Clinical evaluation of excisional new attachment procedure versus laser assisted new attachment procedure in the treatment of periodontal pockets

2021 ◽  
Vol 3 (3) ◽  
pp. 118-123
Author(s):  
Priyanka Kumari ◽  
Manish Khatri ◽  
Mansi Bansal ◽  
Komal Puri
Keyword(s):  
Connective Tissue ◽  
Periodontal Pocket ◽  
Gingival Index ◽  
Gingival Bleeding ◽  
Group I ◽  
Probing Depth ◽  
Insignificant Difference ◽  
Vas Scores ◽  
Clinically Significant

TheLaser Assisted New Attachment Procedure (LANAP) protocol is a laser based periodontal regenerative procedure and was patterned, conceptually, after the Excisional New Attachment Procedure (ENAP) to separate the diseased epithelium from the underlying connective tissue and to selectively vaporize and disrupt inflamed and necrotic tissue from connective tissue.: The present study was designed to compare and evaluate the clinical efficacy of LANAP versus ENAP in the treatment of chronic periodontitis.: Twenty periodontal pocket sites of ≥5mm in systemically healthy patients were selected and randomly allocated to either (ENAP) Excisional New Attachment Procedure (Group I) or (LANAP) Laser Assisted New Attachment Procedure (Group II). Patients were evaluated for Plaque Index, Gingival Index, Gingival Bleeding Index, Probing Depth, Loss of attachment, recession and VAS scores. Patients were recalled for follow up at 1 week, 1 month and 3 months at which clinical parameters were recorded.: The results of the present study revealed statistically insignificant difference in both groups however clinically significant reduction in probing depth was seen with ENAP as compared to LANAP but laser procedure had less VAS scores as compared to ENAP.Although probing depth reduction was more for ENAP, patient discomfort with less bleeding was observed with LANAP.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis

2021 ◽  
pp. 1-10
Author(s):  
Mansour H. Al-Askar ◽  
Fahad A. Abdullatif ◽  
Abdulmonem A. Alshihri ◽  
Asma Ahmed ◽  
Darshan Devang Divakar ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Null Hypothesis ◽  
Gingival Index ◽  
P Values ◽  
Inflammatory Parameters ◽  
Probing Depth ◽  
Crestal Bone Loss ◽  
Group 3 ◽  
Soft Tissue Inflammation

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

scholarly journals Clinical Evaluation of the Effect of Implant-Supported and Implant Retained Distal Extension Removable Partial Dentures on the Supporting Structures

2021 ◽  
Vol 9 (D) ◽  
pp. 170-178
Author(s):  
Ragia Saad Mohamed Kotb ◽  
Ahmed Gamal Ahmed Hassan ◽  
Emad Mohamed Tolba M. Agamy ◽  
Gehan Fekry Mohamed
Keyword(s):  
Class I ◽  
Gingival Index ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
Second Molar ◽  
Group I ◽  
Probing Depth ◽  
Significant Difference ◽  
Abutment Teeth ◽  
Supporting Structures

Objective: To evaluate and compare the effect of implant supported versus implant retained removable partial denture restoring Kennedy's class I cases on the supporting structures by measuring modified gingival index and probing depth for abutment teeth and implants. Subjects and Methods: Twelve patients; who had Kennedy class I mandibular partially edentulous ridge extending distal to the first or second premolar,   were selected from the outpatient clinic, Prosthodontics Department, Faculty of Dentistry, Minia University. The patients were classified into two equal groups; according to the implant superstructures either dome shaped abutment or ball and socket attachment.  Each Patient of both groups had two implants in second molar position (one in each side) and received removable partial denture of the same design. Patients were followed up for one year clinically. Group I: Six patients received RPD supported by dome shaped short abutments.  Group II six patients received RPD retained by ball and socket attachments. Results: Results revealed that, there was no statistically significant difference between the two groups regarding modified gingival index and probing depth around the abutment teeth and implant abutment. Conclusion:  The use of dome shaped abutment or ball and O-ring attachment have the same effect on gingival index and probing depth around natural abutments and implants in Kennedy class I mandibular situations.

scholarly journals Superior Articular Process Osteotomy Navigation (SapON) Technology in Percutaneous Endoscopic Lumbar Discectomy: A New Surgical Technology

