scholarly journals Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis

2019 ◽  
Vol 30 (6) ◽  
pp. 577-586 ◽  
Author(s):  
Camila Camarinha da Silva Cirino ◽  
Hugo Felipe do Vale ◽  
Márcio Zaffalon Casati ◽  
Enilson Antonio Sallum ◽  
Renato Corrêa Viana Casarin ◽  
...  
Keyword(s):  
Surgical Therapy ◽  
Gingival Recession ◽  
Aggressive Periodontitis ◽  
Posterior Teeth ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Microbiological Parameters ◽  
Clinical Benefits ◽  
Nonsurgical Therapy

Abstract The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.

scholarly journals Regeneration of the Periodontal Apparatus in Aggressive Periodontitis Patients

2019 ◽  
Author(s):  
Zvi Artzi ◽  
Shiran Sudri ◽  
Ori Platner ◽  
Avital Kozlovsky
Keyword(s):  
Gingival Recession ◽  
Clinical Results ◽  
Aggressive Periodontitis ◽  
Clinical Attachment Level ◽  
Probing Depth ◽  
Group 12 ◽  
Enamel Matrix Derivatives ◽  
Pre Treatment ◽  
Attachment Level

The aim of this article is to evaluate and compare, retrospectively, the efficacy of two regenerative periodontal procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from multiple intra-bony defects (IBD); that were treated by one of two regenerative modalities of periodontal therapy randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of enamel matrix derivatives (EMD) combined with DBX. The monitoring of the treated sites included recordings of probing depth (PD), clinical attachment level (CAL), and gingival recession. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PD and CAL values, however, not between subject groups. CAL values decreased in all sites. At EMD group (44 sites) CAL gain was 1.92 mm (&plusmn;1.68) from pre-treatment to follow-up (p&lt;0.001) and at the GTR group (12 sites) CAL gain of 2.27 (&plusmn;1.82) mm. In conclusion, 1-10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.

scholarly journals Clinical Factors Influencing the Efficacy of Systemic Moxifloxacin in the Therapy of Patients With Generalized Aggressive Periodontitis: A Multilevel Analysis From a Clinical Trial

2015 ◽  
Vol 8 (3) ◽  
pp. 80 ◽  
Author(s):  
Carlos M. Ardila ◽  
Isabel C. Guzmán
Keyword(s):  
Clinical Trial ◽  
Multilevel Analysis ◽  
Linear Models ◽  
Clinical Results ◽  
Aggressive Periodontitis ◽  
Continuous Variables ◽  
Clinical Factors ◽  
Probing Depth ◽  
Clinical Benefits ◽  
Multilevel Linear Models

<p><strong>BACKGROUND:</strong> It has been reported that clinical results of mechanical periodontal treatment could differ between subjects and among different sites of the tooth in the patient. The objective of this multilevel analysis is to investigate clinical factors at subject and sites of the tooth that influence variations in clinical attachment (CAL) increase and probing depth (PD) diminution of adjunctive moxifloxacin (MOX) at six months post-treatment in generalized aggressive periodontitis.</p> <p><strong>METHODS:</strong> This clinical trial included 40 patients randomly distributed to two therapy protocols: scaling and root planing alone or combined with MOX. Multilevel linear models for continuous variables were formulated to evaluate the clinical impact of the hierarchical configuration of periodontal data.</p> <p><strong>RESULTS:</strong> Six months following therapy, the divergences between both protocols were statistically significant in PD diminution and CAL increase, favouring the MOX therapy (p&lt;0.001). Besides, the multilevel analysis revealed that adjunctive MOX at the subject level, non-molar and the interaction non-molar x MOX at the tooth level, interproximal sites and the interaction interproximal sites x MOX at the site level, were statistically significant factors in determining CAL increase and PD diminution.</p> <p><strong>CONCLUSIONS:</strong> The main cause of variability in CAL gain and PD reduction following adjunctive MOX was attributable to the tooth level. Adjunctive MOX and their interactions with non-molar and interproximal sites showed higher clinical benefits at the tooth and site levels which could be essential for PD reduction and CAL gain in generalized aggressive periodontitis subjects.</p>

scholarly journals Aspectos clínicos, microbiológicos e tratamento periodontal em pacientes fumantes portadores de doença periodontal crônica: revisão da literatura

2016 ◽  
Vol 73 (4) ◽  
pp. 325
Author(s):  
Gabriela Alessandra Da C. Galhardo Camargo ◽  
Mariana Gouvea Latini Abreu ◽  
Renata Dos Santos ◽  
Marcio Alves Crespo ◽  
Leticia De Faria Wenderoscky
Keyword(s):  
Gingival Recession ◽  
Periodontal Therapy ◽  
Clinical Aspects ◽  
Gingival Index ◽  
Periodontal Pathogens ◽  
Clinical Attachment Level ◽  
Qualitative And Quantitative ◽  
Probing Depth ◽  
Microbiological Parameters ◽  
Attachment Level

