scholarly journals Results of an experimental study of subgingival cleaning effectiveness in the furcation area

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miriam Seidel ◽  
Hannah Borenius ◽  
Susanne Schorr ◽  
David Christofzik ◽  
Christian Graetz

Abstract Background Sufficient biofilm removal in the furcation area (FA) is a major challenge in the clinical practice of supportive periodontal therapy. The aim of the present experimental study was to simulate subgingival cleaning of the FA using a powered scaler (sonic scaler (AIR), ultrasonic scaler (US)) for conventional mechanical debridement versus two air polishing with nonabrasive powder (LAPA-1: glycine powder, LAPA-2: erythritol powder) and different nozzles for supra-/subgingival cleaning for each device. Methods Seven trained and calibrated operators with ≥ 2 years each of professional experience in treating periodontitis used the instruments to clean 3D-printed replicas of six molars with through-and-through FA (four 3-rooted and two 2-rooted teeth) in a manikin head. AIR and US were used in the control group; air polishing instruments were used in the test group. For reproducible evaluation, the test teeth were separated vertically into two or three parts, illuminated with ultraviolet light, photographed and evaluated planimetrically. Treatment time (TrT, in s) and relative cleaning efficacy (RCE, in %) were measured. Results Overall, 3-rooted molars (RCE in the entire FA, 23.19 ± 20.98%) could be cleaned significantly less effectively than 2-rooted molars (53.04 ± 28.45%, p < 0.001), regardless of the instrument used. In the cleaning of the entire FA, significantly higher RCE values were achieved with conventional mechanical debridement (AIR/US: 46.04 ± 25.96%/39.63 ± 22.02%; AIR vs. US: p > 0.05) than with air polishing (LAPA-1/LAPA-2: 34.06 ± 29.48%/17.09 ± 18.85%; LAPA-1 vs. LAPA-2: p < 0.001) regardless of whether a supra- or subgingival cleaning nozzle used (p < 0.001). Only LAPA-1 with a subgingival nozzle showed RCE values comparable to those of US (41.07 ± 28.95% vs. 39.63 ± 22.02%, p > 0.05). TrT was longest for US (299.40 ± 120.69 s) and shortest for LAPA-1 with a supragingival nozzle (129.67 ± 60.92 s, p < 0.001). Conclusions All of the examined instruments were effective to some degree in removing the simulated biofilm from the FA, but they differed substantially in cleaning efficacy. Only one air polishing device (LAPA-1) with a rigid subgingival nozzle was able to achieve RCE values similar to those of US. The current investigation confirmed that conventional mechanical debridement with powered scalers were most effective, but treatment took longer with these devices than air polishing.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Holger F. R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevance The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.


2021 ◽  
Vol 11 (Suppl. 1) ◽  
pp. 26-31
Author(s):  
Hakan Ocak ◽  
Erdem Kılıç ◽  
Alper Alkan

Aim: Given the high complication rates associated with orthognathic surgery for the correction of maxillomandibular malformations, studies have focused on alternative methods of strengthening the jaw, such as distraction osteogenesis. However, methods of shortening of the jaw are not well-elucidated in oral and maxillofacial surgery practice. This study aims to investigate the efficacy of a new method of shortening osteotomized jaws. Methodology: A 2.5–3 cm skin incision was made on the left tibia of each of 15 New Zealand white rabbits aged 12–18 months, followed by fixation of 15 mm pre-opened distractor devices to the tibia after osteotomy. After a five-day latency period, the distractors were activated to a total of 8 mm, with closure of the device set at a rate of 0.25 mm/day in the test group. After a five-day latency period, the distractors closed at a rate of 0.125 mm/day, achieving a total contraction of 5 mm. The distractors were not activated in the control group. The bone at the contraction range was evaluated, and the resultant shortening was measured. Results: The tibia was shortened by an average of 4.32 mm. Exaggerated bone formation was identified around the osteotomized cortical bone in all rabbits in the control and study groups, and there were minimal complication rates. Conclusion: This study verified that the jaw can be shortened by performing slow, controlled contraction with a bone resorption pattern.   How to cite this article: Ocak H, Kılıç E. Alkan A, Shortening of the bones using a novel contraction osteogenesis device: An experimental study. Int Dent Res 2021;11(Suppl.1):26-31. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.5   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.


