ± 0.41 (M = 1.80). The index reduction was 2.62 ± 0.48 (M = 2.45), no differences were found among patients of different sexes. Conclusions. The obtained data indicate uneven effectiveness of local treatment of generalized periodontitis, which includes influence on local factors of disease development. The results suggest a faster recovery of the attachment of the marginal periodontium and a decrease in the intensity of inflammation among male patients and the probable presence of higher physiological reserves of periodontal tissue repair.

Periodontal Treatment for Chronic Periodontitis With Rheumatoid Arthritis

BackgroundHistory of rheumatoid arthritis (RA) increases risk of periodontal diseases. A pro-inflammatory condition noted in periodontitis is considered a trigger for RA. Thus, periodontal treatment aimed at attenuating the pro-inflammatory state could aid in potentially reducing the risk of RA. AimsThe objective of this research was to assess the effect of periodontal therapy on rheumatoid factor, Disease Activity Score-28, anti-citrullinated protein antibody, and C-reactive protein levels in patients with chronic periodontitis (CP) and RA. Materials and methodsThe sample consisted of 28 patients with CP and RA. The study was designed to be a double-blind, randomised controlled clinical study. The samples were randomly categorised to either the treatment group (n = 13) or the control group (n = 15). CP status (plaque index, bleeding on probing, probing pocket depth, clinical attachment loss), clinical rheumatologic status (Disease Activity Score), and biochemical status (C-reactive protein, anti-citrullinated protein antibody, and rheumatoid factor) were assessed at baseline and at follow-up at 8 to 12 weeks. ResultsThe treatment group showed a highly statistically significant reduction in bleeding on probing (P < .005), probing pocket depth (P < .001), plaque index (P < .001), and C-reactive protein (P < .001); a gain in the clinical attachment loss (P < .001) and an improvement in Disease Activity Score-28 (P = .001) were observed at reassessment following nonsurgical periodontal treatment as compared to the control group. However, blood serum anti-citrullinated protein antibody (P = .002) and rheumatoid factor levels (P = .351) were found to increase from baseline to 8 to 12 weeks following subgingival scaling and root planing. ConclusionsReduction of inflammation in the periodontium by nonsurgical periodontal therapy did not reduce anti-citrullinated protein antibody and rheumatoid factor levels. However, it has shown improvement in periodontal conditions, and remarkable changes were observed in the clinical Disease Activity Score and C-reactive protein levels of individuals with RA.

A Study on the Use of Phase Transition Lysozyme-Loaded Minocycline Hydrochloride in the Local Treatment of Chronic Periodontitis.

Periodontitis is the most important oral disease causing human tooth loss. Although supragingival and subgingival scaling is the main strategy of periodontitis clinical treatments, drug treatment has an indispensable auxiliary role to some degree. Periodontitis medical treatment is divided into systemically administered treatments and local periodontally administered treatments. Compared with systemic administration, local administration can increase local drug concentrations, reduce dosages, and prolong action times while also improving patient compliance and avoiding possible adverse effects due to systemic administration responses. However, some studies show that minocycline ointment, a clinical local drug commonly used in periodontal pockets, has an unstable release rate; 80% of the drug is usually released within 2-3 days after pocket placement. This release is not conducive to controlling periodontal infection and may hinder the periodontal tissue repair and regeneration. Therefore, choosing a suitable carrier for minocycline hydrochloride is necessary to control its local release in periodontal tissue. Phase transition lysozyme (PTL) has been widely used in many studies and the development of macromolecular carrier material, and we selected PTL as the carrier for minocycline hydrochloride drugs because of its good biocompatibility, good drug-carrying capacity, and stable release. Due to its release characteristics and simple preparation, PTL is a promising carrier material.

Primary dental care treatment in primary Sjögren's syndrome: a possible role in improving salivary flow rate.

