Treatment Of Periodontitis Research Articles

Hemodynamic periodontal changes in the treatment of chronic generalized periodontitis using polarized polychromatic light

Background: Ineffective treatment of inflammatory periodontal diseases is a significant medical and social issue. Previous research have shown that improved vascular response and local immunity activation are crucial for the treatment of periodontal diseases. This can be accomplished using polarized polychromatic light. However, the effect of polarized polychromatic light on microhemocirculation in periodontal tissues is poorly understood. Aim: To assess microhemodynamic changes in periodontal tissues in the treatment of mild chronic generalized periodontitis using polarized polychromatic light. Materials and Methods: A complex dental examination and treatment were performed in 70 patients (32 males and 38 females) with active chronic generalized periodontitis aged 20 to 59 years. The study had two groups (35 subjects each) based on treatment approaches. Group 1 received professional oral care and a course of antimicrobial therapy using Dentamet dental gel. Group 2 received antimicrobial therapy in combination with polarized polychromatic light therapy (wavelength 480–3,400 nm, power 40 mW/cm2, flux density 2.4 J/cm2 per minute, polarization 95%). Laser Doppler flowmetry was used to assess hemodynamics before treatment, as well as 3, 6, and 12 months after treatment. Results: Group 1 demonstrated an improvement in microcirculation parameters for up to 3 months (p=0.0027). In group 2, an improvement was observed for up to one year (p=0.0455). Conclusion: Polarized polychromatic light therapy in mild chronic generalized periodontitis improves microhemocirculation in periodontal tissues, increasing the efficacy of drug therapy.

Retrospective analysis and clinical features of periapical tissue regeneration

Background: Chronic periodontitis is associated with changes in periapical tissues. Untimely diagnosis and lack of appropriate mechanical treatment increase the incidence of chronic periodontitis. Periodontitis that causes destructive changes due to long-term inflammation of periapical tissues is of particular concern. Thus, the treatment of destructive periodontal diseases is a pressing issue in modern dentistry. Aim: To assess periapical tissue regeneration following treatment in chronic periodontitis patients. Materials and Methods: A retrospective analysis of the destruction and regeneration of periapical tissues before and after treatment during 3–6 months was performed in 20 patients. Results: A retrospective analysis of X-ray findings in 20 patients revealed bone destruction of varying degrees. Low-quality root canal preparation was due to various factors, primarily the anatomy and topography of root canals. Of the 20 patients who required treatment for chronic periodontitis with varying degrees of destruction, 16 came back for follow-up appointments and received endodontic treatment. Following treatment, X-ray findings were used to identify taper root canal preparation and assess the quality of obturation up to the root apex. X-ray examination was performed after 3 months in patients with clinical signs of periodontitis and after 6 months in patients without clinical signs of periodontitis. After 3 months, X-ray findings showed a reduction in bone destruction in the causative tooth area, indicating an improvement. Conclusion: The study of periapical tissue regeneration following treatment in chronic periodontitis patients revealed that effective apical preparation, as well as appropriate irrigation and root canal filling, promote regeneration in periodontitis. Healing of periapical tissues is essential for effective root canal treatment.

PECULIARITIES OF ORTHODONTIC TREATMENT FOR PATIENTS WITH GENERALIZED PERIODONTITIS AND PREDOMINANCE OF PARASYMPATHETIC NERVOUS SYSTEM ACTIVITY

