Supportive Periodontal Treatment Research Articles

Antibacterial Herbal Mouthwash Formulation and Evaluation Against Oral Disorders

The goal of the present study is to create and assess a herbal mouthwash and determine how well it works to lower oral cavity bacterial counts. Following their collection, the plant materials' water-soluble components were removed. We also assessed the mouthwash's physicochemical characteristics and antibacterial efficacy. The mouthwash that is now available on the market has strong antimicrobial qualities. The stability investigation's findings attest to the preparation's efficacy. These days, mouthwash is marketed as a liquid and usually includes antiseptic and antibacterial ingredients. These solutions have the potential to serve several purposes, including inhibiting the growth of germs in the oral cavity and acting as an analgesic, anti-inflammatory, or anti-fungal agent. The oral cavity is home to a variety of microbes. While certain types of oral bacteria are harmless, others can lead to mouth illnesses, plaque buildup in the mouth, and bad breath. Therefore, keeping good oral hygiene is essential for both physical and mental well-being. The effectiveness of herbs is thought to be relatively high when compared to chemical products. Medicinal plants are crucial in treating a variety of illnesses due to their potent antibacterial and antifungal effects against human infections. Herbal remedies aid in tooth cleaning, reduce dental plaque, inhibit the growth of bacteria, and freshen breath. Herbal mouthwashes can be used in addition to your normal dental hygiene routine, which includes brushing and flossing. They are helpful in supportive periodontal treatment because of their potent antiinflammatory and anti-plaque characteristics. Many herbal remedies and their extracts, including those made from peppermint, cloves, neem, and turmeric, have demonstrated notable benefits over synthetic alternatives. Due to their long-lasting anti-bacterial, antimicrobial, and anti-fungal actions on human pathogens, medicinal herbs are essential for the treatment of illness. Using natural mouthwash in place of conventional ones may have several advantages. If a formulation like this could be invented that folks could safely and simply prepare at home using natural ingredients. As a result, the general oral health of the community could get better. Because they function on oral infections, quickly relieve pain, have few or no side effects, and target oral pathogens, herbal mouthwashes are quite popular. Among the most common infectious diseases that many individuals encounter at different times in their life are dental caries and periodontal disease. The purpose of this article is to give a general review of natural substances that can be effective mouthwashes. The objective of this study was to use polyherbal components to make mouthwash that has antibacterial properties.

Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study.

To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival. This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded. Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication. Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.

Association between Periodontitis Extent, Severity, and Progression Rate with Systemic Diseases and Smoking: A Retrospective Study.

The aim of this study was to analyze the relationship between extent, severity (stage), and rate of progression (grade) of periodontitis with systemic diseases as well as smoking using a large database. Patients' records identified in the BigMouth Dental Data Repository with a periodontal diagnosis based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions were evaluated. Patients were further categorized based on extent, severity, and rate of progression. Data were extracted from patients' electronic health records including demographic characteristics, dental procedural codes, and self-reported medical conditions, as well as the number of missing teeth. A total of 2069 complete records were ultimately included in the analysis. Males were more likely to have generalized periodontitis and stage III or IV periodontitis. Older individuals were more likely diagnosed with grade B and stage III or IV periodontitis. Individuals with generalized disease, grade C, and stage IV demonstrated a significantly higher number of missing teeth. Higher numbers of tooth loss reported during supportive periodontal treatment were noted in generalized disease and stage IV periodontitis. Multiple sclerosis and smoking were significantly associated with grade C periodontitis. Within the limitations of this retrospective study that utilized the BigMouth dental data repository, smokers were significantly associated with rapid progression of periodontitis (grade C). Gender, age, number of missing teeth, and number of tooth loss during supportive periodontal treatment were associated with disease characteristics.

Air polishing therapy in supportive periodontal treatment: a systematic review

The aim of this study was to analyze tooth surface roughness and clinical parameters by a systematic review of the literature to compare the efficacy of air polishing with hand or ultrasonic instrumentation during supportive periodontal therapy (SPT). This study used a research question based on the PICO method. Bibliographic research was performed using four different databases. For the search of the articles, the work was divided into two parts: the first part analyzed the clinical parameters of air polishing in supportive periodontal therapy, and the second part analyzed the effects of air polishing on hard tissues. Of 164 articles concerning clinical parameters, 49 met the inclusion criteria; from 64 articles concerning hard tissues, it reached 4. Excluding these doubles, 12 were chosen for the literature review: eight RCTs, one retrospective cohort study, and three in vitro studies. The scientific literature has shown that air polishing, scaling, and root planing in supportive periodontal therapy give similar clinical results. However, air polishing seems to preserve the hard tissues of the tooth more than the traditional treatment with ultrasonic or manual instrumentation.