2012 ◽  
Vol 10 (3) ◽  
pp. 208-214 ◽  
Author(s):  
M Sharma ◽  
GP Rauniar ◽  
BP Das

Background: Eugenol is an essential component of many medicinal herbs. It is a member of the allylbenzene class of chemical compounds. Since years, it is being used in dental practice to relieve pain arising from pulpitis and dentinal hypersensitivity. There are few reports of anticonvulsant effect but further effects are less reported. Lack of comprehensive studies and data of eugenol on the central nervous system effects in animal models thus necessitates further research activities. Objective: To observe and evaluate various neuropharmacological effects like antinociceptive effect, anticonvulsant effect, effect on motor co-ordination, pentobarbital induced sleeping time and anxiolytic effect of eugenol in mice and rats. Methods: It was a quantitative experimental study done in the laboratory setting of the department of Clinical Pharmacology and Therapeutics. For each test, respective animal models were used. Animals were divided into three groups of six each, group I as control, group II as standard control and group III as test group. Results: Significant effects were observed in analgesic, anticonvulsant and sedative model whereas no significant effect as compared to control was observed in test of motor co-ordination and in behavioral models. Conclusion: This study shows eugenol to possess analgesic, anticonvulsant and sedative effect whereas it didn.t have any effect on models of anxiety. Various target sites have been implicated but this study doesn.t conclude a plausible mechanism behind all these observed effects. DOI: http://dx.doi.org/10.3126/hren.v10i3.7137 Health Renaissance; September-December 2012; Vol 10 (No.3);208-214


2019 ◽  
Vol 41 (5) ◽  
pp. 495-501 ◽  
Author(s):  
Carole Charavet ◽  
Geoffrey Lecloux ◽  
Nastasia Jackers ◽  
Adelin Albert ◽  
France Lambert

Summary Objective The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided manufacturing) customized orthodontic appliances. Design The study is designed as a parallel group, randomized controlled trial (RCT). Setting University Hospital. Ethical approval The study was approved by the ethic committee of the University Hospital Liege, Belgium. Subjects and methods This RCT was conducted on 24 adult patients requiring orthodontic treatment to release mild overcrowding. Patients were all treated with a customized appliance and randomly assigned by means of sealed envelopes containing group codes to either a test group treated with piezocision or a control group without any further treatment. A blinded orthodontist validated appliance removal or further adjustments based on the model study. Outcome measures The overall treatment time and the time between archwire changes were recorded. Moreover, clinical and radiological features such as tooth resorption, gingival recessions, and the presence of scars were evaluated. Results A total of 24 patients (12 control and 12 test) completed the study. The overall treatment time was significantly shorter in the test group than the control group. Likewise, the time difference between all arch changes was significantly lower when piezocision was performed, except for the first arch at the mandible and the last arches at both maxillae. During the fine-tuning phase, no significant difference was found between the two groups. All periodontal and radiographic parameters remained stable from the start to the end of treatment in both the groups. However, minor scars were found in 66 per cent cases. Limitations This trial was a single-centre trial. Conclusions Piezocision seems to be an effective method to accelerate orthodontic treatment in cases of mild overcrowding. However, the effect was only observed during the alignment phase and a greater efficiency was found in the maxilla. The technique may be contraindicated in patients with a high smile line since the risk of slight scarring exists. Registration ClinicalTrails.gov (Identifier: NCT03406130)


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods:Forty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions:Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery.


2021 ◽  
Vol 11 (16) ◽  
pp. 7463
Author(s):  
Maria Jesús Lisbona-González ◽  
Esther Muñoz-Soto ◽  
Candela Reyes-Botella ◽  
Maria Victoria Olmedo-Gaya ◽  
Javier Diaz-Castro ◽  
...  

Periodontal disease encompasses gingivitis and periodontitis and is one of the most common chronic infections in the adult population. This study aimed to evaluate the influence of Spanish propolis extract (EEP) on the effect of the clinical and microbiological parameters as an adjuvant to scaling and root planning in patients undergoing supportive periodontal therapy (SPT). Forty chronic periodontitis patients were randomly assigned into two groups for the treatment. In the control group (n = 20), the sites were treated by scaling and root planing followed by gingival irrigation with physiological saline and in the test group (n = 20), the sites were treated by scaling and root planing followed by subgingival placement of EEP. At baseline (BL), bleeding on probing positive (BOP+) sites with probing pocket (PPD) ≥ 4 mm were defined as study sites. Plaque index, PPD, BOP, clinical attachment level (CAL), and subgingival plaque were evaluated at BL and 1 month later. The results showed a significant clinical improvement (p < 0.05) in the PPD, CAL and BOP+ comparing them with BL and one month after the periodontal treatment and a significant reduction (p < 0.05) for Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola in both groups. In addition, the improvement of clinical parameters was observed with subgingival use of EEP and also statistically significant differences between groups were observed (p < 0.05) such as reductions of BOP+ % and reduced counts of T. forsythensis and P. gingivalis, considered as the “key pathogens” for the periodontal diseases. Our results suggest prophylactic and therapeutic potential for EEP against periodontal diseases, improving clinical parameters, reducing gingival bleeding and decreasing bacterial counts of T. forsythensis and P. gingivalis. The subgingival use of EEP represents a promising modality as an adjuvant in periodontal therapy to avoid microbial resistance and other adverse effects.