The use of orthodontic treatment for patients with generalized periodontitis enhances the effectiveness of comprehensive care. However, it is important to consider the reduced capacity for alveolar bone regeneration in these patients. Therefore, as part of the complex treatment of generalized periodontitis, the inclusion of medications to support alveolar bone regeneration is essential. The course of various diseases can be influenced by the state of the patient’s autonomic nervous system. In this study, medications were administered to normalize parasympathetic nervous system activity in patients with generalized periodontitis undergoing orthodontic treatment. The objective of the study was to evaluate the effectiveness of orthodontic treatment in patients with generalized periodontitis, particularly those with a predominance of parasympathetic autonomic nervous system activity. This was assessed by the supplementary use of a combination of drugs designed to stimulate alveolar bone formation and regulate parasympathetic nervous system function. Materials and methods. This study involved 35 young patients (aged 18-35) with generalized periodontitis and a predominance of parasympathetic autonomic nervous system activity, all of whom presented with displacement of the maxillary frontal teeth. These patients underwent orthodontic treatment. To correct the state of the autonomic nervous system over the treatment of generalized periodontitis, patients were prescribed to take a complex of medicines including the preparation “Calcinova” for stimulating osteogenesis. A comprehensive periodontal examination, including the assessment of hygienic indices, was conducted to evaluate periodontal status throughout the treatment. Results. The periodontal examination revealed that almost all patients demonstated an improvement in oral health. Noticeable dynamics in the pathological process were observed as a result of the complex treatment. The analysis of these findings underscores the importance of orthodontic treatment for patients with generalized periodontitis, particularly when combined with methods to correct parasympathetic nervous system activity and promote osteogenesis. This approach was shown to positively affect periodontal tissues and enhance the effectiveness of generalized periodontitis treatment. Conclusions. Correction of parasympathetic autonomic nervous system function enhances the effectiveness of therapy. In this study, a complex of medications was used to improve parasympathetic nervous system activity. The addition of “Calcinova” to stimulate osteogenesis further contributed to achieving more stable treatment outcomes in patients with generalized periodontitis.

Effects of Probiotic Therapy on Periodontal and Peri-implant Treatments: An Umbrella Review.

The effectiveness of nonsurgical periodontal treatment is related to patient- and tooth-related factors. To overcome the limitations of the conventional approach, probiotics are one of the adjunct therapies that have been studied. This umbrella review answered the focused question: in adult patients with periodontal diseases or peri-implant diseases, does the use of probiotic therapy as an adjuvant to nonsurgical periodontal treatment when compared with nonsurgical periodontal treatment alone affect treatment effectiveness and clinical disease parameters? A systematic electronic search to identify systematic reviews according to PICOS criteria, defined a priori, was used, and 5 electronic databases were searched (Medline, LILACS, Cochrane Central Registry of Controlled Trials, Google Scholar, and DANS EASY). Included systematic reviews were rated using quality assessment tools by 2 independent reviewers. Thirty systematic reviews were identified evaluating the effectiveness of probiotics in periodontal and peri-implant disease treatment. A quantitative analysis of the results was not possible due to the high heterogeneity of clinical data. Seventeen of 31 reviews reported clinically relevant benefits of probiotic therapy as an adjuvant to scaling and root planning. Twenty-two reviews had a low risk of bias, 7 had a moderate risk, and 2 had a high risk. The evidence from the available studies is conflicting, which means that no definitive conclusions can be made about the effectiveness of probiotic therapy as an adjuvant to nonsurgical periodontal treatment. High-quality primary research studies are needed that control for known confounding variables. This umbrella review provides some evidence regarding the efficacy of probiotics as an adjunct to nonsurgical periodontal therapy, despite some equivocal findings. However, short-term probiotic use alongside therapy appears to be advantageous; there is currently no evidence supporting their long-term benefits. We have also identified that probiotic research is primarily constrained by its origins in gastrointestinal applications, resulting in a lack of approved probiotics for dental use. This review highlights the need for extensive clinical research to ascertain their effectiveness in the oral environment. Nevertheless, the utilization of probiotics alongside periodontal treatment seems safe, with no reported adverse effects in patients. Thus, further clinical validations in oral health care settings are crucial.

