scholarly journals Treatment of Peri-Implant Mucositis with Repeated Application of Chlorhexidine Chips or Gel during Supportive Therapy—A Randomized Clinical Trial

2019 ◽  
Vol 7 (4) ◽  
pp. 115
Author(s):  
Philipp Sahrmann ◽  
Cyrill Bettschart ◽  
Daniel B. Wiedemeier ◽  
Ahmed Al-Majid ◽  
Thomas Attin ◽  
...  

Background: To assess the effect of chlorhexidine (CHX) chip application in patients with peri-implant mucositis as compared to CHX gel application. Methods: In peri-implant sites with mucositis, CHX gel was applied in the control group (GC) and CHX chips in the test group (CC) at baseline and after three months. At baseline and after six months, peri-implant pocket depths (PPD), bleeding-on-probing (BOP) and activated matrix metalloproteinase-8 (aMMP8) were assessed. Longitudinal changes were tested for inter-group differences. Results: Thirty-two patients were treated. BOP was more reduced (p = 0.006) in CC than in GC, with means and standard deviations of 46 ± 28% and 17 ± 27%, respectively. PPD was more reduced (p = 0.002) in CC than in GC with 0.65 ± 0.40 mm and 0.18 ± 0.32 mm, respectively. Regarding BOP, the percentages of improved, unchanged and worsened sites accounted for 32%, 61% and 7% in GC and 46%, 53% and 1% in CC, respectively. For probing pocket depth, the according values were 26%, 66% and 8% (GC) versus 57%, 38% and 5% (CC). Conclusions: During supportive therapy, repeated CHX chip application might resolve marginal peri-implant inflammation in terms of bleeding better than CHX gel.

2021 ◽  
Vol 15 (2) ◽  
pp. 133-139
Author(s):  
Ashish Agarwal ◽  
Anugrah Saxena ◽  
Shiva Shankar Gummaluri ◽  
Bharti Chaudhary ◽  
karthikeyan Subramanyam S Sai ◽  
...  

Background. The present randomized clinical trial aimed to determine the additive clinical and microbiological benefits of diode laser (DL) with modified Widman flap (MWF) to manage chronic periodontitis. Methods. Seventy-two sites in 36 healthy non-smoking patients diagnosed with chronic periodontitis were randomly assigned to the test group (MWF + active DL) or control group (MWF + sham DL). Clinical (probing pocket depth [PPD], clinical attachment level [CAL]) and microbiological (colony-forming units [CFUs]) measurements were recorded at baseline and 6- and 6-month postoperative intervals. Results. Compared to baseline, 6-month results showed significant changes in clinical and microbiological parameters in both groups. However, the intergroup comparison revealed significantly lower PPD (1.90±0.48 mm vs. 2.35±0.41 mm), CAL (4.43±0.57 mm vs. 4.93±0.58 mm), and CFUs for Porphyromonas gingivalis (6.32±0.18 vs. 8.88 ±1.88), Prevotella intermedia (7.62±1.86 vs. 8.12±1.78), and Aggregatibacter actinomycetemcomitans (6.43±1.44 vs. 7.24±1.22) in the test group after six months. Conclusion. Within the limitations, the present study confirmed the useful role of DL with MWF to manage chronic periodontitis.


2020 ◽  
pp. 571-580 ◽  
Author(s):  
Giorgio Lombardo ◽  
◽  
Alessia Pardo ◽  
Caterina Signoretto ◽  
Annarita Signoriello ◽  
...  

Objectives: To clinically and microbiologically evaluate the effects of hyperbaric oxygen (HBO2) therapy in addition to full-mouth ultrasonic subgingival debridement (FM-UD), in the initial treatment of chronic periodontitis.  Methods: Twenty patients presenting moderate to severe generalized forms of chronic periodontitis were included in a three-month randomized, parallel-group, single-blinded, prospective study. At baseline patients were randomly assigned to two treatment groups [Test Group (FM-UD+HBO2) and Control Group (FM-UD)]. Both groups were treated with an FM-UD session. Ten HBO2 sessions (one session per day for 10 days at a pressure of 2.5 ATA) were additionally administered to the Test Group. Soft tissues parameters [probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL) and visible plaque index (VPI)] were assessed at baseline (immediately before FM-UD treatment), after two weeks, after six weeks and at three months. For each patient, a site presenting PPD ≥ 6mm and positive BOP was selected as a qualifying site (QS), to be monitored clinically (at T0, T1, T2 and T3) and microbiologically (at T0, T1 and T3). Results: There were no statistically significant differences between the two groups for any clinical parameter analyzed after three months, except for BOP, which was significantly (p < 0.05) reduced in the Test Group. Reductions in bacterial levels were detected in both groups after therapy. Faster bacterial recolonization occurred after three months in the Control Group. Conclusion: HBO2 therapy in combination with FM-UD may represent an efficacious approach to the treatment of moderate to severe forms of periodontitis.