Primary Sjögren's syndrome (pSS) is an inflammatory chronic disorder that mainly affects exocrine glands. Additionally, oral infections can aggravate the glandular dysfunction. However, data on primary dental care (PDC) treatment in pSS are scarce. This study aimed to appraise the impact of PDC on the Xerostomia Inventory (XI), unstimulated/stimulated salivary flow rates and salivary cytokine profile in pSS. Fifty-two pSS patients and 52 sex- and age-matched control participants without systemic autoimmune diseases were included in a prospective study. At inclusion, all participants were assessed through a standardised protocol, measurement of salivary pro-inflammatory cytokines, and underwent PDC. Dental procedures included: oral hygiene guidance, restorative treatment of caries, surgical removal of residual roots and impacted or partially erupted teeth, cysts, supra and subgingival periodontal scaling and treatment of soft tissue disorders (removal of lesions and treatment of opportunistic infections). After 3 months, the clinical/laboratorial assessments were repeated. At inclusion, the Decayed, Missing and Filled Teeth (DMFT) index was higher in the pSS patients than in the control group (13.3±8.2 vs. 8.6±6.2, p=0.002), whereas periodontal parameters were comparable in both groups (p>0.05). After PDC, 26.9% of pSS patients showed a reduction of at least 6 points (clinical improvement) in XI, but mean XI remained unchanged (p=0.285). PDC resulted in an increase in mean unstimulated (p<0.001) and stimulated (p=0.001) salivary flow rates in pSS, with no change in salivary cytokine profile (p≥0.05). PDC promoted improvement in unstimulated and stimulated salivary flow rates in pSS. This novel finding reinforces the recommendation of this strategy for pSS patients. gov (Identifier: NCT03711214).

Endoscope-assisted subgingival scaling and root planing in the treatment of periodontitis: systematic evaluation of effects

Endoscope-assisted subgingival scaling and root planing in the treatment of periodontitis: systematic evaluation of effects

Causes of Emergency Bleeding after Nonsurgical Periodontal Therapy in Adult Periodontitis Patients: A Retrospective Analysis.

Background Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient's physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.

Probiotic milk drink as adjuvant therapy for the treatment of periodontitis: a randomized clinical trial with 180 days follow-up

The effect of probiotic milk drinks associated with non-surgical periodontal therapy (NSPT) in treating periodontitis was evaluated. A double-blind placebo-controlled randomized clinical trial with patients with periodontitis was conducted. Two groups were used: TG (n=15, test group, probiotic milk drink, Lacticaseibacillus casei 01, 8-9 log CFU/mL) and CG (n=15, control group, conventional milk drink). The milk drinks (100 mL) were consumed once a day at breakfast for 15 days. Both groups also received NSPT, supra and subgingival scaling and root planning per quadrant, and oral hygiene instruction. All patients were clinically evaluated after 30, 90, and 180 days of the last NSPT session. Reductions in clinical attachment loss and probing pocket depth were observed at 30 days in both groups, maintained throughout the follow-up. Decreases in visible plaque index (VPI) and bleeding on probing were observed after probiotic milk drink consumption for 30 days, suggesting an effect provided by probiotics in the control of biofilm and inflammation. However, the impact on VPI was not persistent for more than 30 days, demonstrating the need for regular consumption of the probiotic milk drink. In conclusion, probiotic milk drinks may be used as adjuvant therapy to treat periodontitis.

Effect of periodontal therapy on endothelial dysfunction – A systematic review

Background: Endothelial dysfunction is considered a common precursor to and occurs before cardiovascular events. Therefore, endothelial dysfunction is the first step in atherosclerosis growth that leads to cardiovascular disease CVD. Patients with periodontitis are ideal models for determining how endothelium-dependent vasodilation is affected by inflammation. Objective: The objective is to determine the effect of periodontal therapy on endothelial dysfunction. Methodology: This review was conducted as per the Preferred Reporting Items for Systematic reviews and Meta-Analysis and JBI guidelines. A total of twelve randomized clinical trials published over a period of the past 14 years were included in the review (200420018). Results: There were 813 patients in the research, which lasted between 2 and 6 months and looked at the effects of periodontal therapy on endothelial dysfunction. The common interventions given for the intervention group in all of the studies were supra or subgingival scaling and root planing with some studies providing antibiotic medications such as amoxicillin and minocycline as an adjuvant for periodontal therapy. All included studies reported a high level of evidence (LOE) of 1c. Conclusion: This study focused on periodontal therapy and its effect on endothelial dysfunction precisely and compared the levels of endothelial function before and after intervention, however, the studies included in this review did not do matching between cases and controls on endothelial function levels. This review revealed that more multi-centric randomized control trials are required in this area of research with proper randomization and adequate sample size and proper matching done between cases and controls.

