Treatment Of Periodontitis Patients Research Articles

Implant Health in Treated Periodontitis Patients: A Systematic Review and Meta-Analysis.

The aim of this meta-analysis was to evaluate the role of a history of periodontitis on implant failure. The two main judgment criteria studied are peri-implantitis and the survival rate. The two secondary judgment criteria studied are the mean pocket depth and the mean peri-implant bone loss. An electronic search was performed via five databases (MEDLINE, Embase, ScienceDirect, LILACS and the Cochrane Library) and was supplemented by manual searching. The search was undertaken in June 2024. Of 10 775 potentially eligible articles, 8 were included in the qualitative analysis and 10 in the quantitative synthesis. This meta-analysis suggests that a history of periodontitis has a significant impact on the rate of peri-implantitis, survival rate, mean bone loss and pocket depth.

Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis.

The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.

“Outcome of non-surgical periodontal treatment on Gal-1 and Gal-3 GCF levels in periodontitis patients: a case-control study”

ObjectivesThis study aimed to explore the effect of nonsurgical periodontal treatment on Galectin-1 and -3 GCF levels in gingivitis and periodontitis stage III compared to periodontally healthy individuals, to determine whether they could serve as diagnostic markers / therapeutic targets for periodontitis and revealing their possible role in periodontal disease.Materials and methodsForty-five systemically healthy participants were included and equally subdivided into three groups: gingivitis, periodontitis (stage III), and a periodontally healthy control group. The clinical parameters were recorded. Galectin-1 and -3 GCF levels were evaluated (before and after non-surgical treatment for periodontitis) using an enzyme linked immune-sorbent assay (ELISA) kit. Receiver operating characteristic (ROC) curve was performed to reveal sensitivity, specificity, predictive value, and diagnostic accuracy of both markers.ResultsThe study showed statistical significance between different groups regarding Galectin-3 with higher values in periodontitis and the lowest values in healthy control. Also, Galectin-1 was significantly higher in the periodontitis/gingivitis groups than in the control group. Moreover, non-surgical periodontal treatment in periodontitis patients caused a statistical reduction in clinical parameters and biomarkers. ROC analysis revealed excellent diagnostic ability of both biomarkers in discriminating periodontitis/gingivitis against healthy individuals (100% diagnostic accuracy for Galectin-1 and 93% for Galectin-3, AUC > 0.9) and acceptable diagnostic ability between periodontitis participants against gingivitis (73% diagnostic accuracy for Gal-1 and 80% for Gal-3, AUC > 0.7).ConclusionsBoth Galectin-1 and Galectin-3 seem to have outstanding diagnostic accuracy for the identification of periodontal disease, an acceptable ability to measure periodontal disease activity and the severity of inflammatory status. Additionally, they could serve as therapeutic targets to monitor treatment efficiency.Clinicaltrial.gov registration number(NCT06038812).

Topically Applied Phenytoin Gel as Adjunctive Treatment in Periodontitis Patients

Topically Applied Phenytoin Gel as Adjunctive Treatment in Periodontitis Patients

Comparison of salivary beta-defensin-1 levels in patients with periodontitis before and after phase I periodontal therapy.

This study compared human β-defensin 1 (hBD-1) salivary levels in patients with periodontitis before and after phase I periodontal therapy. This controlled before-and-after study included 16 patients in the intervention group and 28 participants in the control group. Patients in the intervention group had stage 3 grade B periodontitis with no systemic diseases and had not taken any medications in the last six months. The control group included participants with healthy periodontium. Before and after phase I periodontal therapy, salivary samples were collected from the intervention group. ELISA was used to measure hBD-1 levels. Salivary levels of hBD-1 decreased after phase I periodontal treatment in periodontitis patients, approaching those in healthy individuals. However, this reduction was not statistically significant (P=0.389). In patients with a probing depth (PD) of at least 3 mm, salivary levels of hBD-1 decreased significantly (P=0.019) following the intervention. There was no significant correlation between changes in hBD-1 levels and clinical indices, such as clinical attachment loss (CAL), probing depth, or bleeding index (BI) (P˃0.05). The current study demonstrated promising results concerning a probable link between hBD-1 and periodontitis. However, more research with sufficiently large sample sizes and more robust study designs is necessary.

Pilot Study: The Effectiveness of Hyperbaric Oxygen Therapy in the Treatment of Periodontitis in Patients with Type 2 Diabetes.

