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Non-surgical Periodontal Therapy (non-surgical + periodontal_therapy)
Selected AbstractsNon-surgical periodontal treatment with a new ultrasonic device (VectorÔ-ultrasonic system) or hand instrumentsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2004A prospective, controlled clinical study Abstract Objectives: The aim of this prospective, randomized, controlled clinical study was to compare the effectiveness of a newly developed ultrasonic device to that of scaling and root planing for non-surgical periodontal treatment. Material and Methods: Thirty-eight patients with moderate to advanced chronic periodontal disease were treated according to an "one-stage procedure" with either a newly developed ultrasonic device (VUS) (VectorÔ-ultrasonic system) or scaling and root planing (SRP) using hand instruments. Clinical assessments by plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 6 months after treatment. Differences in clinical parameters were analyzed using the Wilcoxon signed ranks test and Mann and Whitney U -test. Results: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the VUS group from 32% at baseline to 20% after 6 months (p<0.001) and in the SRP group from 30% at baseline to 18% after 6 months (p<0.001). The results have shown that at moderately deep sites (initial PD 4,5 mm) mean CAL changed in the test group from 4.6±1.2 to 4.2±1.6 mm (p< 0.001) and in the control group from 4.8±1.3 to 4.4±1.5 mm (p<0.001). At deep sites (inital PD>6 mm) mean CAL changed in the test group from 8.5±1.9 to 7.9±2.4 mm (p<0.001) and in the control group from 7.9±1.6 to 7.2±2.2 mm (p<0.001). No statistically significant differences in any of the investigated parameters were found between the two groups. Conclusion: Non-surgical periodontal therapy with the tested ultrasonic device may lead to clinical improvements comparable to those obtained with conventional hand instruments. [source] Elevated levels of collagen cross-link residues in gingival tissues and crevicular fluid of teeth with periodontal diseaseEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2003Søren Jepsen Lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) are collagen cross-link residues. Lysylpyridinoline is present in most tissues, whereas LP is present mainly in mineralized tissue. Both are elevated in tissue with increased collagen resorption. The purpose of this investigation was to assess if the concentrations of LP and HP are elevated in gingiva and gingival crevicular fluid (GCF) of teeth with advanced periodontitis (AP). We investigated human gingival biopsies of healthy teeth (n = 19) and teeth with AP (n = 43) in 49 individuals. Samples of GCF from 54 teeth with AP were collected in seven patients and compared with samples from 11 patients with experimentally induced gingivitis. Levels of LP and HP were measured by HPLC and fluorescence detection. Gingival concentrations of HP but not LP around teeth with advanced periodontitis were significantly elevated compared with teeth with healthy periodontium. While significant amounts of HP and LP were measurable in the GCF of teeth with AP, no HP and LP was identified 3 months following non-surgical periodontal therapy of the teeth or in fluid from teeth subjected to experimentally induced gingivitis. Elevated concentrations of HP and LP in GCF may serve as indicators of ongoing destruction of periodontal tissues and alveolar bone in advanced periodontitis. [source] The effect of topical doxycycline usage on gingival crevicular fluid MMP-8 levels of chronic and aggressive periodontitis patients: a pilot studyINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2006Abstract:, The aim of this study was to evaluate the efficacy of topical subgingival application of doxycycline hyclate (DH) gel adjunctive to non-surgical periodontal therapy on gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels in chronic and aggressive periodontitis patients. Forty teeth of 10 chronic periodontitis patients and 32 teeth of eight aggressive periodontitis patients were screened for 6 months. Scaling and root planing (SRP) was applied to the control sites and DH gel adjunctive to SRP was applied to the test sites of each patient simultaneously. GCF MMP-8 levels were analysed at baseline, 7 days; and at 1, 3 and 6 months by Sandwich Elisa Method. At 1, 3 and 6 months, probing depth (P < 0.0051) and plaque scores and bleeding on probing values (P = 0.000) significantly decreased in each group when compared with the baseline, but there was no statistically significant difference between