Postbiotic Metabolite Derived from Lactiplantibacillus plantarum PD18 Maintains the Integrity of Cell Barriers and Affects Biomarkers Associated with Periodontal Disease

Background/Objectives: Periodontal disease is caused by oral infections, biofilms, persistent inflammation, and degeneration of cell barrier integrity, allowing pathogens to invade host cells. Probiotics have been extensively studied for the treatment of periodontal disease. However, research on the involvement of beneficial substances produced by probiotics, called “postbiotics,” in periodontal diseases remains in its early stages. The present study aimed to evaluate the effect of a postbiotic metabolite (PM) from Lactiplantibacillus plantarum PD18 on immunomodulation and maintenance of cell barrier integrity related to periodontal disease. Method: The main substance in PM PD18 was analyzed by GC-MS. The cytotoxic effect of PM PD18 was performed using the MTT assay, wound healing through the scratch assay, cell permeability through TEER value, modulation of inflammatory cytokines through ELISA, and gene expression of inflammatory cytokines and tight junction protein was determined using qRT-PCR. Results: The main substance found in PM PD18 is 2,3,5,6-tetramethylpyrazine. PM PD18 did not exhibit cytotoxic effects on RAW 264.7 cells but promoted wound healing and had an antiadhesion effect on Porphyromonas gingivalis concerning SF-TY cells. This postbiotic could maintain cell barrier integrity by balancing transepithelial electrical resistance (TEER) and alkaline phosphatase (ALP) activity. In addition, the gene and protein expression levels of zonula occludens-1 (ZO-1) increased. PM PD18 was found to have immunomodulatory properties, as demonstrated by regulated anti- and pro-inflammatory cytokines. Interleukin-10 (IL-10) increased, while IL-6 and IL-8 were reduced. Conclusions: This study demonstrated that PM PD18 is efficient as a natural treatment for maintaining cell barrier integrity and balancing inflammatory responses associated with periodontal disease.

A Three-Month Clinical Trial on the Efficacy of Hyaluronic Acid Adjunctive Non-Surgical Therapy for Periodontitis in Patients with Type 2 Diabetes Mellitus

Background/Objectives: Conventional periodontal treatment for patients with diabetes has shown promising results, primarily focusing on glycated hemoglobin (HbA1c) levels as an endpoint measure. The properties of hyaluronic acid (HA) have been harnessed in various periodontal therapies, and it is a promising agent also in a non-surgical approach. The aim of this clinical trial was to assess the efficacy of hyaluronic acid in a local adjunctive non-surgical treatment for periodontitis in patients with type 2 diabetes. Methods: Eighty adult participants with well-controlled type 2 diabetes (HbA1c 7% (53 mmol/mol) or less) took part in the trial. The clinical parameters of periodontitis as well as the glycated hemoglobin (HbA1c) levels were evaluated, and an analysis of the potential differences between the control (placebo) and intervention (HA) groups was performed. Results/Conclusions: A decrease in all the clinical values of periodontitis after treatment was observed in the vast majority of patients in both groups. Differences in the clinical parameters were observed 12 weeks after the intervention between the patients in the placebo and HA therapy groups. Bleeding on probing (BoP) was reduced in the control group to 15–25% and was approximately 5.5% more in the intervention group (9.5–18.25%). The clinical attachment level (CAL) decreased 1 mm more in the HA therapy group (1–2 mm) than in the no adjunctive treatment group (2–3 mm). The probing depth (PD) was reduced similarly in both groups (3–3.75 mm). Due to the bilateral relationship between diabetes and periodontitis, healthcare professionals seek advancements in managing periodontal inflammation. The results of this study indicate that non-surgical periodontal treatment with HA as an adjunctive agent is worth considering in the therapy for patients with diabetes.

Preparation and Evaluation of Poloxamer/Carbopol In-Situ Gel Loaded with Quercetin: In-Vitro Drug Release and Cell Viability Study.

