Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

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Microbiological and host-derived biomarker evaluation following non-surgical periodontal therapy with short-term administration of systemic antimicrobials: secondary outcomes of an RCT

Scientific Reports ◽

10.1038/s41598-020-73054-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Raluca Cosgarea ◽

S. Eick ◽

S. Jepsen ◽

N. B. Arweiler ◽

R. Juncar ◽

...

Keyword(s):

Periodontal Therapy ◽

Periodontal Pathogens ◽

Short Term ◽

Minimum Risk ◽

Severe Periodontitis ◽

Nonsurgical Periodontal Therapy ◽

Term Administration ◽

Increasing Risk ◽

Secondary Outcomes ◽

Biomarker Evaluation

Abstract Nonsurgical periodontal therapy with adjunctive use of systemic antimicrobials (for 7–14 days) showed improved clinical, microbiological and immunological results over the mechanical protocol alone. Considering the increasing risk for antimicrobial resistance with longer antibiotic regimes, it is important to establish the optimal antibiotic protocol with a maximum antimicrobial benefit and minimum risk for adverse effects. The aim of the study was to evaluate the microbiological and inflammatory outcomes 12-months after a 3-/7-day systemic antibiotic protocol [amoxicillin (AMX) + metronidazole (MET)] adjunctive to subgingival debridement in severe periodontitis compared to mechanical treatment alone. From the initially treated 102 patients, 75 subjects (Placebo group: n = 26; 3-day AMX + MET group: n = 24; 7-day AMX + MET group: n = 25) completed the 12-month examination. Clinical parameters, eight periodontal pathogens and inflammatory markers were determined at baseline and 3-, 6-, 12-months after therapy using real-time PCR and ELISA respectively. After 6 months, several periodontopathogens were significantly more reduced in the two antibiotic groups compared to placebo (p < 0.05). After 1 year, both antibiotic protocols showed significant reductions and detection of the keystone pathogen P. gingivalis compared to placebo. Antibiotic protocols, smoking, disease severity, baseline-BOP, -CAL and -IL-1β, as well as detection of T. denticola at 12-months significantly influenced the residual number of deep sites. The present data indicate that the systemic use of both short and longer antibiotic protocols (AMX + MET) adjunctive to nonsurgical periodontal therapy lead to higher microbiological improvements compared to subgingival debridement alone. The two investigated antibiotic protocols led to comparable microbiological and inflammatory results.

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Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

10.21203/rs.3.rs-25563/v1 ◽

2020 ◽

Author(s):

Eduardo Montero ◽

Mercedes López ◽

Honorato Vidal ◽

María Martínez ◽

Jorge Marrero ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Clinical Trial ◽

Periodontal Therapy ◽

Periodontal Treatment ◽

Markers Of Inflammation ◽

Severe Periodontitis ◽

Secondary Outcomes ◽

Hs Crp ◽

The Impact

Abstract Background Although there is evidence of positive effect of periodontal therapy on systemic inflammation, this response is highly variable among subjects. It was the aim of this clinical investigation to determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. Methods In this parallel-arm, double blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg, q.d., for three days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on hs-CRP serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipids metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. Results The ITT population consisted on 63 subjects randomly assigned to either MPT (n = 31) or IPT (n = 32) groups. At baseline, mean hs-CRP was 3.9 mg/L (standard deviation, SD = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in their cardiometabolic risk profiles were detected between groups. After 6 months, unadjusted mean hs-CRP were 2.9 mg/L (standard error, SE = 0.4) and 4.0 (SE = 0.8), respectively. Adjusting for baseline hs-CRP, sex, age, smoking status and body mass index, hs-CRP was 1.2 mg/L (95% confidence interval, [CI 0.4; 2.0]; p = 0.004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL-1β, TNF-α, HbA1c and blood pressure were observed in the IPT group at 3 months, when compared to the MPT group. Conclusion Effective periodontal treatment significantly reduced hs-CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients. Trial registration: ClinicalTrials.gov Registration Number: NCT03960216.