2020 ◽  
Author(s):  
Jianhui Li ◽  
Boyuan Ma ◽  
Mengyao Wang ◽  
Jianwei Li ◽  
Shuijing Tian ◽  
...  
Keyword(s):  
Clinical Work ◽  
Lumbar Discectomy ◽  
Clinical Effects ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Articular Process ◽  
Group I ◽  
Vas Scores ◽  
Group Ii ◽  
Endoscopic Lumbar Discectomy

Abstract Background: This research aims to discuss the clinical application value of the superior articular process osteotomy navigation (SapON) technique in percutaneous endoscopic lumbar discectomy.Methods: Patients who underwent intervertebral foraminal endoscopic surgery for degenerative disease of the lumbar spine were collected and divided into two groups from March 2016 to May 2018. Group I: 69 patients were treated by the SapON technique. Group II: 53 patients were treated by Transforaminal Endoscopic Spine Surgery (TESS) technique. Fluoroscopy times, the time of establishment working channel, endoscopic operations, and entire operations in two groups were recorded. Patients' clinical curative effect was evaluated by visual analog scale (VAS) scores, Oswestry disability index(ODI), and MacNab standard at different time points, including before surgeries, one day, three months after surgeries, and the last follow-up time.Results: Operations were all successful both in groups I and II. Fluoroscopy times, establishing the working tunnels time, endoscopic operations time, and entire operations time and other indexes between the two groups were statistically significant. Patients’ low back, legs pain VAS scores, and ODI one day, three months after surgeries, and at the last follow-up in both two groups were significantly lower than those before operations with a statistical difference. The excellent rate in groups I and II were 98.55% and 96.23%. Complications were not observed in group I, while in group II, only one patient suffered the injury of the right L5 nerve root, and recovered after three months’ conservative treatment.Conclusion: The application of SapON in percutaneous endoscopic lumbar discectomy (PELD) has its advantages to popularize in clinical work, including operating simply and orderly, high safety, fewer complications, lower radiation exposure, and good clinical effects

scholarly journals Comparative study between the effect of neural versus intra-articular dextrose prolotherapy on pain and disability in patients with knee osteoarthritis

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Rehab A. Sallam ◽  
Aya A. Abdelkhabir ◽  
Adel A. Shabana
Keyword(s):  
Knee Osteoarthritis ◽  
Womac Pain ◽  
Knee Oa ◽  
Natural Substances ◽  
Group I ◽  
Skin Targeting ◽  
Vas Scores ◽  
Group Ii ◽  
Reduced Mobility

Abstract Background Osteoarthritis (OA) is a degenerative disease which presents with joint pain and stiffness and reduced mobility. Knee OA is the commonest cause of disability in adults. Dextrose prolotherapy is a new option used to treat mild-to-moderate knee OA. Neural prolotherapy (NPT) is multiple small injections under the skin targeting painful areas with natural substances. The aim of work was to evaluate and compare neural prolotherapy versus intra-articular dextrose prolotherapy effect on relieving pain and improving disability of knee OA. Results VAS and WOMAC scores improved significantly immediately and at 3 and at 6 months, respectively, in group I compared with group II (P < 0.001). The decrease in VAS scores and all the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in group I along the follow-up period in comparison with the baseline scores was statistically significant (P < 0.001). In group II, only WOMAC pain and stiffness scores improved significantly. ROM showed insignificant increase in both groups at 3 and 6 months assessment. On follow-up, range of motion increased in both groups and reached significance in group I (P = .002). Conclusion Dextrose prolotherapy both intra-articular and periarticular (neural) is a very effective and cheap therapy for knee OA with good patient selection. Neural prolotherapy significantly relieves pain and improves function in patients with knee osteoarthritis when compared with intra-articular prolotherapy thus avoiding hazards of intra-articular knee injections.

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

2004 ◽  
Vol 18 (2) ◽  
pp. 121-127 ◽  
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.

scholarly journals Effectiveness of the adjunctive use of ozone and chlorhexidine in patients with chronic periodontitis

BDJ Open ◽  
2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Kaveri Kranti Gandhi ◽  
Emil G. Cappetta ◽  
Rajdeep Pavaskar
Keyword(s):  
Chronic Periodontitis ◽  
Gold Standard ◽  
Gingival Index ◽  
Periodontal Pathogens ◽  
Ozone Therapy ◽  
Clinical Attachment Loss ◽  
Probing Depth ◽  
Root Planning ◽  
Scaling And Root Planning