A Comparative Clinical Study of Er:YAG Laser and Hand Instruments in the Treatment of Moderate Chronic Periodontitis.

Moderate chronic periodontitis is the most common periodontal disease. The treatment of this condition should aim at achieving a biocompatible root surface and decontamination of the pocket, thereby restoring the health status. In the present study, the aim was to examine the clinical effectiveness of fibreless Er:YAG laser used for scaling and root planing and to compare it with a conventional treatment with Gracey curettes. The study included 909 periodontal pockets which were treated in a split-mouth design with either Gracey curettes or with Er:YAG laser (1.5 W). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index were recorded. There was a considerable decrease of PPD, CAL, BoP, and plaque presence values at 1 and 3 months after therapy in both treatment groups. Sites treated with Er:YAG laser demonstrated mean CAL gain of about 1.00 mm and 0.44 mm at the first and third month, respectively. In the control group, there was also significant gain of CAL of about 1.33 mm at the first and 0.30 mm at the third month. Significant difference was observed in all parameters between both groups in favour of the laser treatment. The results of the present study suggest that the Er:YAG laser shows clinical effectiveness in the treatment of moderate chronic periodontitis. It can be used as a single treatment modality for subgingival scaling and root planing resulting in greater improvements in all recorded data in contrast to conventional treatment.

EXPERIENCE OF USING ENAMEL MATRIX PROTEIN IN COMBINATION WITH A CORONARY ADVANCED FLAP AND A CONNECTIVE TISSUE GRAFT TO ELIMINATE GUM RECESSION

The article presents the experience of complex managing a patient with gum recession in the area of the maxillary premolars. Periodontal treatment of gum recession consisted of initial therapy, including supra- and subgingival scaling, root planing, pharmacotherapeutic support (broad-spectrum antiseptics, drugs that stimulate regeneration), surgical combined method based on the use of enamel matrix protein to stimulate regenerative processes. The clinical material Emdogaine is a combination of an enamel matrix derivative and propylene glycol alginate, which performs the function of a carrier. Biora company has been producing it for more than 20 years (Emdogain, BIORA): now the rights to this material belong to Straumann). This preparation was developed to stimulate regeneration of periodontal tissues. Amelogenin is a specific enamel protein capable of stimulating regeneration of lost periodontal tissues by influencing cell differentiation. Dental cement is an osteoid connective tissue that covers the roots of teeth and serves to attach periodontal fibers. Application of an enamel matrix derivative to the sanitized root surface leads to regeneration of non-cellular cement and to the formation of periodontal tissues, which was observed in our study. Transplantation of free connective tissue grafts to eliminate gum recessions makes it possible to effectively eliminate gum recession in most clinical cases (complete root coverage, an increase in the level of clinical attachment from the keratinized attached gum area). In our clinical case, free grafts were obtained in the donor area of the maxillary tuberosity. Transplantation of free connective tissue grafts provides an aesthetic result and is currently considered a standard technique for eliminating gum recession. According to the clinical study, a combined use of connective tissue grafts and the enamel matrix derivative, an additional use of enamel matrix derivative enabled to obtain a satisfactory result and to improve the appearance of the dentition. Such combined surgeries are indicated in an aesthetically significant area. The described materials, methods and stages of patient's follow up can serve as the basis for the protocol of managing patients with gum recession.

Effect of periodontal treatments on blood pressure.