2016 ◽  
Vol 20 (3) ◽  
pp. 149-154
Author(s):  
N. Trtić ◽  
A. Bošnjak ◽  
R. Arbutina ◽  
Ž. Kojić ◽  
V. Veselinović

Summary Background: Aggressive periodontitis is one of the most severe forms of periodontal disease, resulting in the destruction of junctional epithelium and alveolar bone around teeth in a very short period of time. The early diagnosis of aggressive periodontitis and timely therapy is of outmost importance in controlling the progress of the disease.Application of the techniques of subgingival air polishing of periodontal pockets (pflow) with glycine powder has contributed to reduce damage to the root surface of the teeth and surrounding soft tissue.Aim: The goal of this paper was to determine the effectiveness of two different types of subgingival air polishing therapy for the periodontal tissue status at the patients with aggressive periodontitis.Methods and materials: the study included 46 patients of both sexes diagnosed with aggressive peridontitis. The patients were divided into two groups: test group (PFLOW), and control group (sonic SRP). The size of the destruction of periodontal tissue was estimated by CAL and assessment of oral hygiene and gingival inflammation was performed using FMPS and FMBS.Results: Monitored indexes values in both groups were reduced.Conclusion: Subgingival air polishing showed equally good results as the SRP, while pflow was more advantageous with respect to patients acceptability, time usability and safety for the soft tissue.


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevance: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration: The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId =trial.HTML&TRIAL


2019 ◽  
Author(s):  
Zhaoguo Yue ◽  
Qi Liu ◽  
Haidong Zhang ◽  
Jingwen Yang ◽  
Yalin Zhan ◽  
...  

Abstract Background Residual alveolar bone volume is a critical factor for the dental implants’ survival [1]. When the volume of alveolar bone in the posterior maxillary region is less than 4mm, the maxillary sinus floor elevation (MSFE) with lateral approach is an effective way to solve this problem [2]. Traditionally, this standard approach is usually delivered 4 months after the extraction of the tooth. However, the defective dentition due to the extraction would cause impaired masticatory function during the long period of the bone regeneration, especially when molars on both sides are severely periodontal compromised and need to be extracted. So, as periodontists, we start to wonder if we can maintain a compromised tooth so that we perform the sinus floor elevation before the extraction (the modified MSFE) to take fully advantage of residual strength of the teeth. Methods/Design The proposed study is designed as a prospective single-center, split-mouth design, randomized controlled trial. We plan to recruit 10 patients whose molars on both sides are severely periodontal compromised and in need of dental implant treatment in the atrophied posterior maxilla. The two sides of each patients will be divided into two groups randomly using Randomizer for Clinical Trials (Institute for Medical Informatics, Statistics and Documentation, Medical Univ. Graz). Test group: sinus floor augmentation before tooth extraction (the modified MSFE); Control group: sinus floor augmentation after tooth extraction (the standard MSFE). Implant survival rates, mucosal conditions around the implants, complications, treatment time and postoperative discomfort (visual analogue scale for intraoperative pain and postoperative pain/discomfort) will be recorded. The volume of the alveolar bone will be measured 6, 12, 18, and 24 months after the MSFE surgery by means of CBCT. Histological and histomorphometic analysis will be performed on biopsies retrieved from both side of grafting sites. Discussion The current study will explore the effectiveness of the modified MSFE on minimizing the discomfort period caused by defected dentition. To determine whether the modified MSFE will promote the grafting outcomes, the quality and the quantity of the osteogenesis on the sinus floor will also be compared. Depending on the result of the current study, we will determine all the protocols and details about the modified MSFE, including indications, detailed methods, post-operational complications and managements.


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods: Fourty-two individuals with periodontitis receiving nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21) were analyzed for clinical variables, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group but not in the controls. There was no further significant difference of any clinical and non-clinical variable between both groups at three and six months after SI. Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI. Trial registration: The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId =trial.HTML&TRIAL


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