Objective: the aim of this study was to evaluate, through literature review, clinical aspects (plaque index, gingival index, probing depth, gingival recession and clinical attachment level) and microbiological (qualitative and quantitative presence of periodontal pathogens) in smokers patients and the response to periodontal therapy. Material and Methods: it was selected scientific articles published between the years 1978 and 2014. We were selected scientific articles from MEDLINE, PUBMED and LILACS databases. Results: there are controversies between tobacco and clinical and microbiological parameters. Conclusion: based on the evaluated studies we can conclude that there are significant clinical and microbiological differences in smoking patients and impaired response to periodontal therapy.

scholarly journals The treatment of chronic periodontitis by non-surgical periodontal therapy in association with diode laser compared to conventional non-surgical therapy

2020 ◽  
Author(s):  
Bellia Loredana ◽  
Ruggiero Roberta ◽  
Nicolò Michele
Keyword(s):  
Surgical Treatment ◽  
Diode Laser ◽  
Surgical Therapy ◽  
Test Group ◽  
Control Group ◽  
Probing Depth ◽  
Baseline Test ◽  
Mechanical Therapy ◽  
Non Surgical Treatment

Mechanical surface treatment and removal of the above and subgingival biofilm (Tartar ablation; SRP) are considered the most suitable tools for the treatment of periodontal inflammatory diseases, with the aim of destroying bacterial bioflim, reducing bacteria, and slowing down recolonization by pathogenic microorganisms. Often, however, the only S&RP are not enough, as there are patients who are experiencing relapses. Recently, laser therapy has been suggested as a potential tool to improve the outcome of periodontal non-surgical treatment. The objective of the following study was to evaluate the clinical healing of periodontal pockets treated with mechanical therapy, scaling and root planing, and diode laser application, compared to that obtained with non-surgical mechanical therapy alone. The study was designed as a randomized controlled clinical trial. Patients in the control group (13 patients) underwent conventional non-surgical therapy only, while patients in the test group (17 patients) were associated with conventional non-surgical treatment, a laser irradiation session. At baseline and after 6 months, the parameters of probing depth (PD), bleeding on probing (BOP), gingival recession (REC) were assessed The main variable of this study was the PD (probing depth) FMPS and FMBS at follow-up improved in both groups. The FMPS baseline test group 32.59 ± 6.74 - follow up 12.00 ± 3.16. The baseline of the control group showed 33.00 ± 9.55, the follow up 13.15 ± 4.85 The FMBS baseline test group found 24.29 ± 5.01 while at follow 9.65 ± 2.69. The baseline control group 30.31 ± 7.74, Follow up 11.08 ± 2.33. There is a statistical significance. (P.VALUE 0.0001) There were no significant differences between the groups in terms of PD, CAL and BOP at baseline and at follow-up. PD Test group 4,89±1,58 3,95±0,85 0,0001 Control group 5,02±1,57 4,01±0,86 CAL (mm)Test group 0,89±2,29 0,77±1,91 Control group 0,28±1,38 0,24±1,14 REC Test group 0,19±0,49 0,19±0,51 Control group 0,06±0,29 0,57±029 BOP Test group 51,2% 23,5% Control group 54,0% 20,9% The results showed differences in both baseline and follow-up for REC. Test group 0,19±0,49 0,19±0,51-Control group0,06±0,29 0,57±029 In intra-group analyzes, there are differences between baseline and follow-up for all values, except for REC in the control group. The diode laser can be used as an appropriate device for periodontal treatments, but it can offer additional and significant benefits if used according to appropriate protocols and parameters, and especially if associated with non-surgical, manual and ultrasound periodontal instrumentation, always site-specific , as it is a tool that does not replace traditional methods.

scholarly journals Regeneration of the Periodontal Apparatus in Aggressive Periodontitis Patients

2019 ◽  
Vol 7 (1) ◽  
pp. 29 ◽  
Author(s):  
Zvi Artzi ◽  
Shiran Sudri ◽  
Ori Platner ◽  
Avital Kozlovsky
Keyword(s):  
Periodontal Regeneration ◽  
Gingival Recession ◽  
Clinical Results ◽  
Aggressive Periodontitis ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Group 12 ◽  
Enamel Matrix Derivatives ◽  
Pre Treatment

The purpose of this study is to evaluate and compare, retrospectively, the outcome of two different periodontal regeneration procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from several intra-bony defects (IBD); that were treated by one of two periodontal regeneration techniques randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of extracted enamel matrix derivatives (EMD) combined with demineralized bone xenograft particles (DBX). Probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession were recorded. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PPD and CAL values, however, not between subject groups. CAL values decreased in all sites. At the EMD group (44 sites), CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p < 0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1–10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.