An association has been hypothesized between periodontitis and hypertension. Periodontal therapy is believed to reduce systemic inflammatory mediators and increase endothelial function, thus having the potential to prevent and treat hypertension. To assess the effect and safety of different periodontal treatment modalities on blood pressure (BP) in people with chronic periodontitis. The Cochrane Hypertension Information Specialist searched for randomized controlled trials (RCTs) up to November 2020 in the Cochrane Hypertension Specialised Register, CENTRAL, MEDLINE, Embase, seven other databases, and two clinical trials registries. We contacted the authors of relevant papers regarding further published and unpublished work. RCTs and quasi-RCTs aiming to detect the effect of periodontal treatment on BP were eligible. Participants should have been diagnosed with chronic periodontitis and hypertension (or no hypertension if the study explored the preventive effect of periodontal treatment). Participants in the intervention group should have undergone subgingival scaling and root planing (SRP) and any other type of periodontal treatments, compared with either no periodontal treatment or alternative periodontal treatment in the control group. We used standard methodological procedures expected by Cochrane for study identification, data extraction, and risk of bias assessment. We used a formal pilot-tested data extraction form for data extraction, and the Cochrane risk of bias tool for risk of bias assessment. We planned the meta-analysis, test for heterogeneity, sensitivity analysis, and subgroup analysis. We assessed the certainty of evidence using GRADE. The primary outcome was change in systolic BP (SBP) and diastolic BP (DBP). We included eight RCTs. Five had low risk of bias, one had unclear risk of bias, and two had high risk of bias. Four trials compared periodontal treatment with no treatment. We found no evidence of a difference in the short-term change of SBP and DBP for people diagnosed with periodontitis and other cardiovascular diseases except hypertension (very low-certainty evidence). We found no evidence of a difference in long-term changes in SBP (mean difference [MD] -2.25 mmHg, 95% confidence interval [CI] -9.41 to 4.92; P = 0.54; studies = 2, participants = 108; low-certainty evidence) and DBP (MD -2.55 mmHg, 95% CI -6.90 to 1.80; P = 0.25; studies = 2, participants = 103; low-certainty evidence). Concerning people diagnosed with periodontitis, in the short term, two studies of low certainty reported no changes in SBP (MD -0.14 mmHg, 95% CI -4.05 to 3.77; P = 0.94; participants = 294) and DBP (MD -0.15 mmHg, 95% CI -2.47 to 2.17; P = 0.90; participants = 294), and we found no evidence of a difference in SBP and DBP over a long period based on low certainty of evidence. Three studies compared intensive periodontal treatment with supra-gingival scaling. We found no evidence of a difference in changes in SBP and DBP for any length of time in people diagnosed with periodontitis (very low-certainty evidence). In people diagnosed with periodontitis and hypertension, we found one study reporting a significant reduction in the short term in SBP (MD -11.20 mmHg, 95% CI -15.40 to -7.00; P < 0.001; participants = 101; moderate-certainty evidence) and DBP (MD -8.40 mmHg, 95% CI -12.19 to -4.61; P < 0.0001; participants = 101; moderate-certainty evidence). We found no evidence of a difference of an impact of periodontal treatments on BP in most comparisons assessed in this review, and given the low certainty of evidence and the lack of relevant studies we could not draw conclusions about the effect of periodontal treatment on BP in people with chronic periodontitis. We found only one study suggesting that periodontal treatment may reduce SBP and DBP over a short period in people with hypertension and chronic periodontitis, but the certainty of evidence was moderate.

Clinical comparative study of ultrasonic subgingival scaling and ultrasonic combined with manual subgingival scaling in the treatment of chronic periodontitis.

article: Clinical comparative study of ultrasonic subgingival scaling and ultrasonic combined with manual subgingival scaling in the treatment of chronic periodontitis - Minerva Surgery 2021 Dec 10 - Minerva Medica - Journals

Periodontal treatment need, interdental cleaning habit and dental services utilization of a Nigerian population