Periodontitis is a chronic inflammatory disease with multifactorial aetiology. The relationship between periodontal disease and systemic diseases such as diabetes, obesity, metabolic syndrome, atherosclerotic, cardiovascular disease, and cognitive disorders has been the subject of many studies. The purpose of this study was to evaluate the effectiveness of hyperbaric oxygen therapy on periodontal health in patients suffering from periodontitis and type 2 diabetes. The study was conducted with 14 patients. A total of 369 periodontal pockets in the study group and 431 in the control group were examined. For further analysis, the pockets were classified as moderately deep (4-5 mm) and deep (≥6 mm). All patients received standard non-surgical treatment: scaling and root planing (SRP). Additionally, a series of 30 hyperbaric chamber sessions was carried out in the study group. The following parameters were compared between groups: PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing). The results of the study showed significantly better results in terms of PD reduction and CAL gain in the study group in comparison to the control group. Both groups showed a reduction in BOP (bleeding on probing) after treatment. The use of hyperbaric oxygen therapy seems to have considerable benefits in patients with type 2 diabetes.

Bifidobacterium animalis subsp. lactis as adjunct to non-surgical periodontal treatment in periodontitis: a randomized controlled clinical trial.

The purpose of this study is to investigate the clinical and microbiological effects of Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt as an adjunct to non-surgical periodontal treatment in periodontitis patients. This is a prospective randomized controlled clinical study registered with NCT05408364 under clinical trial registration. Thirty periodontitis patients were divided into 2 groups at random. As adjunctive to supra and subgingival instrumentation, the test group consumed Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt while the control group consumed natural yogurt, once daily for 28 days. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 28th day, and 3rd month. Microbiological analysis was performed using culture method by obtaining subgingival plaque samples from 2 periodontal sites with 4≤PD≤6 mm at the same time points. The inter-group comparisons of PI, GI, and BOP as well as the changes between the measurement time points were statistically significant in favor of the test group. There were no significant differences in terms of PD and CAL changes between the study groups at all times (∆baseline-28 days, ∆baseline-3 months) (p>0.05). The number of patients presenting subgingival Bifidobacterium species was significantly greater in the test group than the control group at the 28th day (p<0.05). The administration of probiotics has shown beneficial effects, albeit limited, on clinical and microbiological outcomes in the management of periodontitis patients. Daily consumption of probiotic yogurt may be supportive for supra and subgingival instrumentation.

Имитационное моделирование воздушно- капельного пути передачи респираторных вирусов в стоматологической практике

Objective. In simulation modeling, to study the airborne transmission of respiratory viruses to medical personnel during dental treatment of patients. Materials and methods. During the complex treatment of chronic periodontitis with the use of a bacteriophage preparation, a simulation of the airborne respiratory infection viruses was performed. The spread of the staphylococcal phage was evaluated in 50 air samples and 190 flushes from the doctor, his personal protective equipment, tools and environmental objects by a modified Grazia method on the target bacteria of non-pathogenic Staphylococcus xylosus. The identification of the bacteriophage was carried out in PCR. Results. In the complex treatment of periodontitis in patients using bacteriophages, it was detected in 84.00% [95% CI 63.92–95.46] dental office air samples with maximum frequency in the patient's treatment area, the doctor's and assistant's areas (100.00% [95% CI 47.82–134.48]). The bacteriophage equally contaminated the inner surfaces of the medical mask and the nasal cavity of the doctor (p = 0.62). The maximum amount of phage was isolated from dental equipment: air-water syringe ((35.30 ± 10.55)·107 PFU/ml) and an ultrasonic scaler ((23.02 ± 7.72)·107 PFU/ml). Conclusion. The use of aerosol-generating procedures in the treatment of dental diseases is accompanied by intensive contamination by viruses of the air of the dental office, environmental objects and personal protective equipment, which determine the high risks of infection of medical care workers. Key words: aerosol generating technologies, bacteriophage, airborne transmission, medical care workers, patients, dentistry

Relationship between Phenotypic and Genotypic Resistance of Subgingival Biofilm Samples in Patients with Periodontitis.