Periodontitis is a severe chronic inflammatory disease, whose traditional systemic antimicrobial therapy faces great limitations. In-situ gels provide an effective solution as an emerging local drug delivery system. In this study, the novel thermosensitive poloxamer/carbopol in-situ gels loaded with 20μmol/L quercetin for the treatment of periodontitis were prepared by cold method. Thirteen batches of in-situ gels based on two independent factors (X1: poloxamer 407 and X2: carbopol 934P) were designed and optimized by the statistical method of central composite design (CCD). The transparency, pH, injectability, viscosity, gelation temperature, gelation time, elasticity modulus, degradation rate and in-vitro drug release studies of the batches were evaluated, and the percentage of drug release in the first hour, the time required for 90% drug release, gelation temperature, and gelation time were selected as dependent variables. These two independent factors significantly affected the four dependent variables (p < 0.05). The optimization result displayed that the optimized concentration of poloxamer 407 was 20.84% (w/v), and carbopol 934P was 0.5% (w/v). The optimized formulation showed a clear appearance (++), acceptable injectability (Pass), viscosity(151,798mPas), gelation temperature (36°C), gelation time (213s), preferable cell viability and cell proliferation, conformed to first-order release kinetics, and had a significant antibacterial effect. The article demonstrates the great potential of the quercetin in-situ gel as an effective treatment for periodontitis.

Photodynamic therapy – modern views and innovations in dentistry

Photodynamic therapy (PDT) consists of three elements: a photosensitizer, light and oxygen. The photosensitizer has the property of selective accumulation in target tissues without harming healthy cells. This innovative therapeutic method has already been successfully adapted in many areas of medicine, such as dermatology, gynecology, urology and oncology. PDT is also beginning to be introduced in dentistry. The antibacterial and fungicidal properties of the photosensitizer are used to achieve better results in the medical and surgical treatment of patients. Objective. To analyze current scientifi data on the application of photodynamic therapy (PDT) in various fi of dentistry, evaluate its effectiveness, and assess prospects for development. Materials and methods. A review of recent scientifi literature was conducted, including original studies, systematic reviews, and meta-analyses focused on PDT application in dentistry. Data on mechanisms of action, clinical efficacy, and new developments in PDT were analyzed. Results. High effi of PDT was established in the treatment of periodontal diseases, peri-implantitis, endodontic infections, and oral oncological diseases. Advantages of combined application of PDT with other treatment methods were noted. Promising directions for PDT development were identifi including the creation of new photosensitizers and technological innovations in equipment. Conclusions. PDT is a promising treatment method in dentistry, demonstrating high efficacyand safety. Further research is aimed at optimizing treatment protocols, developing personalized approaches, and integrating PDT with other modern technologies.

Photodynamic therapy in the treatment of periodontal diseases. Literature review

Periodontal diseases affect about 90% of the adult population, but the treatment regimens for this pathology are different, with varying degrees of effectiveness. One of the causes of inflammatory phenomena is the microbial factor. In some cases, there is a need for antimicrobial prescriptions, which, against the background of growing antibiotic resistance, becomes a problem. This article describes the possibilities of using such a method of influencing periodontal pathogens as photodynamic therapy. The main conclusions of studies on the effectiveness of PDT in inflammatory periodontal diseases are presented.

Hyaluronic acid methacrylate/Pluronic F127 hydrogel enhanced with spermidine-modified mesoporous polydopamine nanoparticles for efficient synergistic periodontitis treatment

Bacterial infection, reactive oxygen species (ROS) accumulation, and persistent inflammation pose significant challenges in the treatment of periodontitis. However, the current single-modal strategy makes achieving the best treatment effect difficult. Herein, we developed a double-network hydrogel composed of Pluronic F127 (PF-127) and hyaluronic acid methacrylate (HAMA) loaded with spermidine-modified mesoporous polydopamine nanoparticles (M@S NPs). The PF-127/HAMA/M@S (PH/M@S) hydrogel was injectable and exhibited thermosensitivity and photocrosslinking capabilities, which enable it to adapt to the irregular shape of periodontal pockets. In vitro, the PH/M@S displayed multiple therapeutic effects, such as photothermal antibacterial activity, a high ROS scavenging capacity, and anti-inflammatory effects, which are beneficial for the multimodal treatment of periodontitis. The underlying anti-inflammatory mechanism of this hydrogel involves suppression of the extracellular regulated protein kinase 1/2 and nuclear factor kappa-B signalling pathways. Furthermore, in lipopolysaccharide-stimulated macrophage conditioned media, the PH/M@S effectively restored the osteogenic differentiation potential. In a rat model of periodontitis, the PH/M@S effectively reduced the bacterial load, relieved local inflammation and inhibited alveolar bone resorption. Collectively, these findings highlight the versatile functions of the PH/M@S, including photothermal antibacterial activity, ROS scavenging, and anti-inflammatory effects, indicating that this hydrogel is a promising multifunctional filling material for the treatment of periodontitis.

