scholarly journals Effectiveness of Systematic Periodontal Treatment in Male HIV-Infected Patients after 9 Years: A Case Series

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Rainer A. Jordan ◽  
Adrian Lucaciu ◽  
Katharina Schaper ◽  
Hans-Peter Jöhren ◽  
Stefan Zimmer
Keyword(s):  
Case Series ◽  
Periodontal Treatment ◽  
Study Endpoint ◽  
Primary Study ◽  
Scaling And Root Planing ◽  
Open Label ◽  
Pocket Depth ◽  
Highly Active ◽  
Root Planing ◽  
Proportional Increase

Objective. To investigate effectiveness of systematic periodontal treatment in the long term in HIV-infected patients undergoing highly active antiretroviral treatment. Methods. Longitudinal, prospective, open-label case series over a period of nine years. Periodontal treatment was performed by scaling and root planing and supportive periodontal care (SPC) at regular intervals. To measure effectiveness, reductions of pocket probing depths were defined as primary study endpoint. Results. During the study period, there was a proportional increase in periodontal pockets ≥4 mm of +53% and in pockets ≥ 6 mm of +100%. Mean pocket depth reductions on patient’s level were, however, 0.4 mm nine years after scaling and root planing and supportive periodontal care (p=0.180). No teeth were lost during the observation period. Conclusions. In terms of best evidence available, it is concluded that systematic periodontal treatment including SPC is effective in virologically controlled HIV infection and can be performed in dental practice safely.

scholarly journals Adjunctive Subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao
Keyword(s):  
Clinical Outcomes ◽  
Chronic Periodontitis ◽  
Meta Analysis ◽  
Periodontal Treatment ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Manual Search ◽  
Probing Pocket Depth ◽  
Root Planing ◽  
Significant Difference

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP.Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained.Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP.Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.

scholarly journals Efficacy of 2% ibuprofen subgingival irrigation as an adjunct to non-surgical therapy in the treatment of chronic periodontitis: A randomized controlled, split-mouth, clinical trial

2019 ◽  
Vol 11 (2) ◽  
pp. 69-76
Author(s):  
Amirhossein Farahmand ◽  
Ferena Sayar ◽  
Zohreh Omidali ◽  
Mahsa Soleimani ◽  
Bahareh Jafarzadeh Esfahani
Keyword(s):  
Clinical Trial ◽  
Chronic Periodontitis ◽  
Periodontal Treatment ◽  
Periodontal Pocket ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Clinical Attachment Level ◽  
Root Planing ◽  
Mandibular Molar ◽  
Attachment Level

Background. Pharmacological factors, such as ibuprofen, released topically in the periodontal pocket modulate the host response and enhance the influence of non-surgical periodontal treatment. Methods. In this double-blind, randomized, split-mouth, clinical trial, 38 outpatients with mild to moderate chronic periodontitis were enrolled by applying the simple random sampling method. They had at least one tooth with a periodontal pocket depth of >4 mm in each quadrant and had undergone phase I of periodontal treatment one week after scaling and root planing (SRP). The parameters of clinical periodontal evaluation, including probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI), were measured. In addition, two mandibular molar teeth in one quadrant were randomly nominated for subgingival irrigation with 0.5 mL of 2% ibuprofen or placebo mouthwash. The measurements were repeated after at least one week for three months. Results. Thirty-four individuals (18 women and 16 men), with an age range of 28‒36 years, were evaluated for three months. Moreover, periodontal clinical parameters were assessed within three months. There was a significant improvement in pocket depth (PD) and clinical attachment level (CAL) readings after 12 weeks in both groups (paired t-test). On comparing, the group with scaling and root planing (SRP) + ibuprofen showed more favorable results than the group with SRP + placebo (P<0.05). There were significant improvements in PI and BI in both groups; the differences between the two groups were significant (P<0.05). Conclusion. The mouthwashes containing ibuprofen might reduce the symptoms of periodontal disease and might be used as an adjunct in the healing process

scholarly journals Adjunctive Subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao
Keyword(s):  
Clinical Outcomes ◽  
Chronic Periodontitis ◽  
Meta Analysis ◽  
Periodontal Treatment ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Manual Search ◽  
Probing Pocket Depth ◽  
Root Planing ◽  
Significant Difference