scholarly journals Clinical Evaluation of Intrabony Defects in Localized Aggressive Periodontitis Patients with and without Bioglass- An In-vivo Study

2012 ◽  
Vol 10 (1) ◽  
pp. 7-10
Author(s):  
KV Satyanarayana ◽  
BR Anuradha ◽  
G Srikanth ◽  
P Mohan Chandra ◽  
T Anupama ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Test Group ◽  
Gingival Recession ◽  
Aggressive Periodontitis ◽  
Control Group ◽  
Defect Depth ◽  
Clinical Attachment Level ◽  
Probing Depth ◽  
Localized Aggressive Periodontitis ◽  
Attachment Level

Background Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as “rapid attachment loss, bone destruction” and “familial aggregation”. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. Objective The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. Methods Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth ? 2 mm, preoperative probing depths ? 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. Results After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P <0.001) and a gain in clinical attachment level of 4.42+0358mm (P <0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P<0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P <0.001) in the test group and by 0.1792 + 0.031mm (P <0.001) in the control group. Changes in gingival recession showed no significant differences. . Conclusion Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 11-15 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6906

scholarly journals Does the Laser-Microtextured Short Implant Collar Design Reduce Marginal Bone Loss in Comparison with a Machined Collar?

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
B. Alper Gultekin ◽  
Ali Sirali ◽  
Pinar Gultekin ◽  
Serdar Yalcin ◽  
Eitan Mijiritsky
Keyword(s):  
Bone Resorption ◽  
Bone Loss ◽  
Marginal Bone Loss ◽  
Posterior Teeth ◽  
Cumulative Survival ◽  
Probing Depth ◽  
Before And After ◽  
Retrospective Study Design ◽  
Short Implant

Purpose. To compare marginal bone loss between subgingivally placed short-collar implants with machined collars and those with machined and laser-microtextured collars.Materials and Methods. The investigators used a retrospective study design and included patients who needed missing posterior teeth replaced with implants. Short-collar implants with identical geometries were divided into two groups: an M group, machined collar; and an L group, machined and laser-microtextured collar. Implants were evaluated according to marginal bone loss, implant success, and probing depth (PD) at 3 years of follow-up.Results. Sixty-two patients received 103 implants (56 in the M group and 47 in the L group). The cumulative survival rate was 100%. All implants showed clinically acceptable marginal bone loss, although bone resorption was lower in the L group (0.49 mm) than in the M group (1.38 mm) at 3 years (p<0.01). A significantly shallower PD was found for the implants in the L group during follow-up (p<0.01).Conclusions. Our results suggest predictable outcomes with regard to bone loss for both groups; however, bone resorption was less in the L group than in the M group before and after loading. The laser-microtextured collar implant may provide a shallower PD than the machined collar implant.

scholarly journals Fine-Tuning Multilevel Modeling of Risk Factors Associated with Nonsurgical Periodontal Treatment Outcome

2019 ◽  
Author(s):  
João Botelho ◽  
Vanessa Machado ◽  
Paulo Mascarenhas ◽  
Ricardo Alves ◽  
Maria Alzira Cavacas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fine Tuning ◽  
Periodontal Treatment ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Hierarchical Levels ◽  
Variance Component Models

This retrospective study aimed to investigate the effect of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Thirty-seven patients (24 males and 13 females) with moderate to severe chronic periodontitis were treated with nonsurgical periodontal therapy. Follow-up visits at 3, 6, and 12 months included measurement of several clinical periodontal parameters. Data were extracted from a database system. Probing depth (PD) and Clinical Attachment Loss (CAL) reductions after NSPT in an overall of 1416 initially affected sites (baseline PD &ge; 4 mm), distributed on 536 teeth, were analyzed against known risk factors at three hierarchical levels (patient, tooth and site). The variance component models fitted to assess the three-level variance of PD and CAL decrease for each post-treatment follow-up showed that all levels contributed significantly to the overall variance (P &lt; 0.001). Patients that underwent NSPT and were continually monitored had very curative results. All three hierarchical levels included risk factors who had impact on the to influence the magnitude of PD and CAL reduction. Specifically, the tooth&rsquo;s type, surfaces involved and teeth mobility site-level risk factors showed the highest influence on these reductions, being highly relevant factors for the NSPT success.

scholarly journals Antiseptics as Adjuncts to Scaling and Root Planing in the Treatment of Periodontitis: A Systematic Literature Review

2020 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits ◽  
Antiseptic Agent

Abstract Background : Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planning (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.

scholarly journals Antiseptics as Adjuncts to Scaling and Root Planing in the Treatment of Periodontitis: A Systematic Literature Review

2020 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits ◽  
Antiseptic Agent

Abstract Background : Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planning (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.

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