Treating apical fenestration in a previously endodontically treated tooth

Apical fenestration is a defect in the alveolar cortical plate, exposing the root without involving the alveolar bone margin, often linked to trauma, periodontal disease, and orthodontic treatment, leading to symptoms such as pain and abscesses from endodontic infections. This case report describes managing a mucosal fenestration in an endodontically treated tooth with nonsurgical root canal therapy and periodontal surgery. A 44-year-old male presented with mucosal fenestration and pain in the upper front jaw due to trauma and an inadequately treated root canal. Examination revealed an ill-fitting crown and an open apex with periapical radiolucency. Treatment included scaling, root planing, nonsurgical root canal therapy, apexification using Biodentine, and obturation with bioceramic sealer. Persistent fenestration necessitated periodontal surgery to remove extruded material and place an alloplastic graft. Apical fenestrations, although uncommon, require coordinated endodontic and periodontal treatment for successful outcomes.

Hyaluronic acid-based minocycline-loaded dissolving microneedle: Innovation in local minocycline delivery for periodontitis

Periodontitis is a prevalent inflammatory disease that affects tooth-supporting tissues and is induced by complex polymicrobial dental plaques. Prior treatments, including topical antibiotic ointments, have faced difficulties in tissue permeability issues. Although dissolving microneedle (DMN) has been proposed as a painless and highly efficient transdermal drug delivery system to resolve this challenge, minocycline, widely used for the treatment of periodontitis, is light-sensitive, making it challenging to maintain its stability using conventional fabrication methods. Our hyaluronic acid-based minocycline-loaded dissolving microneedle (HAM-DMN) was designed utilizing an innovative light-blocking strategy, preserving 94.4 % of minocycline's stability, as confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. HAM-DMNs demonstrated antimicrobial efficacy in in vitro zone of inhibition tests with Streptococcus mutans strains and provided enhanced local delivery of minocycline to porcine oral gingival mucosa at concentrations 6.1 times higher than those of commercial ointments. In vivo studies in periodontitis-induced rat models showed that HAM-DMNs reduced levels of junctional epithelium more effectively than control and blank DMN groups, indicating enhanced treatment efficacy. HAM-DMN is a novel local delivery system developed to overcome the limitations of systemic delivery and conventional topical treatment. We suggest that HAM-DMNs can replace injections for the treatment of intraoral mucosal and systemic diseases.

Dracocephalum Moldavica L.-Derived carbon dots for effective periodontitis treatment via reprogramming energy metabolism in Macrophages

Dracocephalum Moldavica L. (DML), a Chinese traditional medicine rich in flavone compounds (e.g., tilianin), has shown antioxidant and anti-inflammatory potential for alleviating inflammatory disorders. However, the extraction of active ingredients of DML is complex, and these extracts usually act synergistically to treat inflammatory diseases. In this study, the carbon dots derived from DML (T-CDs) were rapidly prepared via the one-pot method and showed good performance in biocompatibility and free radical scavenging capacity. Then, the T-CDs were loaded into the hydrogel and applied to treat periodontitis. The in vivo experiments demonstrated that T-CDs could promote the inflammation resolution of and the alveolar bone reparation in the periodontitis model after periodontal injection. With further investigation, it could be found that T-CDs involved the alternative polarization of macrophage by rebalancing glycolysis and mitochondrial respiration. Overall, it was the first time DML had been used to prepare carbon dots with anti-inflammation. This study provided an effective drug candidate for the treatment of periodontitis and offered an in-depth understanding of the therapeutic mechanism of T-CDs in periodontitis through macrophage immunomodulation.