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.

scholarly journals Ultrasound-guided epidural anesthesia and sedation foropen abdominal surgery in 20 consecutive children:a prospective case series and proof-of-concept study

2020 ◽  
Author(s):  
Werner Schmid ◽  
Philipp Opfermann ◽  
Markus Zadrazil ◽  
Ursula Tonnhofer ◽  
Martin Metzelder ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Airway Management ◽  
Epidural Anesthesia ◽  
Recovery Room ◽  
Case Series ◽  
Skin Incision ◽  
Study Endpoint ◽  
Primary Study ◽  
Ultrasound Guided ◽  
Drug Induced

Abstract General anesthesia (GA) in children is associated with respiratory events and a potential for drug-induced neurotoxicity. Aiming to reduce airway manipulation and the use of GA drugs, we designed a study of abdominal surgery under epidural anesthesia in sedated, spontaneously breathing children. We enrolled 20 children (3 − 83 months, 6.3 − 25.0 kg) scheduled for open abdominal surgery with Pfannenstiel incision. Sedation was followed by ultrasound-guided epidural anesthesia. Increases in heart rate by > 15% and or patient movements upon skin incision were rated as block deficiencies. Intubation equipment for advanced airway management was kept on standby. The primary study endpoint was successful blockade, meaning that no sequential airway management was required during surgery. Secondary endpoints included any use of fentanyl/propofol intraoperatively and of postoperative analgesics in the recovery room. All 20 blocks were successful, with no block deficiencies upon skin incision, no need for sequential airway management, and stable SpO2 levels (97–100%). Surgery took a median of 120.5 minutes (IQR: 89.3–136.5) and included one bolus of fentanyl 120 minutes into a protracted operation. No more systemic analgesia had to be provided in the recovery room. Sedation and epidural anesthesia emerged as a useful alternative to GA from our consecutive case series.

scholarly journals COMPARATIVE EVALUATION OF EFFICACY OF SCALING AND ROOT PLANING WITH AND WITHOUT CHLORHEXIDINE CHIP AND DIODE LASER IN CHRONIC PERIODONTITIS PATIENTS

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Reya Shree ◽  
Varun Dahiya ◽  
Pradeep Shukla ◽  
Prerna Kataria ◽  
Mona Dagar
Keyword(s):  
Diode Laser ◽  
Chronic Periodontitis ◽  
Control Group ◽  
Clinical Parameters ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Root Planing ◽  
Before And After ◽  
Laser Group

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.

scholarly journals Effects of Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Response to Periodontal Treatment in Patients with Rheumatoid Arthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Gyu-Un Jung ◽  
Ji-Young Han ◽  
Kyung-Gyun Hwang ◽  
Chang-Joo Park ◽  
Panagiota G. Stathopoulou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Diseases ◽  
Periodontal Treatment ◽  
Control Group ◽  
Scaling And Root Planing ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Root Planing ◽  
Significant Difference ◽  
Disease Modifying

Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory diseases and periodontitis is known to be more common and more severe in patients with RA. Based on a paucity of studies about the relationship between common conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and periodontitis, this prospective study aimed to evaluate the adjunctive effect of csDMARDs on response to nonsurgical periodontal treatment in patients with RA. Thirty-two patients with RA (RA group) and 32 systemically healthy patients (control group) with periodontitis were included in this study. The RA group patients were treated with csDMARDs, such as methotrexate, hydroxychloroquine, and sulfasalazine. Conventional nonsurgical periodontal treatment with scaling and root planing was performed in both groups. The extent and severity of periodontitis were evaluated by plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) at baseline and 4 weeks after periodontal treatment. There was no statistically significant difference of periodontal parameters between the RA and control groups at baseline. Four weeks after scaling and root planing, PD reduction, and CAL gain were higher in the RA group treated with csDMARDs compared to the control group, and the difference was statistically significant (P = 0.006 and 0.003, respectively). A post hoc analysis of the RA group showed no statistically significant difference on the response to nonsurgical periodontal treatment in multiple csDMARDs therapy and addition of NSAIDs and/or steroids to csDMARDs. In patients with RA, csDMARDs showed beneficial effect on periodontal clinical parameters following the nonsurgical periodontal treatment.