Abstract Background Scaling and root planning (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. Objective To evaluate and compare the clinical and microbiological efficacy of ozone and chlorhexidine (CHX) as an adjunct to SRP in patients with chronic periodontitis. Methods Twenty-five patients with generalized moderate to severe chronic periodontitis with presence of at least one site in each quadrant with a probing depth ≥5 mm were recruited. In a split mouth study design, two quadrants were randomly allocated to the SRP and ozone therapy and the remaining two quadrants to SRP and CHX therapy. Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. Subgingival plaque samples were obtained for assessment of Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). Results Both groups demonstrated significant intragroup reduction in PI, GI, PD, CAL, Pg count and Aa count from baseline to 3 months follow-up. There were no significant differences between two groups for any of the parameters. Conclusion Ozonated olive oil can be used as an adjunctive subgingival irrigant in patients with chronic periodontitis.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial

2020 ◽  
Vol 46 (5) ◽  
pp. 526-531 ◽  
Author(s):  
Fawaz Alqahtani ◽  
Nasser Alqhtani ◽  
Sree Lalita Celur ◽  
Darshan Devang Divakar ◽  
Abdulaziz A. Al-Kheraif ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Laser Therapy ◽  
Low Level Laser Therapy ◽  
Periodontal Pocket ◽  
Low Level ◽  
Low Level Laser ◽  
Probing Depth ◽  
Level Laser ◽  
Significant Difference

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P &lt; .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P &lt; .05), bleeding upon probing (P &lt; .05), and probing depth (P &lt; .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

scholarly journals O34 Predicting autoimmune connective tissue diseases: three year follow up of an at-risk cohort identifies late progression and predicts need for therapy

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Sabih Ul-Hassan ◽  
Katherine Dutton ◽  
Zoe Wigston ◽  
Ade Alase ◽  
Yuzaiful Md Yusof ◽  
...  
Keyword(s):  
At Risk ◽  
Connective Tissue ◽  
Connective Tissue Diseases ◽  
Clinical Feature ◽  
Clinical Criteria ◽  
Score Analysis ◽  
Clinically Significant ◽  
Future Work ◽  
Significant Disease

Abstract Background Autoimmune connective tissue diseases (AI-CTDs: SLE, pSS, IIM) are preceded by asymptomatic ANA positivity. We previously recruited a cohort of new ANA-positive referrals without AI-CTD. 17% met criteria by AI-CTD at 12 months, and this was predicted an IFN Score. This study includes 3 year follow up of that cohort with more detailed analysis of the non-progressor group and predictors. Methods Patients were recruited if they had: (i) ANA; (ii) did not meet criteria for AI-CTD; (iii) symptoms less than 12 months. Diagnostic criteria for AI-CTDs and therapies were assessed at baseline then 12-monthly for 3 years. We categorised progression as:1. Absolute-non-progressors (no clinical criteria at all time points: 0-36 months), 2. Undifferentiated-CTD ( &gt; =1 clinical criterion at baseline and/or at follow up but not meeting criteria), 3. Year-1-progressor (meeting criteria for AI-CTD within 12 months), 4. Late-progressor (meeting criteria for AI-CTD later than 12 months). A 2-score analysis of IFN Status was performed as previously described (Yusof, ARD 2018). Results 3-year follow up was available in 146/150. Proportions in the above categories were: Absolute-non-progressors: 33/146 (23%); Undifferentiated-CTD: 86/146 (59%); Year-1-progressors: 21/146 (14%); Late-progressors: 5/146 (3%). No patient progressed or required immunosuppression after 2 years. 6/86 patients with Undifferentiated-CTD received an immunosuppressant. The present work therefore defines a larger group of 32/146 (22%) with clinically significant disease including 21 Year-1-progressors, 5 late-progressors, and 6 undifferentiated-CTD who needed an immunosuppressant. Clinical features had limited utility in predicting these outcomes. Of 31 patients with no clinical criteria at baseline, 1 progressed to meet criteria within 1 year, 2 progressed at 1-2 years, 3 were prescribed hydroxychloroquine and 1 was prescribed an immunosuppressant. The 108 patients with at least 1 criterion at baseline had the highest risk: 20 progressed to meet criteria within 1 year, 2 progressed at 1-2 years, the others all had U-CTD. 35 were prescribed hydroxychloroquine and 13 were prescribed an immunosuppressant. There was also no association between ENA, C3 or C4 and clinical outcome. The association between Interferon Score B and progression was stronger when comparing Year 1 progressors with absolute non-progressors (p = 0.007). Late progression was not predicted by baseline IFN Scores. However, within U-CTD, patients who required an immunosuppressant had higher expression of IFN Score A (p = 0.011) and IFN Score B (p &lt; 0.001) than those who did not. Conclusion Among ANA-positive referrals, no clinical feature or routine laboratory test could rule out development of clinically significant disease, which included AI-CTD or undifferentiated CTD needing therapy. However, IFN Scores had a unique value in predicting these outcomes. At-risk individuals who ultimately developed clinically significant disease are therefore immunologically but not clinically distinctive. Future work will incorporate biomarkers into clinically applicable risk models to allow earlier exclusion of AI-CTD or trials of preventative treatment. Disclosures S. Ul-Hassan None. K. Dutton None. Z. Wigston None. A. Alase None. M. Md Yusof None. E.M. Vital None.

Reflexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial

2009 ◽  
Vol 15 (11) ◽  
pp. 1329-1338 ◽  
Author(s):  
CM Hughes ◽  
S. Smyth ◽  
AS Lowe-Strong
Keyword(s):  
Multiple Sclerosis ◽  
Primary Outcome Measure ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Positive Effects ◽  
Vas Scores ◽  
Clinically Significant ◽  
Randomised Controlled

Multiple sclerosis (MS) results in pain and other symptoms which may be modified by conventional treatment, however, MS is still not curable. Several studies have reported positive effects of reflexology in the treatment of pain, however, no randomised controlled clinical trials for the treatment of pain have been conducted within this population. The objective of this study was to investigate the effectiveness of reflexology on pain in and MS population. We randomly allocated 73 participants to receive either precision or sham reflexology weekly for 10 weeks. Outcome measures were taken pre-and post-treatment with follow-up at 6 and 12 weeks by a researcher blinded to group allocation. The primary outcome measure recorded pain using a Visual Analogue Scale (VAS). A significant (p < 0.0001) and clinically important decrease in pain intensity was observed in both groups compared with baseline. Median VAS scores were reduced by 50% following treatment, and maintained for up to 12 weeks. Significant decreases were also observed for fatigue, depression, disability, spasm and quality of life. In conclusion, precision reflexology was not superior to sham, however, both treatments offer clinically significant improvements for MS symptoms via a possible placebo effect or stimulation of reflex points in the feet using non-specific massage.

Comparative Evaluation of Bioactive Glass (Putty) and Platelet Rich Fibrin in Treating Furcation Defects

2016 ◽  
Vol 42 (5) ◽  
pp. 411-415 ◽  
Author(s):  
Shriparna Biswas ◽  
Savita Sambashivaiah ◽  
Rithesh Kulal ◽  
Shivaprasad Bilichodmath ◽  
Gregori M Kurtzman
Keyword(s):  
Bioactive Glass ◽  
Plaque Index ◽  
P Value ◽  
Gingival Index ◽  
Platelet Rich Fibrin ◽  
Group I ◽  
Probing Depth ◽  
Furcation Defects ◽  
Mandibular Molar ◽  
Depth Reduction

The aim of this study was to compare a second-generation bioactive glass putty biomaterial against platelet rich fibrin in treating grade II furcation defects. Subjects were 15 systemically healthy patients (10 males and 5 females, ages 20–50 with a mean age of 38.33) with 20 mandibular molar class II furcation defects according to Glickman's classification. The 20 mandibular molar furcation defects were randomly allocated as follows: Group I, 10 furcation defects were treated using bioactive glass (NovaBone) bone graft putty material; Group II, 10 furcation defects were treated using platelet rich fibrin (PRF). Customized acrylic stents were fabricated on study casts and trimmed to the height contour of the teeth to serve as a fixed reference point for measurements. The following measurements were collected: gingival index, plaque index, vertical probing depth (from gingival margin to base of the pocket), clinical attachment level (CEJ to the base of the pocket), and horizontal probing depth of furcation involvement (using stent). Results showed that both groups had improvement in gingival index (GI) and plaque index (PI) at the recall intervals. There was an overall reduction in both vertical and horizontal probing depth in both groups; however, the Putty group (Group I) showed consistently more vertical probing depth reduction than the PRF group (Group II) at the end of third month (P-value = 0.0004), sixth month (P-value = 0.00001), and ninth month (P-value = 0.0004). Our conclusion was that use of bioactive glass osteostimulative biomaterial yields superior clinical results, including increased pocket depth reduction of class II furcation defects as compared to an autologous platelet concentrate. The clinical significance of our findings include the ease of use and superior biologic performance of second-generation putty bioglass biomaterials in furcation defects.

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