CCL2-scavenging nanodecoy hydrogel multi-step remodel monocytes recruitment and macrophages polarization for periodontitis treatment

CCL2-scavenging nanodecoy hydrogel multi-step remodel monocytes recruitment and macrophages polarization for periodontitis treatment

Nonsurgical root canal treatment of an Oehlers type IIIa maxillary central incisor with dens invaginatus: a case report

Dens invaginatus has a complex anatomy, making endodontic treatment challenging. We report the case of a 11-year-old girl who presented with radiolucency at the apex of the maxillary central incisor; she was diagnosed with symptomatic apical periodontitis. Cone-beam computed tomography (CBCT) revealed dens invaginatus. The invagination and root canal were observed using a dental operating microscope, and nonsurgical root canal treatment was performed. The invagination was connected to the periodontal tissue, and the tooth was classified as Oehlers type IIIa. Root canal preparations were performed using NiTi files and an ultrasonic device. A calcium hydroxide paste was used as an intracanal dressing. The root canal was filled using a single-cone hydraulic condensation technique with a highly fluid calcium silicate-based sealer. At the 2-year follow-up, no clinical symptoms were observed, and CBCT images revealed no radiographic lesions. Nonsurgical endodontic treatment using CBCT imaging, dental microscope, effective cleaning systems, and a highly fluid sealer facilitated the successful treatment of apical periodontitis attributed to dens invaginatus. The single-cone hydraulic condensation technique using a bio-ceramic sealer is considered effective even in cases with a complex morphology and open apex.

Identify novel therapeutic targets for type II diabetes and periodontitis: insights from single-cell analysis and Mendelian randomization analysis

BackgroundPeriodontitis is a common complication of type II diabetes (T2D). However, the existing research cannot fully elucidate the association between them, let alone identify therapeutic targets for precise treatment of diabetic periodontitis. Therefore, we employed integrated genetic approaches such as single-cell analysis, Mendelian randomization (MR) analysis and colocalization analysis to uncover novel therapeutic targets for T2D and periodontitis.MethodsThis study integrated single-cell analysis, MR analysis, colocalization analysis, phenotype scanning, cell-cell communication analysis and metabolic pathway activity analysis to unveil novel therapeutic targets for periodontitis and T2D. We firstly identified core cell clusters of T2D and periodontitis, and important marker genes were selected. The causal associations between these genes and the two diseases were evaluated through MR analysis. Reverse MR analysis, colocalization analysis, additional validation and phenotype scanning further supported our findings. Finally, cell-cell communication analysis and metabolic pathway activity analysis were employed to preliminarily investigate the mechanisms of the observed causal associations.ResultsThrough analysis of scRNA-seq data, we identified classical monocytes and intermediate monocytes as core cell subclusters. Differential analysis identified 221 differentially expressed genes (DEGs). MR analysis identified 13 genes exhibiting causal associations with T2D, and 11 causal genes with periodontitis. Colocalization analysis, reverse MR analysis, additional validation and phenotype scanning further enhanced the robustness of our results. Finally, we identified NCF1 as the core therapeutic target for T2D (OR = 1.09, 95% CI: 1.03-1.14, p = 1.85 ×10−3) and LRRC25 for T2D (OR = 0.96, 95% CI: 0.93-0.99, p = 3.44 ×10−2) and periodontitis (OR = 0.92, 95% CI: 0.84-0.99, p = 4.45 ×10−2). At last, cell-cell communication analysis indicated significant differences in functions and metabolic pathway activity between monocytes expressing or not expressing the core causal genes, which preliminarily interpreted the observed causal associations.ConclusionThis study integrated single-cell analysis, MR analysis and colocalization analysis to identified novel therapeutic targets for T2D and periodontitis. 13 causal genes were identified for T2D, and 11 for periodontitis. Among them, NCF1 and LRRC25 were regarded as core therapeutic targets. Our findings bridge the gap in the understanding of the association between T2D and periodontitis, and pave the way for targeted therapy of the two diseases.