The phenotypic expression of antibiotic resistance genes (ARGs) can hamper the use of antibiotics as adjuncts to subgingival instrumentation in the treatment of periodontitis patients. The aim of the study was to analyze the relationship between the phenotypic and genotypic resistance against ampicillin-sulbactam, clindamycin, doxycycline and metronidazole of subgingival biofilm samples from 19 periodontitis patients. Samples were analyzed with shotgun sequencing and cultivated anaerobically for 7 days on microbiological culture media incorporating antibiotics. All growing isolates were identified to the species level using MALDI-TOF-MS and sequence analysis of the 16S ribosomal RNA (rRNA) gene. Phenotypic resistance was determined using EUCAST-breakpoints. The genetic profile of eight patients matched completely with phenotypical resistance to the tested antibiotics. The positive predictive values varied from 1.00 for clindamycin to 0.57 for doxycycline and 0.25 for ampicillin-sulbactam. No sample contained the nimI gene. It can be concluded that antibiotic resistance may be polygenetic and genes may be silent. Every biofilm sample harboring erm genes was phenotypic resistant. The absence of cfx and tet genes correlated to 100%, respectively, to 75%, with the absence of phenotypic resistance. The absence of nimI genes leads to the assumption that constitutive resistance among several species could explain the resistance to metronidazole.

Efficacy of the additional use of subgingival air-polishing with erythritol powder in the treatment of periodontitis patients: a randomized controlled clinical trial. Part II: effect on sub-gingival microbiome

ObjectivesTo date, scarce evidence exists around the application of subgingival air-polishing during treatment of severe periodontitis. The aim of this study was to evaluate the effect on the health-related and periodontitis-related subgingival microbiome of air-polishing during non-surgical treatment of deep bleeding pockets in stage III–IV periodontitis patients.Materials and methodsForty patients with stage III–IV periodontitis were selected, and pockets with probing depth (PD) 5–9 mm and bleeding on probing were selected as experimental sites. All patients underwent a full-mouth session of erythritol powder supragingival air-polishing and ultrasonic instrumentation. Test group received additional subgingival air-polishing at experimental sites. Subgingival microbial samples were taken from the maxillary experimental site showing the deepest PD at baseline. Primary outcome of the first part of the present study was the 3-month change in the number of experimental sites. Additional analysis of periodontal pathogens and other sub-gingival plaque bacteria sampled at one experimental site at baseline and 3 months following treatment was performed through a real-time quantitative PCR microarray.ResultsIn the test group, a statistical increase of some health-related species was observed (Abiotropha defectiva, Capnocytophaga sputigena, and Lautropia mirabilis), together with the decrease of pathogens such as of Actinomyces israelii, Catonella morbi, Filifactor alocis, Porphyromonas endodontalis, Sele-nomonas sputigena, Tannerella forsythia, Treponema denticola, and Treponema socranskii. In the control group, statistical significance was found only in the decrease of Filifactor alocis, Tannerella forsythia, and Treponema socranskii.ConclusionsThe addition of erythritol-chlorhexidine powder seems to cause a shift of the periodontal micro-biome toward a more eubiotic condition compared to a conventional treatment. The study was registered on Clinical Trials.gov (NCT04264624).Clinical relevanceSubgingival air-polishing could help re-establishing a eubiotic microbioma in deep bleeding periodontal pockets after initial non-surgical treatment.

Features of oral care in the treatment of periodontitis in patients who have undergone a new coronavirus infection COVID-19

A new coronavirus infection (COVID-19) leads to changes in the oral cavity, which makes it important to consider the optimal use of oral care products. The aim of the work was to evaluate the effectiveness of the use of preventive toothpastes with herbal components, along with the use of antiseptic rinses, in the treatment of elderly patients suffering from chronic generalized periodontitis and against the background of postcovid syndrome. 48 elderly patients with postcovid syndrome suffering from chronic generalized periodontitis of moderate severity were examined, who underwent the generally accepted complex treatment of periodontitis, but the methods of individual oral care differed due to the inclusion of rinses to the toothpastes used in the technique. It has been established that in elderly people suffering from periodontitis against the background of a new coronavirus infection, there are large violations of hemomicrocirculation in periodontal tissues, as well as a high incidence of periodontal pathogens. It was also noted that toothpastes in combination with mouthwashers are highly effective for individual oral hygiene in such patients. Despite the relatively identical clinical characteristics of oral hygiene and indicators of the condition of periodontal tissues, the use of a rinse aid with chlorhexidine during the week at the beginning of complex treatment helps to reduce the frequency of detection of periodontal pathogens, which is important for the secondary prevention of periodontitis and its recurrence.

Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial.

