Clinical and radiographic evaluation of applying 1% metformin biofilm with plasma rich in growth factor (PRGF) for treatment of two-wall intrabony periodontal defects: A randomized clinical trial

Background. The ultimate aim of periodontal treatment is to regenerate periodontium and regenerative treatment after that. The aim of this study was to evaluate the effect of PRGF with 1% metformin biofilm in the treatment of two-wall intrabony periodontal defects. Methods. In this clinical trial, 8 patients with moderate chronic periodontitis and two-wall intrabony defect were selected. The defects were assigned to 4 groups: debridement, 1% metformin, PRGF, PRGF and metformin. The parameters of vertical probing depth, vertical clinical attachment level and gingival index were measured at baseline, immediately before surgery, and 3 and 6 months after surgery. In addition, the radiographic changes were evaluated with digital subtraction radiography before and 6 months after surgery. Analysis of the results was performed with repeated measurements, Friedman test and chisquared test. Results. All the groups exhibited improvements in all the clinical parameters after 6 months. Inter-group comparison of GI, CAL and PPD parameters revealed no statistically significant differences. Radiographic changes in the group of 1% metformin with PRGF revealed statistically significant differences compared with other groups; however, there were no statistically significant differences in other groups. Conclusion. Application of PRGF with 1% metformin in intrabony two-wall periodontal defects was effective in improving the clinical parameters but this effect revealed no difference compared with other groups; however, in terms of radiographic changes significant improvements were noted.

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Efficacy of Double Pedicle Graft with and without PRGF in Treating Cl I and Cl II Gingival Recessions

Journal of Periodontology & Implant Dentistry ◽

10.15171/jpid.2015.009 ◽

2018 ◽

Vol 7 (2) ◽

pp. 44-49

Author(s):

Nader Abolfazli ◽

Afsoon Asadollahi ◽

Masoumeh Faramarzi ◽

Fariba Saleh Saber

Keyword(s):

Test Group ◽

Control Group ◽

Clinical Parameters ◽

Test Results ◽

Control Groups ◽

Clinical Attachment Level ◽

Probing Depth ◽

And Control ◽

Attachment Level ◽

Paired T Test

Background and aims. The aim of this study was to evaluate the effect of double pedicle graft (DPG) with and without plasma rich in growth factor (PRGF) in the treatment of Miller's Cl I and II gingival recessions. Materials and methods. Thirty-two bilateral buccal gingival Miller’s Cl I and II recessions were selected. Sixteen of the recessions were treated with DPG and PRGF (test group). The remaining sixteen recessions were treated with DPG (control group). The clinical parameters, including clinical probing depth (CPD), clinical attachment level (CAL), recession depth (RD), recession width (RW) and keratinized gingiva width (KGW), were measured at baseline and 1, 3 and 6 months later. Data were analyzed with paired t-test. Results. After 6 months, both groups exhibited a significant improvement in all the criteria mentioned above. However, none of the groups showed significant differences in pocket depths after 6 months. At the end of the study there were significant improvements in recession depths and widths and clinical attachment levels and keratinized gingiva width between test and control groups Conclusion. The method using DPG+PRGF resulted in more favorable clinical outcomes than only DPG.

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Evaluation of PRF Efficiency in the Treatment of Infrabony Defects

PRILOZI ◽

10.2478/prilozi-2020-0025 ◽

2020 ◽

Vol 41 (1) ◽

pp. 79-86

Author(s):

Jana Milutinovic ◽

Mirjana Popovska ◽

Biljana Rusevska ◽

Milan Nacevski ◽

Stefan Anastasovski ◽

...

Keyword(s):

Test Group ◽

Control Group ◽

Clinical Parameters ◽

Flap Surgery ◽

Clinical Attachment Level ◽

Positive Effects ◽

Probing Depth ◽

Infrabony Defects ◽

Open Flap Debridement ◽

Attachment Level

AbstractAim: The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively.Material and Methods: Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively.Results: Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant.Conclusion: Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.