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Objective: Optimal home-use plaque-control measure maintains a functional dentition and reduces the risk of loss of periodontal attachment throughout life. The combination of toothbrushing and inter-proximal oral hygiene devices optimally prevents plaque accumulation. Individual’s attitude, lack of awareness and affordability are barriers for the utilization of dental services. This study evaluated the interdental cleaning habits; periodontal treatment needs and dental service utilization of a Nigerian population.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Methods: Self-administered questionnaires were used to obtain information on socio-demographics, use of interdental cleaning aid and health services utilization of participants. A full-mouth examination was done to assess the periodontal status and the treatment needs of the participants using the CPITN probe. Data was analyzed using Epi info 2008 version 3.5.1.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Result: Only 24.4% of the participants who claimed to clean interdentally actually used dental floss and interdental brushes) while majority of them ({160(71.2%)} used toothpicks. Three out of five participants {49(59%)} who do not clean interdentally, didn’t know that they had to do so. Though 284(92.2%) of the participants do not routinely access oral care, almost half (49.7%) had previous dental check-ups, scaling and polishing, tooth extractions and restorations. 44(14.3%) did not need periodontal treatment, 131(42.5%) needed Oral Hygiene Instruction (OHI) and Scaling and Polishing (S&amp;P) and 19(6.2%) needed OHI, S&amp;P and sub-gingival scaling.&#x0D; Conclusion: Dental services utilization was low until they perceived that they have a dental ailment, appropriate interdental aids were not used and knowledge on the need for interdental cleaning and advance periodontal treatment need of the participants were low.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Effect of Twinlight Laser on the Attachment of Human Gingival Fibroblasts to the Root Surface In Vitro.

BackgroundThis study aimed to compare the effectiveness of subgingival scaling and root planing with the Twinlight laser, Er: YAG laser, and hand instrumentation on the removal of endotoxin and attachment of human gingival fibroblasts (HGFs) to cementum surfaces in vitro.Material/MethodsSingle-rooted teeth extracted for periodontal disease were collected and divided into 3 groups: group A, root planing with Gracey curet no. 5/6; group B, irradiation with Er: YAG laser; group C, irradiation with Er: YAG laser and Nd: YAG laser. Endotoxins were determined by the limulus amebocyte lysate test. Cell attachment and proliferation of HGFs on root specimens were evaluated by cell counting kit-8 assay. The root surface and cell morphology were observed by scanning electron microscope.ResultsA flat root surface with scratches was found in group A, Group B had a homogeneous rough morphology without carbonization, and group C had a non-homogeneous rough morphology with ablation. The endotoxin concentration was highest in group A (P<0.05) and lowest in group C (P>0.05). HGFs cultured in group B showed significantly increased adhesion and proliferation compared with groups A and C (P<0.05). HGFs in group B were well attached, covered densely by pseudopodia. HGFs in group A were round with poor extension and short pseudopodia, while the cells in the group C were in narrow, triangular, or polygonal shapes.ConclusionsTwinlight laser-assisted periodontal treatment effectively improved the biocompatibility of root surface and promoted the attachment and proliferation of fibroblasts by removing calculus and reducing the concentration of endotoxins.

Clinical study of periodontal endoscope-assisted subgingival scaling in the treatment of residual pocket.

To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets. A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared. A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (P<0.001). For sites in a single-rooted tooth, sites with PD≥5 mm, and sites without vertical alveolar bone resorption and furcation involvement, the PD in endoscopy group was significantly lower than that in the control group at 6 weeks and 3 months after treatment (P<0.05). Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.

Low-Cost Antiseptics in Periodontal Therapy- A Review Article

Periodontitis is a major health problem in low-income populations. Low-income individuals in developing countries tend to demonstrate a high level of risk factors for periodontal disease and are at increased risk of developing severe periodontitis and even potentially fatal oral infections such as noma (cancrum oris). Successful periodontal healthcare of low-income populations must be based upon affordable professional therapy and self-care techniques with proven efficacy and safety. Antiseptics are broad-spectrum microbicidal agents that are applied topically onto living tissue to prevent or treat clinical infections caused by bacteria and viruses.1 The high degree of safety allows frequent and broad use of antiseptics in periodontal treatment. Antiseptics when used together with subgingival scaling are more effective than scaling alone in reducing periodontal pathogens and in improving clinical attachment and alveolar bone mass.

