Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial

Abstract Background The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis. Methods Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear. Trial registration NCT02839408, 10/28/2017, Clinicaltrial.gov.

Download Full-text

Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planing in the treatment of periodontitis stage III: A pilot randomized controlled clinical trial

10.21203/rs.3.rs-45864/v2 ◽

2020 ◽

Author(s):

Alicia Morales ◽

Rafael Contador ◽

Joel Bravo ◽

Paola Carvajal ◽

Nora Silva ◽

...

Keyword(s):

Clinical Trial ◽

Stage Iii ◽

Treatment Modalities ◽

Controlled Clinical Trial ◽

Clinical Effects ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Root Planing

Abstract Background: The aim of this triple- blind placebo- controlled parallel- arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis.Methods: Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; 1) placebo (n=15), 2) probiotics (n=16) and 3) antibiotics-azithromycin (n=16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results: All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p<0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p=0.002) and the antibiotic-azithromycin (p=0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p=0.003). The number of sites and teeth with PPD ≥5, ≥6 and ≥7mm were significantly reduced in all groups at 12 months follow-up (p<0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion: The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.

Download Full-text

Clinical Effects of Probiotic or Azithromycin as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis Stage III: A Pilot Randomized Controlled Clinical Trial

10.21203/rs.3.rs-45864/v1 ◽

2020 ◽

Author(s):

Alicia Morales ◽

Rafael Contador ◽

Joel Bravo ◽

Paola Carvajal ◽

Nora Silva ◽

...

Keyword(s):

Clinical Trial ◽

Stage Iii ◽

Treatment Modalities ◽

Controlled Clinical Trial ◽

Clinical Effects ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Root Planing

Abstract Background The aim of this triple- blind placebo- controlled parallel- arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with periodontitis stage III. Methods Forty-seven systemically healthy participants with periodontitis stage III were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; 1) placebo (n = 15), 2) probiotics (n = 16) and 3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of periodontitis stage III. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.

Download Full-text

Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planing in the treatment of periodontitis stage III: A pilot randomized controlled clinical trial

10.21203/rs.3.rs-45864/v3 ◽

2020 ◽

Author(s):

Alicia Morales ◽

Rafael Contador ◽

Joel Bravo ◽

Paola Carvajal ◽

Nora Silva ◽

...

Keyword(s):

Clinical Trial ◽

Stage Iii ◽

Treatment Modalities ◽

Controlled Clinical Trial ◽

Clinical Effects ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Root Planing

Download Full-text

Evaluation of the clinical efficacy of 1.2% atorvastatin by CBCT in the treatment of periodontal intrabony defects: A randomized controlled clinical trial

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.15171/joddd.2019.029 ◽

2019 ◽

Vol 13 (3) ◽

pp. 183-191

Author(s):

Prerna Y. Shirke ◽

Abhay P. Kolte ◽

Rajashri A. Kolte ◽

Pranjali V. Bawanakar

Keyword(s):

Clinical Trial ◽

Statistical Significance ◽

Periodontal Regeneration ◽

Controlled Clinical Trial ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Treat Ment ◽

Group 2 ◽

Attachment Level ◽

Group 1

Background. Atorvastatin (ATV), which belongs to the statin class of drugs, is the formidable inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. This clinical trial evaluated and compared the clinical and radiographic changes in chronic periodontitis (CP) patients, obtained through 1.2% ATV as an adjunct to scaling and root planing (SRP) in the treat-ment of intraosseous defects. Methods. Twenty CP patients, with a minimum of one pair of bilateral intraosseous, were randomly selected for this split-mouth study. Group 1 included 20 sites treated with SRP and subgingival delivery of a placebo gel, whereas an equal number of sites in group 2 were treated by SRP along with subgingival delivery of 1.2% ATV gel. The plaque index (PI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD) and clinical attachment level (CAL) were evaluated at baseline and 3- and 6-month intervals, while the intraosseous defect was assessed at baseline and 6-month interval using cone-beam computed tomography (CBCT). Paired t-test was used to determine statistical significance. Results. A greater reduction in the mean PPD and gain in CAL was found in group 2 compared to group 1 at 3- and 6-month intervals. Furthermore, a significantly greater bone fill was obtained in group 2 (1.70±0.54 mm) compared to group 1 (0.22±0.43 mm) after six months.Conclusion. ATV, as an adjunct to SRP, enhanced periodontal regeneration, as a noninvasive way to treat periodontal in-traosseous defects.