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Systemic use of metronidazole in the treatment of chronic periodontitis: a pilot study using clinical, microbiological, and enzymatic evaluation

Brazilian Oral Research ◽

10.1590/s1806-83242004000200006 ◽

2004 ◽

Vol 18 (2) ◽

pp. 121-127 ◽

Cited By ~ 9

Author(s):

Solange Alonso Vergani ◽

Emílio Barbosa e Silva ◽

Adriana Helena Vinholis ◽

Rosemary Adriana Chiérici Marcantonio

Keyword(s):

Periodontal Disease ◽

Clinical Parameters ◽

Scaling And Root Planing ◽

Gingival Index ◽

Clinical Attachment Level ◽

Group I ◽

Probing Depth ◽

Chronic Periodontal Disease ◽

Attachment Level ◽

Systemic Metronidazole

The aim of the present parallel, double-blind investigation was to evaluate the effect of using systemic metronidazole alone or associated to scaling and root planing on adult chronic periodontal disease, monitored at baseline, 30, 60 and 90 days. Twelve subjects were divided into three groups: the first group (Group I - 22 sites) was submitted to scaling and root planing (SRP) alone; the second group (Group II - 30 sites) received SRP and 250 mg of metronidazole (3 times a day for 10 days), and the third group (Group III - 31 sites) was treated with metronidazole alone. The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index (PlI), gingival index (GI) and bleeding upon probing (BP). Microbiological (BANA test) and enzymatic (Pocket Watch) tests were also performed. All three proposed treatments produced significant improvements in clinical conditions of subjects, from baseline, 30, 60 and 90-day period, except for clinical attachment level. The results obtained by microbiological and enzymatic tests did not show statistical differences among the groups for the 90-day period (r = 0.7924 and r = 0.7757, respectively). In relation to clinical parameters, statistical differences among groups were observed only for the gingival index (p = 0.0261) between Groups I and II, and probing depth (p = 0.0124) between Group I and the others. We conclude that the use of systemic metronidazole did not produce additional effects on the microbiological conditions of these patients with chronic periodontal disease.

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Application of Glass Reinforced Hydroxyapatite Composite in the Treatment of Human Intrabony Periodontal Angular Defects – Two Case Reports

Solid State Phenomena ◽

10.4028/www.scientific.net/ssp.161.93 ◽

2010 ◽

Vol 161 ◽

pp. 93-101 ◽

Cited By ~ 4

Author(s):

G. Pavan Kumar ◽

A. Jaya Kumar ◽

P. Krishnanjaneya Reddy ◽

Sooraj Hussain Nandyala ◽

M.A. Lopes ◽

...

Keyword(s):

Case Reports ◽

Clinical Parameters ◽

Regenerative Therapy ◽

Synthetic Graft ◽

Bioactive Glasses ◽

Clinical Attachment Level ◽

Probing Depth ◽

Hydroxyapatite Composite ◽

Attachment Level ◽

Implantation Period

Bony defects caused by periodontitis are often treated by regenerative therapy using autografts and/or allografts. Alloplasts such as hydroxyapatite or ceramics and bioactive glasses are used as osteoconductive materials that serve as scaffold for new bony ingrowth. The purpose of this study was to ascertain the possible regenerative capability of glass reinforced hydroxyapatite (Bonelike¬)¬¬¬ an osteoconductive synthetic graft in the treatment of human periodontal intrabony angular defects. The material was placed in 2 defects in 2 individual patients and clinical parameters such as probing depth (PD) and clinical attachment level (CAL) have been included. Bone fill was determined using an intra oral periapical radiograph (IOPA) and Autocad Software. After 3 months implantation period, there was an improvement in CAL and reduction in PD along with bone fill was observed.

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Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No Aggregatibacter actinomycetemcomitans Is Detected—A Randomized Clinical Trial

Antibiotics ◽

10.3390/antibiotics9100686 ◽

2020 ◽

Vol 9 (10) ◽

pp. 686

Author(s):

Holger F. R. Jentsch ◽

Martin Dietrich ◽

Sigrun Eick

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Gingival Crevicular Fluid ◽

Aggregatibacter Actinomycetemcomitans ◽

Periodontal Therapy ◽

Clinical Attachment Level ◽

Probing Depth ◽

Crevicular Fluid ◽

Systemic Antibiotics ◽

Attachment Level

Background: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when Aggregatibacter actinomycetemcomitans was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no A. actinomycetemcomitans in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; n = 29) or amoxicillin/metronidazole (AMX/MET; n = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. Results: PD, CAL and BOP improved at 3 and 6 months (each p < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (p < 0.001) with a higher reduction of PD in the AMX/MET group (p < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (p < 0.05). MMP-8 and IL-1β were without significant changes and differences between the groups. Conclusion: When A. actinomycetemcomitans was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled.