Effect of Porphyromonas gingivalis lipopolysaccharide on calcification of human umbilical artery smooth muscle cells co-cultured with human periodontal ligament cells.

Periodontitis is an independent risk factor for coronary heart disease. Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) was considered to be one of the main virulence factors. In addition, vascular smooth muscle cells transform into osteoblast-like cells in an arterial calcification process under chronic inflammatory conditions. The present study aimed to determine the calcification induced by Pg-LPS in human umbilical artery smooth muscle cells (HUASMCs) co-cultured with human periodontal ligament cells (HPDLCs). An in vitro co-culture system was established using Transwell inserts. HUASMC proliferation and alkaline phosphatase (ALP) activity were measured with a Cell Counting Kit-8 and an ALP kit, respectively. Calcium nodule formation was detected using alizarin red S staining. The effects of Pg-LPS on the mRNA expression of the calcification genes of ALP, core-binding factor α1 (Runx2) and bone sialoprotein (BSP) were assessed using reverse transcription-quantitative PCR. The results indicated that Pg-LPS increased HUASMC proliferation and ALP activity. Furthermore, among all of the groups, calcium nodule formation was most extensive in co-cultured cells in the mineralization-inducing medium containing Pg-LPS. In addition, the expression of specific osteogenic genes (Runx2, ALP and BSP) significantly increased in the presence of Pg-LPS and mineralization-inducing medium, which was further enhanced in co-culture with HPDLCs. In conclusion, co-culture with HPDLCs increased the effect of Pg-LPS to stimulate the calcification of HUASMCs. It was suggested that besides the inflammation, periodontitis may promote the occurrence of vascular calcification. The study indicated that periodontal treatment of subgingival scaling to reduce and/or control Porphyromonas gingivalis may decrease the occurrence or severity of vascular calcification.

Placentrex gel used as a surgical wound healing agent: A case report

Gingival enlargement is an inflammatory response to plaque present on tooth surfaces or due to factors like drugs and several systemic conditions. In cases where the local factors are responsible and subgingival scaling and root planing do not help, gingivectomy/gingivoplasty is performed which creates a raw wound which heals slowly. Since surgical practice primarily depends upon the healing of these wounds without serious complication and infection occurring, to increase the rate of healing of a postoperative surgical wound, placental extract gel has been used as a therapeutic agent because it has unique pharmacological effects like enhancement of wound-healing, anti-inflammatory action, analgesic effect etc. A variety of substances with biological and therapeutic activity present in human placenta have been isolated and identified as hormones, proteins, glycosaminoglycans, nucleic acids, polydeoxyribonucleotides (PDRNs) etc. which therefore play a major role in the faster healing of a surgical wound.

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.

Validation of the criteria matrix about the generalist's education in Dentistry Undergraduate Courses.

The generalist training planned by Brazilian National Curriculum Guidelines for Dentistry undergraduate courses should provide actions for the development of health promotion in the field of public health, as well as disease prevention, diagnosis, planning, and dental treatment in the clinical field. Considering this complexity, the aim of the present study was to validate dimensions and sub-dimensions in dentistry training, allowing the identification of the main necessary competences and clinical skills for the generalist practice. For this, an evaluation study was carried out through the Delph's Method with the participation of 19 professors of Dentistry courses in Brazil working in the clinical area, considered "experts" in this theme. It was possible to identify clinical competences and skills in four dimensions and respective sub-dimensions: Transversal skills (biosafety, patient-team communication, humanization, ethical principles, dental documentation); Diagnosis and planning (diagnosis of dental caries, pulp and periapical changes, and periodontal diseases, clinical and imaging exam, and single treatment planning); Preventive activities (oral hygiene guidance and oral cancer prevention); and Dental care (anesthesia, basic oral surgery, drug prescription, subgingival scaling and root planing, dental restoration, minimally and non-invasive restoration treatment, and dental urgencies). The developed model represents a differentiated alternative for the construction of an innovative curriculum in Dentistry, aimed at the training of general practitioners to provide humanized, highly effective, and resolving care. The importance of clinical tutoring by professors on the essential clinical skills and abilities is highlighted in this study.