Objective: The aim of this study was to evaluate the efficacy of diode laser (DL) therapy as an adjunct to nonsurgical periodontal therapy in the treatment of periodontitis in patients after myocardial infarction (MI). Methods: After given permission by Ethics Commission of the Pomeranian Medical University (KB-0012/06/12), 36 patients <65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after MI were enrolled for the study. The control group (n = 18) received nonsurgical periodontal therapy, whereas the test group (n = 18) received nonsurgical periodontal therapy followed by laser therapy of the periodontal pockets with 980 nm DL, 1 W, continuous wave mode, and 20 sec per tooth side. Procedures were repeated twice at 5-7 day intervals. Clinical periodontal parameters and inflammatory markers in gingival crevicular fluid (GCF) [elastase, aspartate transaminase (AST), alanine transaminase (ALT) and interleukin (IL)-6, proteins], bloodstream [fibrinogen, high-sensitivity CRP (hs-CRP), IL-6, AST and ALT], and lipid fractions (triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol) were measured before treatment, 2 weeks, and 3 months after treatment. Results: The difference between groups in the reduction of periodontal pocket depth (PPD) in pockets ≥7 mm was found to be significant in the test group (p < 0.05). There was also a statistically significant reduction in the volume of GCF and hs-CRP concentration in blood 2 weeks after the completion of treatment in the test group (p < 0.05). Conclusions: Within the limits of this study, it can be concluded that in the nonsurgical treatment of periodontitis with patients after MI, the additional use of DL enables greater reduction of PPD in pockets ≥7 mm. In addition, a faster reduction of GCF volume and hs-CRP was noted in the laser group.

Interdental plaque reduction after the use of different devices in patients with periodontitis and interdental recession: A randomized clinical trial.

ObjectivesTo determine the efficacy of four different oral hygiene protocols involving adjunctive interdental devices in terms of plaque and bleeding scores in periodontitis‐affected patients.Material and methodsThis was a randomized clinical trial with a 5‐week follow‐up, including previously treated periodontitis patients not undergoing any supportive care. Patients were randomly allocated to 4 groups: manual toothbrush (group TB); toothbrush plus dental floss (group TB/F); toothbrush plus interdental brushes (group TB/IDB) and toothbrush plus rubber interdental picks (group TB/RIDB). Oral hygiene instructions (OHI) were provided at baseline (T‐7) and at T0 (1‐week) then bi‐weekly (T14/T28). At T0, supragingival professional cleaning was delivered. Plaque and bleeding indexes were taken at all timepoints by a single calibrated examiner, blind to group allocation.ResultsAt T‐7, patients were comparable for age, body mass index (BMI) and all clinical parameters, exceptions for the Interdental Angulated Bleeding Index. At T28, significant reductions of plaque and gingival inflammation were noted in all groups (p < 0.001) and within the expected ranges. Intergroup comparisons identified that group TB/IDB and group TB/RIDB achieved lower levels of plaque and inflammation than group TB (p < 0.05). Group TB/IDB and group TB/RIDB showed lower levels of plaque and lower inflammation as measured by angulated bleeding index than group TB/RIDB (p < 0.05).ConclusionInterdental brushes and rubber interdental picks were more efficient than toothbrushing alone and toothbrushing and floss in reducing plaque and gingival inflammation measured in a periodontitis‐affected population.

Clinical response of doxycycline administration to periodontal tissues of periodontitis patients with type 2 diabetes mellitus: Rapid Review

ABSTRACT Diabetes mellitus is a group of physiological dysfunctions due to insulin resistance and inadequateinsulin secretion characterized by hyperglycemia. Diabetic patients have an increased risk and severity ofperiodontitis. Therefore, additional periodontal treatment is required. Doxycycline is a broad-spectrum antibioticand has the anti collagenase ability to inhibit tissue damage. This study aims to determine the clinical response ofperiodontal tissue in patients with periodontitis with type 2 diabetes mellitus to doxycycline. This rapid review wasconducted online in May-July 2021 on randomized controlled trial articles about systemic doxycycline as anadjunctive periodontal treatment in periodontitis patients with type 2 diabetes mellitus. The search was carried outfrom three electronic databases, Pubmed NCBI, Cochrane Library, and Google Scholar concerning PRISMA analysisguidelines, using PICO strategy and the study quality assessed by SORT. Five articles were selected with goodevidence quality (level 1). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP),plaque index (PI), gingival index (GI), and gingival recession were evaluated. The result showed a more significantreduction in clinical parameters in periodontitis patients with type 2 diabetes mellitus who received additionalsystemic doxycycline treatment, except gingival recession. Systemic doxycycline as an adjunctive periodontaltreatment in periodontitis patients with type 2 diabetes mellitus gave a positive clinical response, with better resultsthan no other doxycycline treatment group. KEYWORDS: Doxycycline, periodontitis, diabetes mellitus