TOPICAL CHEMOTHERAPEUTIC ADJUNCTS IN NON-SURGICAL PERIODONTAL THERAPY – A RANDOMISED CONTROLLED DOUBLE BLINDED TRIAL.

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Upendra Prasad ◽  
Abhinav Deshpande ◽  
Praneeta Kamble ◽  
Abhishek Singh ◽  
Adiya Apon ◽  
...  
Keyword(s):  
Chronic Periodontitis ◽  
Comparable Efficacy ◽  
Control Group ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Root Planing ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Group A ◽  
Chlorhexidine Gel

Introduction: Topical chemotherapeutic agents used in treatment of chronic periodontitis are antimicrobial agents which help in plaque control. The present study evaluates the efficacy of ornidazole gel with gold standard chlorhexidine gel when used as adjunct to scaling and root planing. Material and Methods: 90 patients diagnosed as chronic periodontitis, having pocket depth ?3 mm and in good systemic health were selected by systematic sampling method and divided in 3 groups. In all 3 groups scaling and root planing was done. In group A, Ornidazole gel application was done while in Group B Chlorhexidine gel application was done while Group C was control group. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline, 1 and 3 months while Probing pocket depth (PPD) and Clinical attachment level (CAL) were recorded at baseline and 3 months. Results: PI and GI showed significant reduction in all three groups after 1 and 3 months compared to baseline. On inter group comparison, both PI and GI showed no significant difference in reduction of scores after 1 month and 3 months (p>0.05). PPD and CAL values showed statistically significant reduction after 3 months when compared to baseline values. The intergroup comparison revealed statistically significant reduction in group A and B compared to control group C (p<0.05). Conclusion: Ornidazole showed comparable efficacy as Chlorhexidine when used as adjunct to scaling and root planing for treatment of chronic periodontitis.

scholarly journals Clinical Evaluation of Topical Metronidazole and Chlorhexidine Gel following Scaling and Root Planing in Patients with Chronic Periodontitis

2019 ◽  
Vol 15 (1) ◽  
pp. 10-17
Author(s):  
Pujan Acharya ◽  
Manoj Kumar ◽  
CS Saimbi
Keyword(s):  
Chronic Periodontitis ◽  
Etiologic Agent ◽  
Etiologic Factor ◽  
Clinical Parameters ◽  
Scaling And Root Planing ◽  
Antimicrobial Drugs ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Root Planing ◽  
Topical Metronidazole

Background: Chronic periodontitis is the most prevalent form of periodontitis with a multifactorial  etiology, dental plaque being the primary etiologic agent. The removal of such etiologic factor through scaling and root planing builds the foundation of treatment. In addition, the use of an antimicrobial adjunct augments elimination of microbes leading to subsequent control of the disease. Chlorhexidine and Metronidazole have been found to be active against several periodontopathogens. In this study, the use of these antimicrobial gels has been made. To evaluate and compare the clinical efficacy of subgingival application of 1% Metronidazole, 1% Chlorhexidine and Combination gel when used as an adjunct to non-surgical therapy. Methods: A total of 120 patients, age group 30-60 years with chronic generalized periodontitis were included in the randomized, controlled, double blinded study. The patients were randomly divided into four groups and treated with scaling and root planing along with antimicrobial adjunct. The antimicrobials used were Chlorhexidine, Metronidazole, Combination of Chlorhexidine and Metronidazole, and Placebo. Clinical parameters (plaque index, gingival index, probing pocket depth and clinical attachment level) were recorded at baseline, 1 month and 3 months. Results: In all the groups, there was a statistically significant reduction in all the clinical parameters at different time intervals. Inter-group comparison with respect to clinical changes showed that Combination gel was the best. Conclusions: Long term, controlled randomized trials with more samples are suggested to further validate the efficacy of these antimicrobial drugs.  

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