2010 ◽  
Vol 11 (3) ◽  
pp. 9-16 ◽  
Author(s):  
Satish Gupta ◽  
Manohar L. Bhongade ◽  
Vikas Deo ◽  
Ritika Jaiswal

Abstract Aim Diabetic patients have more severe periodontal destruction, but periodontal therapy can improve metabolic control. Recently, interest has focused on the use of subantimicrobial dose doxycycline (SDD) as a treatment paradigm. Therefore, this study was undertaken to evaluate clinical efficacy of SDD with scaling and root planning (SRP) in chronic periodontitis patients with diabetes. Methods and Materials Twenty chronic periodontitis patients with diabetes mellitus were randomly allocated to either a test and a control group. Clinical measurements were recorded at baseline and at six months for probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR). After SRP, patients in the test group were instructed to take SDD 20-mg capsules twice a day while patients in the control group took a placebo twice a day. Both groups were on this regimen for a six-month period. Results A greater reduction in mean PPD was demonstrated in patients in the test group compared to the control group. The mean CAL increase observed in the test group was significantly greater (0.67 mm) than that in the control group. Conclusion It can be concluded that SRP, in conjunction with the SDD therapy described, is more effective then SRP alone in terms of CAL gain and PPD reduction in diabetic patients with severe periodontal disease. Clinical Significance Given the widespread prevalence of both chronic periodontitis and diabetes, the proposed treatment approach will prove to be of great value and contribute significantly to the overall health of the patients. Citation Deo V, Gupta S, Bhongade ML, Jaiswal R. Evaluation of Subantimicrobial Dose Doxycycline as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Diabetes: A Randomized, Placebo-Controlled Clinical Trial. J Contemp Dent Pract [Internet]. 2010 May; 11(3):009-016. Available from: http://www.thejcdp.com/journal/view/volume11- issue3-deo.


2011 ◽  
Vol 05 (01) ◽  
pp. 008-018 ◽  
Author(s):  
Renata Squariz Brotto ◽  
Regina Célia Vendramini ◽  
Iguatemy Lourenço Brunetti ◽  
Rosemary Adriana Chierici Marcantonio ◽  
Adriana Pelegrino Pinho Ramos ◽  
...  

ABSTRACTObjectives: The aim of this study was to assess a suggested association between periodontitis and renal insufficiency by assaying kidney disease markers. Methods: Variables used to diagnose periodontitis were: (i) probing pocket depth (PPD), (ii) attachment loss (AL), (iii) bleeding on probing (BOP), (iv) plaque index (PI) and (v) extent and severity index. Blood and urine were collected from 60 apparently healthy non-smokers (men and women), consisting of a test group of 30 subjects with periodontitis (age 46±6 yrs) and a control group of 30 healthy subjects (age 43±5 yrs). Kidney function markers (urea, creatinine, uric acid and albumin contents) were measured in the serum and urine. Also, the glomerular filtration rate was estimated from creatinine clearance, from the abbreviated Modification of Diet in Renal Disease formula and from the albumin : creatinine ratio in a 24–h sample of urine. Results: It was found that the control group had a greater mean number of teeth than the test group and that the two groups also differed in PPD, AL, BOP and PI, all these variables being higher in the test group (P=0.006). For the extent and severity index of both PPD and AL, the test group had much higher medians of both extent and severity than the control group (P=0.001). With regard to kidney function, none of the markers revealed a significant difference between the control and test groups and all measured values fell within the reference intervals. Conclusions: It is proposed that severe periodontitis is not associated with any alteration in kidney function. (Eur J Dent 2011;5:8-18)


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Umberto Romeo ◽  
Gianna Maria Nardi ◽  
Fabrizio Libotte ◽  
Silvia Sabatini ◽  
Gaspare Palaia ◽  
...  