the test and control sites. GCF MMP-8 levels reduced presenting statistically significant differences on 7 days, 1, 3 and 6 months in four of the groups (P < 0.05); however, intergroup differences were not statistically significant. Developing functional and immunological-based chair-side MMP tests might serve as useful adjunctive diagnostic tools when monitoring the effects of DH gel application. [source] Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Ana Belén Navarro-Sanchez Abstract Objetives: The purpose of this study was to compare the local efficacy of nonsurgical periodontal therapy between type 2 diabetic and non-diabetic patients and the effect of periodontal therapy on glycaemic control. Background: A complex two-way relationship exists between diabetes mellitus and periodontitis. Material and Methods: After selection, 20 subjects (10 diabetic and 10 non-diabetic) underwent baseline examination, periodontal clinical study and biochemical analysis of gingival crevicular fluid (GCF). After the pre-treatment phase, subgingival scaling and root planing were performed. Subsequently, all subjects continued the maintenance programme and were re-examined at 3 and 6 months. Results: Diabetic and non-diabetic subjects responded well after therapy, showing a very similar progression during the follow-up period. Both groups showed clinically and immunologically significant improvements. Significant reductions were also found in the total volume of GCF and levels of interleukin-1, and tumour necrosis factor- ,. Diabetic subjects showed an improvement in their metabolic control. The change in glycosylated haemoglobin (HbA1C) was statistically significant at 3 and 6 months. Conclusions: The clinical and immunological improvements obtained were accompanied by a significant reduction in HbA1C values in type 2 diabetic subjects. Larger studies are needed to confirm this finding and establish whether periodontal therapy has a significant effect on glycaemic control. [source] Predictive value of clinical and microbiological parameters for the treatment outcome of scaling and root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2005P. F. Brochut Abstract Objectives: To compare the clinical and microbiological outcome of non-surgical periodontal therapy after 6 months with data obtained after hygienic phase or 6 weeks after completion of non-surgical therapy, in order to evaluate the value of clinical and microbiological parameters to predict treatment success. Material and Methods: Clinical and microbiological data were available from 271 sites in 10 systemically healthy non-smokers with moderate-to-advanced chronic periodontal disease (24,32 sites per individual). Subgingival plaque samples were tested for the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythensis and Treponema denticola using RNA probes. Results: Stepwise multiple linear regression analysis revealed a significant impact of the number of sites with visible plaque index >1 after hygienic phase on the bleeding tendency of a subject at month 6 (p<0.01). Furthermore, an association could be demonstrated between the number of residual pockets (PD>3 mm) 6 months after therapy and the number of bleeding sites and suppurating sites after hygienic phase (p=0.016). Six weeks after therapy, the mean total bacterial loads had a significant impact on the bleeding tendency of a subject at month 6 (p<0.01). Although the average numbers of sites with persisting P. gingivalis, A. actinomycetemcomitans, T. forsythensis and T. denticola seemed to be very similar 6 weeks and 6 months after therapy, large variations were noted between subjects, and therefore the microbiological status of a subject at week 6 could not predict the status at month 6. Conclusions: The present study showed a limited potential of microbiological tests, performed after hygienic phase or shortly after non-surgical periodontal therapy, to predict the clinical outcome 6 months later, but confirmed the importance of an establishment of perfect oral hygiene before non-surgical therapy. [source] Periodontal treatment of patients with Papillon,Lefèvre syndrome: a 3-year follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2004T. Lundgren Abstract Background/aim: Conventional mechanical periodontal treatment of Papillon,Lefèvre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented. Methods: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin,metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years. Results/Conclusion: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene. [source] Evaluation of enamel matrix derivative