The Effectiveness of Therapeutic and Prophylactic Complexes in the Treatment of Chronic Generalized Periodontitis in Patients with Diabetes Mellitus

Local drug anti-inflammatory therapy is an integral part of the comprehensive treatment and prevention of periodontal diseases. Preparations used for topical use in periodontics are often poorly fixed at the place of application, as a result of which the exposure of the drug is not maintained. In addition, they are combined arbitrarily, without taking into account their compatibility and dosage, during one course of treatment, drugs with a different mechanism of action are used each time, the multiplicity of procedures is not maintained. The selection of medicines is carried out by the doctor empirically. The aim of the study was to determine the effectiveness of the use of various therapeutic and prophylactic complexes in the treatment of periodontitis in patients with diabetes mellitus.

Effect of orthodontic therapy in periodontitis and non-periodontitis patients: a systematic review with meta-analysis.

To answer these PICO questions: #1: In adult patients with malocclusion, what are the effects of orthodontic tooth movement (OTM) on clinical attachment level (CAL) changes in treated periodontitis patients with a healthy but reduced periodontium compared to non-periodontitis patients? #2: In adult patients with treated periodontitis and malocclusion, which is the efficacy of skeletal anchorage devices compared to conventional systems in terms of orthodontic treatment outcomes? Seven databases were searched until June 2020 looking for randomized, non-randomized trials and case series. Mean effects (ME) and 95% confidence intervals (CIs) were calculated. Twenty-six studies with high risk of bias were included. PICO#1: In 26 patients without periodontitis and in 69 treated periodontitis patients, minimal changes in periodontal outcomes were reported after orthodontic therapy (p>0.05). A significant CAL gain (mm) (ME=3.523; 95% CI [2.353; 4.693]; p<0.001) was observed in 214 patients when periodontal outcomes were retrieved before a combined periodontal and orthodontic therapy. PICO#2: Orthodontic variables were scarcely reported, and objective assessment of the results on orthodontic therapy was missing. Based on a small number of low-quality studies, in non-periodontitis and in stable treated periodontitis patients, OTM had no significant impact on periodontal outcomes.

Clinical and Radiographic Outcomes of Implants with Two Different Collar Surfaces in Treated Periodontitis Patients: A 10-Year Retrospective Study.

This retrospective study compares clinical and radiographic results of implants with and without a laser-microtextured collar placed in patients with a past history of periodontitis after 10 years of follow-up. A total of 57 implants (29 implants with laser-microtextured collar, 28 implants with a smooth collar) were placed in 35 patients. After 10 years of follow up, the survival rates (SRs) were 87.9% and 84.8% for implants with and without a laser-microtextured collar, respectively. No statistically significant differences (P > .05) were found between groups in terms of full-mouth plaque and bleeding scores. However, a statistically significant difference (P < .05) was recorded in terms of probing depth (PD) and marginal bone loss (mBL). Within the limitations of this study, implants with a laser-microtextured collar and implants with a smooth collar placed in patients with a past history of periodontitis yielded no statistically significant differences in SRs after 10 years of follow-up. However, implants with a laser-microtextured collar showed lower PD and mBL compared to implants with a smooth collar.

Periodontitis and Helicobacter pylori Infection: Eradication and Periodontal Therapy Combination.

Objectives This study was aimed to assess (1) the prevalence of salivary and gastric Helicobacter pylori (HP) infection in patients with and without periodontitis, (2) the prevalence of HP infection in patients with periodontitis according to its clinical classification, (3) the effect of periodontitis treatment in patients with or without gastric HP infection, and (4) if gastric HP eradication in combination with periodontitis treatment influences periodontitis clinical outcome. Materials and Methods Thirty-three adults with periodontitis treated by quadrant scaling and root planning (QSRP). The simplified plaque index (PI), bleeding on probing index (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed pretreatment and 3 months of posttreatment. The patients were tested for oral and gastric HP. Gastric HP (+) patients received eradication therapy. A control group of 32 periodontically healthy volunteers was tested for oral and gastric HP. Saliva samples were evaluated by real-time polymerase chain reaction (rtPCR); gastric HP was detected by urea breath test (UBT). Statistical Analysis Normality of variables assessed by the Kolmogorov–Smirnov test, while the differences of pre- and post-treatment were analyzed by paired samples t -test. Differences between subgroups were compared by a Student’s t -test or a Mann–Whitney U -test. Comparisons of nominal variables were made by Pearson’s Chi-square test. Results No saliva samples were positive for HP. Gastric HP was detected in six patients with periodontitis and seven controls ( p > 0.05). HP infection affected patients with higher disease stages and grades. All HP (+) patients underwent successful eradication treatment. All clinical periodontitis indices improved following QSRP. HP (+) patients who received QSRP as adjunctive to eradication treatment showed improvement in BOP ( p < 0.001), PI ( p < 0.013), and CAL ( p < 0.004) compared with HP (−) patients who received QSRP alone. Conclusion Periodontitis was not associated with gastric HP infection. Saliva was not a gastric HP supply reservoir. Gastric HP infection was associated with advanced stages and grades of periodontitis. Although all periodontal clinical markers improved after QSRP, BOP, PI, and CAL, they were further improved when combined with eradication treatment. Periodontal evaluation and treatment combined with HP eradication are recommended in patients with HP gastric infection.