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Gingival Crevicular Fluid Levels of Prolidase and Alkaline Phosphatase in Periodontitis

Balkan Journal of Dental Medicine ◽

10.1515/bjdm-2017-0027 ◽

2017 ◽

Vol 21 (3) ◽

pp. 158-161

Author(s):

Berrak Guven ◽

Cigdem Turer

Keyword(s):

Alkaline Phosphatase ◽

Gingival Crevicular Fluid ◽

Clinical Parameters ◽

Clinical Attachment Level ◽

Probing Depth ◽

Healthy Control ◽

Periodontal Destruction ◽

Crevicular Fluid ◽

Fluid Levels ◽

Attachment Level

SummaryBackground/Aim: The purpose of this study was to investigate gingival crevicular fluid (GCF) alkaline phosphatase (ALP) and prolidase levels in subjects with different periodontal status. Material and Methods: Fifteen periodontitis, fifteen gingivitis and fifteen healthy subject were included. GCF samples were collected from participants. Probing depth, clinical attachment level, gingival index was recorded. ALP and prolidase levels were determined in GCF by spectrophotometrically. Results: Higher values of ALP were found in periodontitis compared with gingivitis and healthy control (p<0.001). The values of prolidase were lower in periodontitis than healthy control (p<0.05). A statistically significant positive correlation was found between clinical parameters and ALP levels (p<0.001). There is no significant correlation between clinical parameters and prolidase levels (p>0.05). Additionally, no significant correlation was detected between ALP and prolidase (r= -0.309, p>0.05). Conclusion: Our preliminary data suggest that low prolidase level in periodontitis was not associated with ALP and clinical parameters, which represent periodontal destruction and inflammation.

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Adjuvant Transgingival Therapy with Visible Light Plus Water-Filtered Infrared-A (VIS + wIRA) in Periodontal Therapy—A Randomized, Controlled, Stratified, Double-Blinded Clinical Trial

Antibiotics ◽

10.3390/antibiotics10030251 ◽

2021 ◽

Vol 10 (3) ◽

pp. 251

Author(s):

Stefanie Anna Peikert ◽

Anil Fischer ◽

Anne Brigitte Kruse ◽

Ali Al-Ahmad ◽

Johan Peter Woelber ◽

...

Keyword(s):

Clinical Trial ◽

Visible Light ◽

Pain Perception ◽

Clinical Parameters ◽

Analog Scale ◽

Clinical Attachment Level ◽

Randomized Controlled ◽

Plaque Control ◽

Double Blinded ◽

Attachment Level

The aim of this randomized, controlled, double-blinded clinical trial was to examine the additional healing effect of transgingival visible light and water-filtered infrared-A (VIS + wIRA) in the treatment of periodontitis patients compared with the standard therapy by subgingival instrumentation (SI). Therefore, forty patients with untreated periodontitis received a non-surgical periodontal treatment. Using a split-mouth study design, one quadrant of the upper jaw was randomly either exposed to VIS + wIRA four times for 20 min within two weeks in addition to SI or received only SI. Three and 6 months after intervention, clinical parameters (probing depths (PDs), clinical attachment level, bleeding on probing (BOP), furcation, tooth mobility, plaque control record, and papilla bleeding index) were re-evaluated. In the presence of PD of 4 mm and positive BOP or PD > 4 mm, SI was performed again. Moreover, the patients were asked about their discomfort using a visual analog scale from 1 to 10 for each side of the maxilla. Statistical analysis demonstrated no differences between quadrants at re-evaluation for clinical parameters (p > 0.05) after 3 and 6 months. Concerning pain perception, patients described less pain on the irradiated side (p = 0.016). In the treatment of patients with periodontitis, VIS + wIRA did not show an additional effect on the clinical outcome after 3 and 6 months. Patients described less pain on the irradiated quadrant after treatment.

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A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy

BMC Oral Health ◽

10.1186/s12903-021-01397-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ingvild M. Ulvik ◽

Terje Sæthre ◽

Dagmar F. Bunæs ◽

Stein Atle Lie ◽

Morten Enersen ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Clinical Attachment Level ◽