as an adjunct to non-surgical periodontal therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003Mauricio A. Gutierrez Abstract Objectives: The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) on periodontal healing following nonsurgical periodontal therapy (scaling and root planing , SRP). Material and methods: The study was performed as an intraindividual, longitudinal trial of 3 months duration with a double-blinded, split-mouth, controlled, and randomized design. Twenty-two patients with moderate to severe chronic periodontitis were enrolled in the study. In each patient, two sites with pocket depths 5 mm and with radiographic angular bone defects >3 mm were selected. Baseline examination included measurement of probing pocket depth (PPD) and clinical attachment levels (CAL). The presence or absence of plaque and bleeding on probing at selected sites was also recorded. Following initial examination, full-mouth SRP was performed. Study sites were then treated with 24% EDTA for 2 min, followed by thorough irrigation with sterile saline. The sites were then randomized. The experimental site received subgingival application of enamel matrix derivative (Emdogain®, BIORA AB, Malmo, Sweden). The control site received no additional treatment. At 3 months, all sites were re-examined. The response to therapy in experimental and control sites was evaluated, using change in probing depth and CAL as the primary outcome variables. Statistical analysis (paired t -tests) was used to compare response to treatment in control versus experimental sites. Results: Statistically significant changes in PPD and CAL were seen in both treatment groups from baseline to 3 months. The mean PPD reduction was 2.3±0.5 mm for control sites and 2.0±0.3 mm for experimental sites. The mean CAL gain was 1.8±0.4 mm for control sites, and 1.4±0.3 mm for experimental sites. Statistical analysis, however, revealed no significant difference in PPD reduction or CAL gain between experimental and control groups (p>0.4). In addition, no difference was found between treatment groups in bleeding or plaque indices at 3 months. Conclusion: The findings from the present study do not support the use of EMD during routine, nonsurgical debridement of periodontal pockets as measured 3 months post SRP. Zusammenfassung Ziel: Das Ziel dieser Studie war die Evaluation eines adjunktiven Gebrauchs von Schmelzmatrixderivaten (EMD) auf die parodontale Heilung nach nicht chirurgischer parodontaler Therapie (Wurzelreinigung und ,glättung, scaling und root planing , SRP). Material und Methoden: Die Studie wurde als eine intraindividuelle, für 3 Monate longitudinale Studie mit einem doppelt blinden, split-mouth, kontrolliertem und randomisiertem Protokoll durchgeführt. 22 Patienten mit moderater bis schwerer chronischer Parodontitis wurden in die Studie einbezogen. Bei jedem Patient wurden zwei Flächen mit Sondierungstiefen5 mm und mit radiographisch feststellbaren angulären Knochendefekten>3 mm ausgesucht. Die Basisuntersuchung umfasste die Messung der Sondierungstiefen (PPD) und des klinischen Stützgewebeniveaus (CAL). Die An- oder Abwesenheit von Plaque und Provokationsblutung an den ausgesuchten Flächen wurden auch dokumentiert. Nach der anfänglichen Untersuchung wurde eine alle Zähne betreffende SRP durchgeführt. Die Studienflächen wurden dann mit 24% EDTA für zwei Minuten behandelt, gefolgt von einer sorgsamen Spülung mit steriler Kochsalzlösung. Die Flächen wurden dann randomisiert. Die experimentellen Flächen erhielten eine subgingivale Applikation von Schmelzmatrixderivaten (Emdogain®, BIORA AB, Malmö, Schweden). Die Kontrollflächen erhielten keine zusätzliche Behandlung. Zum dritten Monat wurden alle Flächen reexaminiert. Die Antwort auf die Therapie bei den experimentellen und Kontrollflächen wurden evaluiert in Hinsicht der Veränderung der Sondierungstiefe und CAL als die primären Ergebnisvariablen. Statistische Analysen (gepaarter t -Test) wurden für den Vergleich der Behandlung zwischen experimentellen und Kontrollflächen genutzt. Ergebnisse: Statistisch signifikante Veränderungen bei der PPD und dem CAL wurden in beiden Behandlungsgruppen zwischen Basis und 3 Monaten beobachtet. Die mittlere PPD Reduktion betrug 2.3±0.5 mm für die Kontrollflächen und 2.0±0.3 mm für die experimentellen Flächen. Der mittlere CAL Gewinn betrug 1.8±0.4 mm für die Kontrollflächen und 1.4±0.3 mm für die experimentellen Flächen. Die statistischen Analysen erbrachten jedoch keine signifikanten Differenzen für PPD Reduktion und CAL Gewinn zwischen den experimentellen und Kontrollgruppen (p>0.4). Es wurden auch keine