Evaluation of the implant disease risk assessment (IDRA) tool: A retrospective study in patients with treated periodontitis and implant-supported fixed dental prostheses (FDPs).

AimTo evaluate the Implant Disease Risk Assessment (IDRA) tool for the prediction of peri‐implantitis in treated periodontitis patients with implant‐supported fixed dental prostheses (FDPs) after at least 5 years of function.Material and methodsFrom the patient pool of implant patients enrolled in a regular supportive periodontal therapy programme (SPT) for at least 5 years, 239 patients were screened. Eighty patients met the inclusion criteria and underwent evaluation through the criteria of the IDRA tool. Areas under the curve (AUCs) for receiver operating characteristic (ROC) curves including 95% confidence intervals were estimated.ResultsSeventy‐nine patients (43 males and 36 females, 8 smokers), aged on average 59.0 years (range: 40–79 years) at baseline (i.e. FDP delivery) were analysed. The calculated IDRA‐risk was in 34 patients (42.5%) a moderate risk, while 45 patients (56.3%) were considered at high IDRA‐risk. One patient categorized at low IDRA‐risk was excluded from the analysis.The AUC was 0.613 (95% CI: 0.464–0.762) if the IDRA‐risk was associated with prevalence of peri‐implantitis at the most recent follow‐up. Peri‐implantitis was diagnosed in 4 patients (12%) at moderate and in 12 patients (27%) at high IDRA‐risk, respectively. The calculated odds ratio for developing peri‐implantitis in patients with high IDRA‐risk compared with patients with moderate IDRA‐risk was 2.727 with no statistically significant difference between the two groups (95% CI: 0.793–9.376).ConclusionWithin the limitations of the present retrospective study, the IDRA algorithm might represent a promising tool to assess patients at moderate or high risk of developing peri‐implantitis.

Effect of omega 3 fatty acids plus low dose aspirin as a host modulating agent in the treatment of periodontitis patients- A Systematic Review

Background and Objectives: Host Modulatory Therapy is a treatment modality for periodontal diseases. It aims at reducing the periodontal destruction and enhances the regenerative capacity of periodontal tissues. Various host modulating agents are used as an adjunct to scaling and root planing. Omega 3 Fatty acids and non-steroidal anti-inflammatory drugs like Aspirin modify the activity of inflammatory mediators and exert anti-inflammatory effect. The objective of the systematic review was to evaluate the effect of Omega 3 Fatty acids plus low dose Aspirin as adjunct to mechanical debridement in reduction of pocket depth in patients with periodontitis. Methods: In this systematic review, Randomized controlled trials in subjects with periodontitis in age group of 25-70 years were considered. Follow up period ranged from 6 weeks to 6 months. A systematic review of literature was performed using Pubmed, PMC, Google scholar, EBSCO host databases. Studies concerning the use of Omega 3 Fatty acids plus low dose Aspirin as host modulating agent in periodontitis treatment were selected. A total 2650 of studies were selected through search strategy and 5 articles which attained the inclusion criteria have been included in present systematic review. Results: Oral supplementation of omega 3 fatty acids in combination of low dose Aspirin as adjunct to mechanical debridement reduces the pocket depth during the 6 weeks to 6 months follow up period. Limitations: There are limited studies which are available. Also there is lack of data evaluating the long term follow up of the intervention. Conclusion: Use of omega 3 fatty acids and low dose aspirin in periodontitis patients improves periodontal status but further long-term studies need to be conducted.