Treatment Difference ◽

Randomized Controlled ◽

Air Polishing ◽

Probing Depth ◽

Furcation Defects ◽

Supportive Periodontal Therapy ◽

Attachment Level

Abstract Background Due to complex morphology and limited access, the cleaning of the furcation area is extremely challenging. Therefore, novel therapeutic approaches need to be tested to potentially overcome debridement limitations. The aim of the present prospective 12-month study was to compare clinical and microbiological effects following erythritol air-polishing versus conventional mechanical debridement of furcation defects in a cohort of periodontal maintenance patients. Methods Twenty patients with grade II mandibular molar furcation defects volunteered to enroll in this single-centre, examiner masked, randomized controlled trial. In a split-mouth study design, two furcation sites in each patient were randomly assigned to either receive subgingival debridement using erythritol air-polishing (test) or conventional ultrasonic/curette debridement (control) at baseline, and at 3, 6, 9 and 12 months. Probing depth, clinical attachment level and bleeding on probing were recorded at 3-month intervals. Subgingival microbiological samples obtained at baseline, 6 and 12 months were analyzed using checkerboard DNA–DNA hybridization. Discomfort from treatment was scored at 12 months using a visual analogue scale. The differences between treatments, and time-points, were tested using multilevel analysis (mixed effect models and robust variance estimates). Results A significant reduction in probing depth took place following both treatments (p < 0.001). Control sites experienced a significant mean gain in clinical attachment level of 0.5 mm (± 0.2) (p = 0.004), whereas a non-significant gain of 0.4 mm (± 0.3) was observed at test sites (p = 0.119). At 6 months, a significant between-treatment difference of 0.8 mm (± 0.4) was observed in favor of the control (p = 0.032). No significant between-treatment differences were observed in microbial load or composition. Notably, at 12 months patients experienced significantly less discomfort following air-polishing compared with control (p = 0.001). Conclusions The 12-month observations indicate that erythritol air-polishing and conventional mechanical debridement both support clinical improvements. A significant between-treatment difference in clinical attachment level was, however, detected in favour of control debridement at 6 months. In terms of patient comfort, erythritol air-polishing is superior. Trial Registration: The clinical trial was retrospectively registered in ClinicalTrial.gov with registration NCT04493398 (07/28/2020).

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Treatment of Intrabony Defects with a Combination of Hyaluronic Acid and Deproteinized Porcine Bone Mineral

Materials ◽

10.3390/ma14226795 ◽

2021 ◽

Vol 14 (22) ◽

pp. 6795

Author(s):

Darko Božić ◽

Ivan Ćatović ◽

Ana Badovinac ◽

Larisa Musić ◽

Matej Par ◽

...

Keyword(s):

Hyaluronic Acid ◽

Bone Mineral ◽

Gingival Recession ◽

Intrabony Defects ◽

Clinical Attachment Level ◽

New Approach ◽

Novel Approach ◽

Probing Depth ◽

Baseline Values ◽

Attachment Level

Background: this study evaluates the clinical outcomes of a novel approach in treating deep intrabony defects utilizing papilla preservation techniques with a combination of hyaluronic acid (HA) and deproteinized porcine bone mineral. Methods: 23 patients with 27 intrabony defects were treated with a combination of HA and deproteinized porcine bone mineral. Clinical attachment level (CAL), pocket probing depth (PPD), gingival recession (REC) were recorded at baseline and 6 months after the surgery. Results: At 6 months, there was a significant CAL gain of 3.65 ± 1.67 mm (p < 0.001) with a PPD reduction of 4.54 ± 1.65 mm (p < 0.001), which was associated with an increase in gingival recession (0.89 ± 0.59 mm, p < 0.001). The percentage of pocket resolution based on a PPD ≤4 mm was 92.6% and the failure rate based on a PPD of 5 mm was 7.4%. Conclusions: the present findings indicate that applying a combined HA and xenograft approach in deep intrabony defects provides clinically relevant CAL gains and PPD reductions compared to baseline values and is a valid new approach in treating intrabony defects.

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Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta Tricalcium Phosphate – A 12-Month Retrospective Clinical Evaluation

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.82 ◽

2010 ◽

Vol 53 (4) ◽

pp. 229-234 ◽

Cited By ~ 4

Author(s):

Sujith Sukumar ◽

Ivo Dřízhal ◽

Josef Bukač ◽

Vladimíra Paulusová ◽

Shriharsha Pilathadka

Keyword(s):

Tissue Regeneration ◽

Tricalcium Phosphate ◽

Gingival Recession ◽

Calcium Sulphate ◽

Intrabony Defects ◽

Clinical Attachment Level ◽

Beta Tricalcium Phosphate ◽

Probing Depth ◽

One Year ◽

Attachment Level

Alloplastic bone graft materials are widely been used in combination with barrier membranes to achieve guided tissue regeneration in the treatment of periodontal intrabony defects. This study was designed to evaluate the clinical outcome of a composite material, beta tricalcium phosphate in combination with calcium sulphate in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. Thirty nine intrabony defects in 21 patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK). Clinical parameters were evaluated including changes in probing depth, clinical attachment level/loss and gingival recession at baseline and one year postoperatively. The mean differences in measurements between the baseline and one year postoperatively are a reduction of 1.98±1.16 mm (p=0.000) in case of probing depth and a gain of 1.68±1.12 mm (p=0.000) in clinical attachment level and an increase of 0.31±0.67 mm (p=0.009) in gingival recession measurements. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects one year postoperatively.

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