Differenzen zwischen den Gruppen hinsichtlich Provokationsblutung und Plaqueindex zum dritten Monat beobachtet. Schlussfolgerung: Die Ergebnisse von der vorliegenden Studie unterstützen nicht die Anwendung von EMD während der routinemäßigen nicht chirurgischen Reinigung der parodontalen Taschen, wie die Messungen drei Monate nach SRP. Résumé Objectif: Le but de cette étude fut d'évaluer l'utilisation des dérivés de la matrice amellaire (EMD) sur la cicatrisation parodontale après un traitement parodontal non chirurgical (détartrage et surfaçage radiculaire). Matériel et méthodes: L'étude fut conçue en essai longitudinal intra-individuel d'une durée de 3 mois randomisée, contrôlée en double aveugle et en bouche croisée. 22 patients atteints de parodontites chroniques modérées ou sévères furent enrôlés. Pour chaque patient, 2 sites avec des profondeurs de poches5 mm et des lésions osseuses angulaires radiographiques>3 mm furent sélectionnés. L'examen initial comportait la mesure des profondeurs de poche au sondage (PPD) et les niveaux cliniques d'attache (CAL). La présence ou l'absence de plaque et de saignement au sondage sur les sites sélectionnés furent aussi enregistrées. Après l'examen initial, un détartrage et un surfaçage complet étaient réalisés. Les sites étudiés étaient alors traités par de l'EDTA à 24% pendant 2 minutes, puis fortement rinçés avec du serum physiologique. Les sites étaient alors répartis aléatoirement. Le site expérimental recevait une application sous gingivale d'EMD (Emdogain®, BIORA AB, Malmo, Sweden). Le site contrôle ne recevait pas de traitement supplémentaire. A 3 mois, les sites étaient réévalués. La réponse au traitement était évaluée par les modifications de profondeur de poches et de niveau d'attache comme variables primaires. L'analyse statistique (Test t apparié) permit de comparer la réponse au traitement. Résultats: Des modifications statistiquement significatives de PPD et de CAL ont été observées dans les deux groupes de traitement. La réduction de PPD moyenne était de 2.3±0.5 mm pour les sites contrôles et de 2.0±0.3 mm pour les sites expérimentaux. Le gain de CAL moyen était respectivement de 1.8±0.4 mm et de 1.4±0.3 mm.L'analyse statistique, cependant, ne révélait pas de différences significatives entre les deux groupes (p>0.4). De plus, aucune différence n'apparaissait entre les groupes pour le saignement et les indices de plaque au troisième mois. Conclusion: Les données de cette étude n'étayent pas l'utilisation routinière d' EMD lors du débridement non chirurgical des poches parodontales lorsqu'on en mesure les résultats 3 mois après détartrage et surfaçage radiculaire. [source] Serum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2002Tom J. Sims Abstract Background: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species-specific antigens of Porphyromonas gingivalis or to cross-reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin-dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings: 1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients. We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis -specific antigens may be useful in assessing risk for refractory periodontitis in such patients. Aim: To determine whether PDC resulting from non-surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalisspecific antigens, human HSP, and GAD65. Methods: PDC was assessed two months after non-surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme-linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent-onset IDDM patients and 46 non-diabetic controls. Results: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non-diabetic controls for GAD65 Ab + (p°= 0.002) and GAD65 Ab- (p =,0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log-transformed titers to HSP90 (r =,, 0.62, p = 0.008), HSP70 (r =,+ 0.62, p = 0.009), GAD65 (r =,, 0.60, p = 0.01) and P. gingivalis LPS (r = , 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log-transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann,Whitney). Conclusion: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non-surgical periodontal therapy. [source] Myeloid-related protein (MRP8/14) expression in gingival crevice fluid in periodontal health and disease and after treatmentJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2010E. Andersen Andersen E, Dessaix IM, Perneger T, Mombelli A. Myeloid-related protein (MRP8/14) expression in gingival crevice fluid in periodontal health and disease and after treatment. J Periodont Res 2010; 45: 458,463. © 2010 John Wiley & Sons A/S Background and Objective:, Myeloid-related protein (MRP8/14) and its subunits are biomarkers of inflammation. The present study evaluated whether gingival crevice fluid levels of these markers discriminate periodontitis from healthy sites in patients with chronic periodontitis or diseased from healthy subjects, and whether these biomarkers detect longitudinal changes after therapy. Material and Methods:, Levels of MRP8/14, MRP14 and total protein were quantified in 19 periodontitis patients before non-surgical periodontal therapy, after 3 and 6 mo of treatment, and were measured once in 11 periodontally healthy subjects. In total, diseased subjects contributed 59 sites with probing depths >4 mm (PP) and 21 sites <4 mm (PH); healthy subjects contributed 91 sites (HH). Results:, Overall, in diseased subjects, MRP8/14, MRP14 and total protein were not significantly different between PP and PH sites. However, at baseline, MRP8/14 and total protein had significantly higher values at sites in periodontally diseased than in healthy subjects. Clinical improvement was associated with a significant decrease of MRP8/14 and MRP14 from baseline to month 6 in PP sites. Interestingly, a similar decrease was observed in PH sites for all three markers. At 6 mo, however, levels of MRP8/14 and protein in PP and PH sites of patients were still significantly higher than in healthy subjects. Conclusion:, Gingival crevice fluid levels of MRP8/14 did not differentiate between clinically diseased and healthy sites in patients with chronic periodontitis. However, this marker was elevated in periodontally diseased compared with healthy subjects, and its values decreased following therapy. MRP8/14 may be used to monitor the response to treatment. [source] Effects of scaling and root planing on the amounts of interleukin-1 and interleukin-1 receptor antagonist and the mRNA expression of interleukin-1, in gingival crevicular fluid and gingival tissuesJOURNAL OF PERIODONTAL RESEARCH, Issue 3 2004Nobuo Yoshinari Objective:, The purpose of this study was to evaluate the relationship between the clinical changes after non-surgical periodontal therapy and interleukin 1 (IL-1) in gingival crevicular fluid (GCF) and gingival tissues from patients with chronic periodontitis. Background:, The inflammatory responses mediated by IL-1 play an important role in periodontal tissue destruction. Although numerous studies have attempted to elucidate the dynamic movement involved in chronic periodontitis, the results have often conflicted. Such discrepancies may have been due to the inability to determine clinical disease activity. Methods:, Seven patients with chronic periodontitis were examined. The severity of periodontal inflammation was expressed using clinical parameters before and after a scaling and root planing (SRP) procedure. The amounts and concentrations of IL-1,, IL-1, and IL-1 receptor antagonist in GCF were measured by enzyme-linked immunosorbent assay (ELISA) and IL-1 activity index was calculated. A needle biopsy in matching gingival tissues was also performed before and after the SRP procedure. The localization and mRNA expression of IL-1, were determined using histological methods. Results:, Clinical parameters improved slightly after the SRP procedure. Only the probing pocket depth (PPD) was reduced significantly (p < 0.05). However, the amount of IL-1, in GCF was slightly increased. The localization and mRNA expression of IL-1, could still be observed after the SRP procedure. Therefore, none of the clinical parameters showed a high sensitivity or specificity for evaluating subgingival inflammation. Conclusion:, These observations suggest that IL-1 is effective for evaluating in detail the state of subgingival inflammation. [source] The effect of periodontal therapy on serum TNF-, and HbA1c levels in type 2 diabetic patientsAUSTRALIAN DENTAL JOURNAL, Issue 1 2009Abstract Background:, To determine the effect of non-surgical periodontal therapy on serum TNF-, and HbA1c levels in poorly and well-controlled type 2 diabetic patients. Methods:, In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c , 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-, concentration were measured at baseline and three months after the non-surgical periodontal therapy. Results:, All periodontal parameters and serum TNF-, levels were significantly decreased three months after the non-surgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-, levels at baseline and after three months between the two groups. Conclusions:, Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-,, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period. [source] | ||||||||||