Supportive Periodontal Treatment for the natural dentition and dental implants: a review

Aim: To assess the importance of successful periodontal treatment during long-term supportive periodontal treatment.
 The maintenance phase has been named the "cornerstone" of effective periodontal treatment when a patient is transferred from active treatment to a maintenance phase which is considered the final stage in comprehensive patient care, it takes effort and time from the patient, staff, and the dentist.
 Surgical and non-surgical techniques are used in periodontal therapy; patients should be put on a schedule of periodic reminder visits for supportive care once periodontal therapy is completed to avoid the recurrence of the disease. PD can recur due to poor mouth oral hygiene, insufficient subgingival removal, the microscopic nature of the dentogingival unit healing after periodontal treatment, and other factors. As a result, effective treatment should be provided to prevent disease recurrence.
 Conclusion: The success of periodontal therapy is based on a continuous schedule of periodontal maintenance therapy

Effectiveness of Supportive Care in the Prevention of Peri-implant Diseases in Brånemark Protocol Rehabilitations: A Retrospective Cohort Study.

This retrospective cohort study aimed to evaluate the efficiency of supportive periodontal treatment (SPT) on peri-implant disease prevention. A total of 63 rehabilitated patients with 504 implants were selected with both maxillary and mandibular Brånemark-type protocols (all-on-four system) placed between 2004 and 2014 in a private practice with 5 to 15 years of follow-up. Study participants were divided into those who adhered to SPT with regular intervals of two or more times a year (Group 1) and those with irregular intervals with more than 1 year without attending SPT (Group 2). The implants placed were evaluated clinically and radiographically to assess peri-implant diseases. The prevalence of mucositis and peri-implantitis in the total population was 64.7% (326 implants) and 3.7% (19 implants), respectively. Group 2 had higher rates of mucositis (181 implants) and peri-implantitis (16 implants) than Group 1 (145 and 3 implants, respectively) (P < .05). The odds ratio for peri-implantitis in Group 2 was 7.1. The results suggest that patients who regularly received SPT had lower chances of developing peri-implant diseases.

An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients

This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.

Adherence to supportive periodontal treatment in relation to patient awareness.

BackgroundTo evaluate the risk profile of noncompliant patients in relation to adherence to supportive periodontal therapy in order to identify factors associated with this profile, and be able to prevent the abandonment of periodontal therapy. Material and MethodsThis cross-sectional observational and comparative study was carried out on the patients who attended the Periodontics department of a University in Valencia (by a questionnaire and followed-up the periodontal supportive therapy through the medical history.) 220 patients were interviewed and gave their informed consent and data release permission before taking part in the study, which was approved by the Ethics Committee (UCV/2019-2020/048). Results48.84% of self-reported patients were regular compliers, in contrast with 10.62% of referred patients. Those with acute symptoms were greater adherent than those patients who didn´t present symptoms. Regarding patients undergoing surgical procedures, significant results were obtained: 69.70% showed adherence, in contrast with 18.67% patients with basic treatment. Results between men and women were similar. However, the age of the non-compliant patients was slightly older. ConclusionsSelf-reported patients presented a significantly higher degree of adherence to periodontal supportive therapy than the referred patients. Patients with acute symptoms presented higher adherence than those without them. Patients who underwent surgery presented a significantly higher degree of adherence than patients who received basic periodontal treatment. No conclusive data have been found regarding sex and age. Key words:Awareness, periodontal disease, compliance, SPT.

Periodontal treatment outcomes in smokers: A narrative review.

Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.

Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?

ObjectiveTo assess whether bacterial colonisation in a power-driven water flosser can be prevented.Materials and methodsTwenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp.ResultsContamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19–56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans.ConclusionNeither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU.Clinical relevanceBacterial colonisation in a power-driven water flosser seems impossible to prevent; to restrict the risk of cross-contamination within a household, one device per person should be recommended.

Molecular docking study and antireabsorptive activity of a semi-synthetic coumarin derivative from Platymiscium floribundum in the ligature-induced periodontitis in rats: the involvement of heme oxygenase-1.