Research progress on the application of virtual artificial intelligence in risk assessment and diagnosis of periodontal disease

Periodontal disease is a common and frequently-occurring disease in China. Early detection, diagnosis, and treatment of periodontal disease are of great significance for achieving universal oral health and even systemic health. Artificial intelligence endows machines with the ability to mimic human intelligent behavior, and is commonly used in medical field with both physical and virtual forms. Virtual artificial intelligence empowers traditional experience in the application of periodontal disease risk assessment and diagnosis, with the potential to develop a variety of oral health screening tools. It helps to provide new evidence for the prognosis of periodontal disease, improve the accuracy and efficiency of diagnosis, reduce technical sensitivity and further promote the periodontal treatment transformation from "treatment-oriented" to "prevention-oriented". This paper reviews the current applications and progresses of virtual artificial intelligence in periodontal risk assessment and diagnosis, as well as its limitations, providing ideas for future researches on the application of virtual artificial intelligence in this field.

A study of CPITN score in Periodontics Clinic Patients, RSGM Airlangga University, 2022

Background: Approximately 90% of the global population suffers from periodontal disesase, characterizes by bleeding gums, pain, and bad breath. The impact of this disease is diverse, ranging from tooth loss, disruption of aesthetics and confidence, to influencing individual nutritional status. The disease can be caused by damage of the periodontal tissues. Therefore, the Community Periodontal Index of Treatment Needs (CPITN) is highly essential for assessing the extend of issues in periodontal tissues, including evaluating oral and dental health problems in patients. This assessment can aid in the treatment and prevention of periodontal disease. Material and Methods: This research is a descriptive study. The population consists of all patients who visited the periodontology clinic at the Faculty of Dentistry, Airlangga University, in the year 2022. The sample was taken using a total sampling technique, involving secondary data obtained from the periodontal status cards of patients, specifically focusing on the examination data related to the condition of periodontal tissues based on the Community Periodontal Index of Treatment Needs (CPITN). Conclusion: The CPITN scores vary between gender and age groups of the patients. Therefore, bivariate research is needed to analyze the relationship of these parameters with the CPITN scores of periodontology patients.

Evaluating Clear Aligners Versus Fixed Appliances for Periodontal Patients: A Comprehensive Narrative Review of Current Evidence

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient’s dental condition.

Preclinical Validation of MIN-T: A Novel Controlled-Released Formulation for the Adjunctive Local Application of Minocycline in Periodontitis

Background: Adjunctive treatment of periodontitis lacks solutions which allow for enough time for wound healing in the periodontal pockets by avoiding fast re-colonization. Such a solution might be an antibiotic-containing formulation with a controlled release over a period of weeks. Here, a recently described minocycline-containing approach is qualified for further clinical development by focusing on proof-of-concept, systemic burden, resistance development, and degradation studies. Methods: Animal studies were done in two different (mouse-chamber, rat Porphyromonas gingivalis challenging) models, including effects on inflammation markers, bone loss, and bone structure. Also, serum concentrations of minocycline after local application were determined by HPLC-MS/MS. The resistance status of bacterial clinical isolates against minocycline was investigated and the degradation of the formulation was characterized by laser scanning and scanning electron microscopy. Results: Animal studies clearly demonstrated the applicability of the new formulation in the investigated models. Inflammation markers decreased in a dose-dependent manner and reduced bone loss compared to non-treated group was observed. Therefore, the systemic burden of the antibiotic was neglectable. Minocycline is still effective against oral pathogens; resistance development was not seen. The biodegradable thread was first swollen and subsequently degraded over a period of weeks. Conclusions: The results support the continued clinical development of this new formulation. A phase I clinical trial is planned to further evaluate its safety and efficacy.