Download Full-text

Probing Pocket Depth and Clinical Attachment Level between Non-Surgical and Surgical Periodontal Therapy in Chronic Periodontitis Patients: A Randomised Controlled Clinical Trial

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v2i2.23611 ◽

2018 ◽

Vol 2 (2) ◽

pp. 40-44

Author(s):

Harish Kumar Shah ◽

Shivalal Sharma ◽

Khushboo Goel ◽

Sajeev Shrestha ◽

Surya Raj Niraula

Keyword(s):

Clinical Trial ◽

Surgical Therapy ◽

Chronic Periodontitis ◽

Controlled Clinical Trial ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

The Mean ◽

The Difference ◽

Attachment Level

Background: : Chronic periodontitis is one of the most common form of periodontal diseases which either require non-surgical periodontal therapy or open flap debridement-surgical therapy or both. To date, it is unclear as of how much changes occur after NSPT or OFD and which therapy provides the best outcome in chronic periodontitis having probing pocket depth ≥ 5-7 mm. Aim: The aim of this randomized controlled clinical trial was to evaluate the Probing Pocket Depth and Clinical Attachment Level between NSPT and OFD in chronic periodontitis patients. Materials and Methods: A total of 52 healthy patients with PPD ≥ 5-7 mm were included in the present study. Half of the patients assigned for the NSPT and half in the OFD group. The PPD and CAL were measured at baseline, three and six months. Independent sample t-test was used to compare the change in mean PPD and CAL between NSPT and OFD group at three and six months, respectively. Results: The difference in the mean decrease of PPD between NSPT and OFD group at three and six months were 0.15 mm (P<0.05) and 0.19 mm (P<0.05), respectively. The difference in the mean gain of CAL between NSPT and OFD group at three and six months were 0.03 mm (p>0.05) and 0.12 mm (P<0.05), respectively. Conclusion: Substantial improvement in periodontal status occurred with both the therapies, however, significantly higher decrease in PPD and gain in CAL were seen with surgical therapy.

Download Full-text

Treatment of Periimplantitis with Electrolytic Cleaning versus Mechanical and Electrolytic Cleaning: 18-Month Results from a Randomized Controlled Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10163475 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3475

Author(s):

Markus Schlee ◽

Hom-Lay Wang ◽

Thomas Stumpf ◽

Urs Brodbeck ◽

Dieter Bosshardt ◽

...

Keyword(s):

Clinical Trial ◽

Controlled Clinical Trial ◽

Clinical Parameters ◽

Regenerative Therapy ◽

Randomized Controlled Clinical Trial ◽

Pocket Depth ◽

Randomized Controlled ◽

Probing Pocket Depth ◽

Bone Level ◽

The Mean

Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration, and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), and 6 (T2) and 12 (T3) months after the replacement of the restoration. Results: The mean PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 were 100%, BoP decreased at T2 to 36.8% and at T3 to 35.3%. Suppuration was found to be at a level of 10.6% at T2 and 11.8% at T3. The radiologic bone level measured from the implant shoulder to the first visible bone to the implant contact was 4.9 ± 1.9 mm at mesial sites and 4.4 ± 2.2 mm at distal sites at T0 and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and the improvement of clinical parameters were demonstrated 18 months after therapy.

Download Full-text

Treatment of Periimplantitis - Electrolytic Cleaning versus Mechanical and Electrolytic Cleaning - A Randomized Controlled Clinical Trial – 18 Months Results

10.20944/preprints202107.0122.v1 ◽

2021 ◽

Author(s):

Markus Schlee ◽

Hom-Lay Wang ◽

Thomas Stumpf ◽

Urs Brodbeck ◽

Florian Rathe

Keyword(s):

Clinical Trial ◽

Controlled Clinical Trial ◽

Clinical Parameters ◽

Regenerative Therapy ◽

Randomized Controlled Clinical Trial ◽

Pocket Depth ◽

Randomized Controlled ◽

Probing Pocket Depth ◽

Bone Level ◽

Bone To Implant Contact

Background: this RCT assesses the 18 months clinical outcomes after regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), 6 (T2) and 12 (T3) months after replacement of the restoration. Results: Mean of PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 was 100 % BoP decreased at T2 to 36.8 % and at T3 to 35.3 %. Suppuration could be found 10.6% at T2 and 11.8% at T3. Radiologic bone level measured from the implant shoulder to the first visible bone to implant contact was 4.9 ± 1.9 mm at me-sial and 4.4 ± 2.2 mm at distal sites (T0) and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and improvement of clinical parameters were demonstrated 18 months after therapy.

Download Full-text

Treating periodontitis-A systematic review and meta-analysis comparing ultrasonic and manual subgingival scaling at different probing pocket depths.

10.21203/rs.2.13066/v2 ◽

2019 ◽

Author(s):

Xin Zhang ◽

Zixuan Hu ◽

Xuesong Zhu ◽

Wenjie Li ◽

Jun Chen

Keyword(s):

Meta Analysis ◽

Gingival Recession ◽

Periodontal Treatment ◽

Dental Calculus ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Probing Pocket Depth ◽

Study Results ◽

Subgingival Scaling

Abstract Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: Public databases were searched. Weighted mean differences in PPD and clinical attachment loss (CAL) reduction were estimated by random effects model. Bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus were analyzed by comparing the results of each study. Results: Ten randomized controlled trials were included out of 1,434 identified. Selected outcomes were PPD and CAL. Initial PPD and follow-up periods formed subgroups. For 3-month follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-month follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial probing pocket depth was 4-6mm, PPD reduction proved manual scaling superior to ultrasonic subgingival scaling, but CAL and GR results showed no statistical differences between the two means. When initial probing pocket depth was ≥6mm, PPD, CAL and BOP reductions suggested that manual subgingival scaling was superior to ultrasonic subgingival scaling, but GR results showed no statistical differences. No conclusion could be drawn about residual dental calculus.

Download Full-text