This study aimed to evaluate the anti-resorptive activity of a semi-synthetic coumarin derivative from Platymiscium floribundum, named 6,7-dimethoxy-3-nitrocoumarin. Molecular docking studies were performed to test the binding performance of the derivative against targets associated with alveolar bone loss (TNF-α, IL-1β, and catalase) and a target considered an antioxidant defense (HO-1) during periodontitis. Periodontitis was induced by placing a nylon ligature around the second molars. The rats received for 11days 6,7-dimethoxy-3-nitrocoumarin (0.01, 0.1, or 1mg/kg) or vehicle. We investigated by RT-qPCR analysis (TNF-α, IL-1β, and HO-1 mRNA expression levels) and by colorimetric assay (catalase activity) the mechanism of action mediated by 6,7-dimethoxy-3-nitrocoumarin. The in vivo toxicity of 6,7-dimethoxy-3-nitrocoumarin was evaluated. 6,7-Dimethoxy-3-nitrocoumarin (0.1 or 1mg/kg) reduced alveolar bone loss (1.05 ± 0.24), when compared to vehicle-treated group (3.05 ± 0.30). The interactions of 6,7-dimethoxy-3-nitrocoumarin and the four targets (TNF-α, IL-1β, catalase, and HO-1) showed firm bonds above 6.0kcal/mol. 6,7-dimethoxy-3-nitrocoumarin (1mg/kg) lowered mRNA expression levels of TNF-α (2.33 ± 0.56) and IL-1β (19.87 ± 2.9), while it increased both the mRNA expression levels of HO-1 (43.40 ± 1.05) and the catalase activity (46.42 ± 4.59), when compared to vehicle-treated group (46.29 ± 8.43; 37.83 ± 4.38; 1.58 ± 0.11; 8.93 ± 1.86, respectively). The animals did not show any signs of toxicity. 6,7-Dimethoxy-3-nitrocoumarin decreased inflammatory bone loss in the ligature-induced periodontitis in rats, and the activation of the HO-1 pathway may contribute, at least partially, to its protective effects by reducing TNF-α and IL-1β mRNA levels and increasing catalase activity. 6,7-Dimethoxy-3-nitrocumarin could be used as an adjunct to subgingival instrumentation during active and supportive periodontal treatment.

A novel biofilm removal approach (Guided Biofilm Therapy) utilizing erythritol air-polishing and ultrasonic piezo instrumentation: A randomized controlled trial.

To evaluate the effectiveness of biofilm removal of a treatment protocol combining an air-abrasive device using erythritol powder (AIRFLOW®) and an ultrasonic piezon instrumentation (Guided Biofilm Therapy/GBT) compared with the conventional mechanical approach (Scaling and Root Planing/SRP) during supportive periodontal treatment (SPT). Fifty patients, scheduled for supportive periodontal treatment at the Department of Preventive Dentistry, Periodontology and Implant Biology of the Aristotle University of Thessaloniki were randomly assigned to either a GBT (group A: 24 participants) or a SRP (Group B: 26 participants) treatment protocol. Therapeutic interventions and clinical measurements were performed at baseline and repeated at 6weeks. Oral hygiene instructions were reinforced at each visit. A questionnaire was handed to the participants for evaluation of patient perception of both utilized approaches. At 6weeks, the two groups showed statistically significant reduction in plaque score and in gingival bleeding index compared with baseline. GBT required approximately 15% less chair-time than SRP with a mean difference of 5.1min, which was statically significant (p=0.049). Patient perception was more favourable for GBT than SRP. Biofilm removal using erythritol AIRFLOW® and ultrasonic piezo-electric instruments (GBT) can be considered equally efficient compared with the conventional SRP. Moreover, GBT seemed to require shorter treatment time and to exhibit a more favourable patient perception than the conventional approach.

Microbiological testing of clinical samples before and after periodontal treatment. A comparative methodological study between real‐time PCR and real‐time‐PCR associated to propidium monoazide

ObjectivesThe aim of the present methodological study was to evaluate the discrepancies in the detection of a number of periodontally involved pathogenic bacteria obtained from clinical samples by two methods: the quantitative Polymerase Chain Reaction (qPCR) and the qPCR combined with pre‐treatment by Propidium Monoazide (PMA).Material and methodsPlaque and saliva samples were obtained from 30 subjects: 20 subjects with chronic or aggressive periodontitis in need of periodontal therapy with or without antibiotics and 10 subjects in Supportive Periodontal Treatment (SPT). The clinical samples taken before treatment (BL) and 1 month later (M1), were divided in two aliquots: one was immediately treated with PMA while the other was left untreated. All samples were further analyzed with qPCR after DNA extraction, for the detection of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Parvimonas micra (Pm), and Prevotella intermedia (Pi).ResultsLarge inter‐individual variations were observed in the concentration of the studied bacteria. At both instances (BL and M1) and for the three groups, significantly lower counts of bacteria were depicted when plaque and saliva samples were pre‐treated with PMA as compared to those without treatment. Treatment resulted in significant decreases in the number of bacteria, mainly in the plaque samples. However, these changes were almost similar in the three groups independently of the method of detection used (PMA‐qPCR vs. q‐PCR).ConclusionRemoval of DNA from non‐viable cells with PMA treatment is an easily applied step added to the classical qPCR that could give accurate information on the presence of viable bacterial load and evaluate the response to periodontal treatment.