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Persistence of Porphyromonas gingivalis is a negative predictor in patients with moderate to severe periodontitis after nonsurgical periodontal therapy

Clinical Oral Investigations ◽

10.1007/s00784-016-1933-x ◽

2016 ◽

Vol 21 (2) ◽

pp. 665-674 ◽

Cited By ~ 5

Author(s):

Sigrun Eick ◽

Ayse Mathey ◽

Karolin Vollroth ◽

Martin Kramesberger ◽

Walter Bürgin ◽

...

Keyword(s):

Porphyromonas Gingivalis ◽

Periodontal Therapy ◽

Severe Periodontitis ◽

Nonsurgical Periodontal Therapy ◽

Negative Predictor

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Periodontitis and Systemic Inflammation: Control of the Local Infection is Associated with a Reduction in Serum Inflammatory Markers

Journal of Dental Research ◽

10.1177/154405910408300214 ◽

2004 ◽

Vol 83 (2) ◽

pp. 156-160 ◽

Cited By ~ 389

Author(s):

F. D’Aiuto ◽

M. Parkar ◽

G. Andreou ◽

J. Suvan ◽

P.M. Brett ◽

...

Keyword(s):

Systemic Inflammation ◽

Inflammatory Markers ◽

Healthy Subjects ◽

Periodontal Therapy ◽

Serological Markers ◽

Intervention Trial ◽

C Reactive Protein ◽

Reactive Protein ◽

Severe Periodontitis ◽

Inflammatory Burden

Severe periodontitis is associated with elevated inflammatory markers in otherwise healthy populations. However, the nature of this association has not been determined. Our aim was to assess whether the degree of response to periodontal therapy was associated with changes in serological markers of systemic inflammation. Ninety-four systemically healthy subjects with severe generalized periodontitis participated in a prospective six-month blind intervention trial. Periodontal parameters and inflammatory markers [C-reactive Protein (CRP) and Interleukin-6 (IL-6)] were evaluated prior to and 2 and 6 mos after delivery of standard non-surgical periodontal therapy. Six months after treatment, significant reductions in serum IL-6 (p < 0.001, median decrease 0.2 ng/L, 95% CI 0.1–0.4 ng/L) and CRP (p < 0.0001, median decrease 0.5 mg/L, 95% CI 0.4–0.7) were observed. Decreases in inflammatory markers were significant in subjects with above average clinical response to periodontal therapy after correction for possible confounders. Periodontitis may add to the systemic inflammatory burden of affected individuals.

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Effect of Periodontal Therapy on Crevicular Fluid Interleukin-6 and Interleukin-8 Levels in Chronic Periodontitis

International Journal of Dentistry ◽

10.1155/2012/362905 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 15

Author(s):

Paschalina Goutoudi ◽

Evdoxia Diza ◽

Malamatenia Arvanitidou

Keyword(s):

Interleukin 6 ◽

Chronic Periodontitis ◽

Gingival Crevicular Fluid ◽

Strong Relationship ◽

Periodontal Therapy ◽

Interleukin 8 ◽

Treatment Modalities ◽

Enzyme Linked Immunosorbent Assay ◽

Nonsurgical Periodontal Therapy ◽

Crevicular Fluid

Purpose. The aim of this study was to analyse the levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in gingival crevicular fluid (GCF) of patients with chronic periodontitis prior to and following surgical and/or nonsurgical periodontal therapy for a period of 32 weeks.Methods. GCF samples were obtained from 24 nondiseased and 72 diseased sites of 12 periodontal patients prior to as well as at 6, 16, and 32 weeks following non-surgical and surgical periodontal therapy. IL-6 and IL-8 levels were determined by enzyme-linked immunosorbent assay (ELISA).Results. Periodontal treatment improved all clinical parameters. Both treatment modalities resulted in similar IL-6 as well as IL-8 levels. Mean IL-6 and IL-8 concentrations were significantly higher in non-diseased compared to diseased sites and increased significantly following treatment in diseased sites. Mean total amounts of IL-6 and IL-8 (TAIL-6, TAIL-8) did not differ significantly between diseased and nondiseased sites, while following therapy TAIL-8 levels decreased significantly.Conclusions. The data suggest that periodontal therapy reduced the levels of IL-8 in GCF. However, a strong relationship between IL-6, IL-8 amounts in GCF and periodontal destruction and inflammation was not found.

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