Introduction. The aim of this study is to demonstrate the effectiveness of addition of the antimicrobial photodynamic therapy to the conventional approach in the treatment of peri-implantitis.Materials and Methods. Forty patients were randomly assigned to test or control groups. Patients were assessed at baseline and at six (T1), twelve (T2), and twenty-four (T3) weeks recording plaque index (PlI), probing pocket depth (PPD), and bleeding on probing (BOP); control group received conventional periodontal therapy, while test group received photodynamic therapy in addition to it.Result. Test group showed a 70% reduction in the plaque index values and a 60% reduction in PD values compared to the baseline. BOP and suppuration were not detectable. Control group showed a significative reduction in plaque index and PD.Discussion. Laser therapy has some advantages in comparison to traditional therapy, with faster and greater healing of the wound.Conclusion. Test group showed after 24 weeks a better value in terms of PPD, BOP, and PlI, with an average pocket depth value of 2 mm, if compared with control group (3 mm). Our results suggest that antimicrobial photodynamic therapy with diode laser and phenothiazine chloride represents a reliable adjunctive treatment to conventional therapy. Photodynamic therapy should, however, be considered a coadjuvant in the treatment of peri-implantitis associated with mechanical (scaling) and surgical (grafts) treatments.


2018 ◽  
Vol 7 (1) ◽  
pp. 21-25
Author(s):  
Mahdi Kadkhodazadeh ◽  
Reza Amid ◽  
Parisa Zarnegarnia ◽  
Fatemeh Mollaverdi ◽  
Yaser Safi ◽  
...  

Background and aims. The goal of this study was to evaluate the clinical efficacy of a standard oral hygiene routine (daily tooth brushing and flossing) along with cetylpyridinium chloride (CPC) mouthwash in comparison to the same protocol without mouthwash in chronic periodontitis patients during a 14-day period. Materials and methods. This comparative study was carried out or 50 non-smoking patients with chronic periodontitis; 25 patients followed an oral hygiene regimen using a toothbrush and dental floss (control group) and the remaining 25 used the mentioned protocol along with CPC mouthwash (test group) for 14 days. The plaque index (PI), modified gingival index (MGI) and probing pocket depth (PPD) were assessed. Wilcoxon and Mann-Whitney U tests were used to evaluate and compare the prevalence of indices between the two groups. Statistical significance was set at P<0.05. Results. The results showed greater improvement of MGI in the test group (P=0.001). No statistically significant differences were observed in PI (P=0.47) and PPD (P=0.43) between the two groups. Conclusion. Adding mouthwash to a standard oral hygiene regimen may improve some clinical gingival parameters when compared with an oral hygiene routine without a mouthwash


Author(s):  
Ranjita Shrestha Gorkhali ◽  
Shaili Pradhan ◽  
Rejina Shrestha ◽  
Shweta Agrawal ◽  
Krishna Lamicchane ◽  
...  

Introduction: Treatment of periodontal diseases done by surgical therapy depends upon extent and severity of disease. The ultimate goal of periodontal reconstructive surgery is to regenerate tissues destroyed during periodontal disease. Objective: To evaluate the effectiveness of bovine-derived xenograft with collagen membrane in treatment of intrabony defects by comparing it with open flap debridement alone. Methods: This non-randomised controlled trial was conducted after ethical clearance, at Bir hospital from 2018 March to 2019 April. The study recruited 38 patients by convenience sampling, age from 25-44 years, with chronic periodontitis, and willing to sign informed consent. Intrabony defects were treated by open flap debridement with bovine-derived xenograft and bioresorbable collagen membrane (Test group) and open flap debridement alone (Control group). Probing pocket depth, clinical attachment level, gingival recession, oral hygiene status, and gingival status were assessed at baseline and six months. Results: Six months after therapy, in Test group probing pocket depth reduction was 5.2 mm and gain in mean clinical attachment level was 4.3 mm. In Control group, mean probing pocket depth reduction was 3.8 mm and mean gain in clinical attachment level was 2.7 mm. The test treatment resulted in statistically higher probing pocket depth reduction and clinical attachment level gain than Control group. Conclusion: Both therapies resulted in significant probing pocket depth reductions and clinical attachment gains, and treatment with open flap debridement with bovine-derived xenografts and collagen membrane resulted in significantly higher probing pocket depth reduction and clinical attachment gain than treatment with open flap debridement alone.


Author(s):  
Gianna Maria Nardi ◽  
Francesca Cesarano ◽  
Giulio Papa ◽  
Lorella Chiavistelli ◽  
Roman Ardan ◽  
...  