Does a history of periodontal disease affect implant survival?

Data sources Three electronic databases were searched (Medline, EMBASE and Cochrane Central) with date of publication between January 2003 and May 2018. Only articles written in English were included. Following electronic searches, the authors conducted manual searches of oral implant/periodontal journals from January 2012 to May 2018. In the event of disagreement on article selection, a further senior reviewer would make the final decision on its inclusion or exclusion following discussion.Study selection In total, 172 articles from the electronic search and ten from manual search were identified for initial screening. From the title and abstract, 18 articles were identified for full-text screening. Following this, 13 articles were included for quantitative synthesis and meta-analysis. The articles assessed the impact of history of periodontitis (HP) on implant survival, radiographic bone loss, pocket depth and bleeding on probing around the dental implant. All studies were either cohort or controlled studies. Seven of the 13 identified studies were prospective. Included studies fulfilled the following criteria: any human studies with supportive periodontal treatment (SPT) application, details of SPT provided in the studies for implant maintenance, compares the outcomes of implants from both patients with and without a HP and peri-implant conditions recorded.Data extraction and synthesis Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. The Newcastle-Ottawa Scale was used to carry out quality assessment. Data was extracted to calculate risk ratio (RR) of implant survival, weighted mean difference (WMD) for radiographic bone loss, pocket depth, bleeding on probing and plaque index in patients with and without a HP.Results Implant survival rate was assessed as the primary outcome. Secondary outcomes also assessed were radiographic bone loss, pocket depth, bleeding on probing and plaque indices. In implants with rough surfaces, the HP group showed a reduced implant survival rate (RR: 0.96, 95% CI: 0.94-0.98, P <0.001) even under regular supportive post-implant treatment. They also showed more radiographic marginal bone loss (WMD: 0.34 mm, 95% CI: 0.2-0.48, P <0.001), pocket depth (WMD: 0.47 mm, 95% CI: 0.19-0.74, P <0.001) and bleeding on probing (WMD: 0.08 mm, 95% CI: 0.04-0.11, P <0.001) when compared to the non-HP group. In implants with a machined surface, again the HP group had more radiographic bone loss (WMD: 0.88 mm, 95% CI: 0.65-1.11, P <0.001) than the non-HP group. However, in implants with machined surfaces, there was no statistically significant difference in survival rate between HP and non-HP groups (RR: 0.98, 95% CI: 0.92-1.04, P = 0.895).Conclusion In implants with rough surfaces, a history of periodontal disease has a negative impact on survival rate, even with SPT.

The impact of supportive periodontal treatment on the outcome of regenerative surgical therapy in aggressive periodontitis patients.

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ± 0.5 mm and 0.04 ± 1.1 mm, and -0.65 ± 3.0 mm and -0.73 ± 3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task.

Nonsurgical periodontal management of Papillon–Lefevre syndrome

Papillon–Lefevre syndrome (PLS) is an autosomal recessive genetic disorder caused by a deficiency in Cathepsin C. It is characterized by palmoplantar keratosis and premature loss of both primary and permanent dentition. Patients are often edentulous at an early age. Other symptoms include increased susceptibility to infections. Various etiologic factors such as genetic mutations, immunologic alterations, and bacteria have been implicated. We present a case report of 12-year-old female who reported to the dental clinic with a history of pain and swollen gums. Family history revealed consanguinity. On clinical examination, there was palmoplantar keratosis and examination of the oral cavity showed generalized periodontal pockets, tooth mobility, and periodontal abscess. Radiographic examination revealed generalized horizontal bone loss. Lateral cephalogram revealed retarded somatic development. A diagnosis of PLS was arrived based on history, clinical and radiological findings. Nonsurgical periodontal treatment along with the treatment of skin lesions was performed. A combined and intensive mechanical and antimicrobial treatment with supportive periodontal treatment in PLS patients may halt the periodontal disease progression. The dentists should be aware of the same because an early diagnosis of the syndrome can help to preserve the teeth by the timely institution of treatment, using a multidisciplinary approach.

Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study.

PurposeThe aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients.MethodsIn total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs).ResultsTwelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22–23.91; P=0.026) than patients with stage I (grade A or B) periodontitis.ConclusionsAlthough fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

A retrospective cohort study on peri-implant complications in implants up to 10 years of functional loading in periodontally compromised patients.

Prevalence of peri-implantitis is directly proportional to the time of functional loading. The aim of this retrospective study was to assess the survival and success rates as well as the incidence of peri-implantitis among patients with a history of periodontitis and among implants with 1 to 10 years of functional loading. We evaluated clinical records of periodontally compromised patients treated between January 1998 and July 2002, with implants enrolled in a supportive periodontal and peri-implant treatment follow-up program. The following assessment indexes during follow-up were recorded: suppuration on probing, modified bleeding on probing, probing depth, implant mobility, bone changes, and criteria of success of Albrektsson. Clinical data of 475 patients with 1,991 implants were analyzed for a period of 10 years of functional loading. The survival and success rates were 91.8% and 75.4%, respectively, and the cumulative incidence of peri-implantitis among patients was 24.4%. The survival rate was 96.1%, and the success rate was 83.7% among implants. The incidence of peri-implantitis exhibited a peak rate after the seventh year (2.1%). The prevalence of peri-implantitis increased from 3.2% to 9.7% between 5 and 10years of follow-up, and the peri-implantitis rate among implants was 12.9% after 10 years of functional loading. Peri-implantitis begins to appear more frequently after the fifth year of functional loading, especially between the seventh and eighth years of function.

Photo-activated disinfection with light-emitting diode reduces some key periodontal pathogens in chronic periodontitis

The aim of the present study was to evaluate the potential of minimally invasive periodontal treatment using repeated photo-activated oral disinfection (PAD) with red light emitting diodes as an adjunct to ultrasonic scaling (US) in the treatment of chronic periodontitis. In a single-centred, randomized clinical trial involved 40 patients with untreated chronic periodontitis received US with repeated 3 episodes of PAD (test group) or US alone (control group). Clinical parameters (plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL)) were recorded for 12 months and subgingival biofilm analyses for five periodontal pathogens (A. actinomycetemcomitans (Aa), P. gingivalis (Pg), P. intermedia (Pi), T. forsythia (Tf), T. denticola (Td)) were performed for 6 months. Supportive periodontal treatment (SPT) was repeated every 3 months during the clinical trial, additional one episode of PAD was also applied in the test group. Both treatment modalities improved clinical parameters after 3 months and SPT maintained favourable clinical outcomes during 12 months. There were no statistical significant differences between the treatment groups. Statistical significant reduction of Aa, Pg, Tf, Td (p<0.05) was observed in the test group. In moderate pockets significant reduction of Pg, Tf, Td (p<0.05) and in deep periodontal pockets reduction of Pg, Pi, Td (p<0.05) was observed. Within the limits of the present study it may be concluded that the addition of PAD to US significantly reduced some key periodontal pathogens, however, patients with a history of periodontitis should be on SPT every 3-4 months.

Cleansing efficacy of waist-shaped inter-dental brushes. A randomized-controlled crossover study.

ObjectiveTo compare the cleansing efficacy of waist‐shaped versus cylindric inter‐dental brushes in patients receiving supportive periodontal therapy.Materials and methodsAfter sample size estimation, 20 periodontal maintenance patients diagnosed with periodontitis stage 3 were recruited. Brushing efficacy of waist‐shaped and cylindric inter‐dental brushes was evaluated in a randomized‐controlled, examiner‐blinded, two‐period crossover study by assessment of the Turesky modification of Quigley‐Hein plaque index (T‐QHI) and the papillary bleeding index (PBI) at four sites per tooth.ResultsSeventeen probands with 1,474 tooth sites finished the study. At baseline, median of overall T‐QHI scores was 1.4 (interquartile range 1.38–1.92). After 1 month, T‐QHI for waist‐shaped inter‐dental brushes was 1.24 (1.03–1.52); in 15 individuals, T‐QHI 0 was the grade most often measured. T‐QHI for cylindric brushes was 1.71 (1.18–2.29; p = .042), with T‐QHI 0 being the grade most often measured only in seven individuals. The odds ratio for establishing plaque‐free inter‐dental sites with waist‐shaped relative to cylindric brushes was 1.8 [95% CI 1.6–1.9] (p < .001; logistic regression analysis). There were no statistically significant differences between PBI levels of waist‐shaped and cylindric brushes.ConclusionThis study has demonstrated the superiority in cleansing efficacy of waist‐shaped over cylindric inter‐dental brushes in individuals receiving supportive periodontal treatment.