Background: Extracellular matrix metalloproteinases (MMPs) play a pivotal role in the damage to the periodontal tissue in patients with periodontitis. Scaling and root planning (SRP) attempt to control the plaque amount and consequentially reduce the bacterial load. Non-surgical periodontal treatment could be integrated with drug therapy and physiotherapy procedures such as ozone therapy. The aim of this study was to evaluate in a cohort of patients with a diagnosis of periodontitis: (1) the efficacy of non-surgical periodontal therapy assisted by the use of ozonated olive oil-based mouthwash on salivary metalloproteinase (MMP-8) and (2) the reduction of periodontal indices. Methods: Ninety-six subjects with a diagnosis of periodontitis were enrolled in this study and randomly assigned to the study group (SRP + mouthwash) or control group (SRP). The study duration was 3 months. Data on MMP-8, plaque index (PI), bleeding on probing (BoP) and probing pocket depth (PPD) were recorded at T0, T1 (14 days), T2 (1 month) and T3 (6 months). Group differences were assessed using Student’s t-test for independent samples. Results: A significant improvement in PI, BoP, PPD and salivary MMP-8 levels was observed in both groups. An analysis of differences in relative changes of indices revealed the efficacy of ozonated olive oil in decreasing MMP-8 level. Simultaneously, it slowed the decrease of BoP index. Conclusions: Scaling and root plaining with the aid of ozonated olive oil mouthwash were found to be more effective on salivary MMP-8 reduction than scaling and root plaining alone.


2012 ◽  
Vol 83 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Tony N. F. To ◽  
A. Bakr M. Rabie ◽  
Ricky W. K. Wong ◽  
Colman P. McGrath

Abstract Objective: To evaluate the effectiveness of diode laser gingivectomy as an adjunct to nonsurgical periodontal treatment in the management of periodontal health among patients receiving fixed orthodontic appliance therapy (FOAT). Materials and Methods: Thirty patients undergoing FOAT with gingival enlargement were block randomized into two treatment groups. The test group received diode laser gingivectomy (940-nm diode laser, ezlase, Biolase Technology Inc) as an adjunct to nonsurgical periodontal treatment. The control group received nonsurgical periodontal treatment only. For both groups, five periodontal parameters were assessed at baseline, 1 month, 3 months, and 6 months: Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, and Gingival Overgrowth Index. Intra- and intergroup variations in the periodontal parameters were determined over time. Results: Both groups showed statistically significant improvements in periodontal health over the study period (P &lt; .05). However, significant improvements in periodontal health were evident earlier among the test group subjects (P &lt; .05). The magnitude of improvement in periodontal health compared to baseline was greater in the test group than in the control group for Gingival Overgrowth Index at 1 month (P &lt; .001) and 3 months (P &lt; .05), Gingival Index at 3 months (P &lt; .05) and 6 months (P &lt; .05), and probing pocket depth at 1 month (P &lt; .05). Conclusions: Nonsurgical periodontal management with or without the adjunct use of lasers can be effective in the management of gingival health problems among patients receiving FOAT. The adjunctive use of lasers can produce an earlier and greater improvement in gingival health.


Author(s):  
Maryam Faghani ◽  
Niloofar Jenabian ◽  
Sina Haghanifar ◽  
Sorayya Khafri

Objectives: Intrabony defects are among the most important signs of progression of periodontal disease. Complete tissue regeneration is the ideal goal of periodontal treatment, and regenerative methods aim to achieve this goal. New studies have reported the positive efficacy of chitosan to enhance the recovery of bony defects. This study aimed to clinically and radiographically assess the efficacy of chitosan particles for treatment of intrabony periodontal defects. Materials and Methods: In this clinical trial, 18 intrabony three-wall periodontal defects were randomly divided into three groups (n=6). The control group only received conventional flap surgery with a sulcular incision. In the second group, low molecular weight (100,000-300,000g/mol) chitosan was used in the three-wall intrabony defects during surgery while high molecular weight chitosan particles (600,000-800,000 g/mol) were used in the third group. The probing pocket depth (PPD), clinical attachment level (CAL) and radiographic defect depth (RDD) were measured at baseline and at 6 and 12 months later. Repeated measures ANOVA, and McNemar’s test were used for statistical analysis. Results: In both the control (P<0.001) and coarse chitosan (P=0.035) groups, a significant difference was noted in PPD before and after surgery. CAL was not significantly different among the three groups (P>0.05). No significant difference was noted on radiographs between the groups regarding the regenerated bone density. Conclusion: Chitosan showed no positive efficacy for treatment of three-wall periodontal bone defects.


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