scholarly journals Antiseptics as Adjuncts to Scaling and Root Planing in the Treatment of Periodontitis: A Systematic Literature Review

2020 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits ◽  
Antiseptic Agent

Abstract Background : Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planning (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.

scholarly journals Antiseptics as Adjuncts to Scaling and Root Planing in the Treatment of Periodontitis: A Systematic Literature Review

2020 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits ◽  
Antiseptic Agent

Abstract Background : Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planning (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.

scholarly journals Antiseptics As Adjuncts To Scaling And Root Planing In The Treatment Of Periodontitis: A Systematic Literature Review

2019 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Scaling And Root Planing ◽  
Randomized Controlled Clinical Trials ◽  
Root Planing ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits

Abstract Background: Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planing (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone.

scholarly journals ANTISEPTICS AS ADJUNCTS TO SCALING AND ROOT PLANING IN THE TREATMENT OF PERIODONTITIS: A SYSTEMATIC LITERATURE REVIEW

2019 ◽  
Author(s):  
Egle Ramanauskaite ◽  
Vita Machiulskiene
Keyword(s):  
Sustained Release ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Current Evidence ◽  
Scaling And Root Planing ◽  
Randomized Controlled Clinical Trials ◽  
Root Planing ◽  
Central Register ◽  
Nonsurgical Periodontal Therapy ◽  
Clinical Benefits

Abstract Background: Periodontitis is microbially-associated, host-mediated inflammatory condition that results in loss of periodontal attachment. The goals of periodontal therapy include arresting the disease progression, establishing healthy, stable, maintainable periodontal conditions. A fundamental strategy of treating periodontitis is scaling and root planing (SRP), however its efficacy may be restricted in areas inaccessible for mechanical instrumentation. As periodontitis is infectious in nature, it might be helpful to use additional antimicrobial adjuncts, in order to eliminate or inactivate pathogenic microflora. The aim of this study is to evaluate the current evidence regarding the potential clinical benefits of using additional antiseptics for SRP in nonsurgical periodontal therapy. Methods: An electronic literature search was conducted in the MEDLINE (Ovid) and Cohrane Central Register of Controlled Trials (CENTRAL) databases for articles published between January 1, 2000 and September 22, 2019. Randomized controlled clinical trials in English that compare the effectiveness of one or more antiseptic agents as adjuncts to SRP with a follow-up of ≥ 6 months were included. A meta-analysis using the random-effects model was performed on the selected qualifying articles. Results: The search resulted in 12 articles that met the inclusion criteria. Based on the vehicle employed to deliver the antiseptic agent, studies were divided into adjunctive sustained-release antiseptics (gels, chips and varnish) and adjunctive irrigation with antiseptics. The meta-analysis demonstrated significant improvements in probing depth (PD) reduction (p = 0.001), clinical attachment level (CAL) gain (p = 0.001), and bleeding on probing (BOP) values (p = 0.001) following the adjunctive subgingival application of sustained-release antiseptics. Additional subgingival irrigation with antiseptics failed to show significant improvements in PD (p = 0.321), CAL (p = 0.7568), or BOP values (p = 0.3549) over SRP alone. Conclusions: Adjunctive subgingivally delivered antiseptics with a sustained-release delivery have significant clinical benefits compared to SRP alone. Key Words: Periodontitis, Antiseptics, Treatment, Review

scholarly journals Efficacy of laser monotherapy or non-surgical mechanical instrumentation in the management of untreated periodontitis patients. A systematic review and meta-analysis

2020 ◽  
Author(s):  
Zhikai Lin ◽  
Franz J. Strauss ◽  
Niklaus P. Lang ◽  
Anton Sculean ◽  
Giovanni E. Salvi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Controlled Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Clinical Benefits ◽  
Mean Differences ◽  
Patient Related Outcome ◽  
Meta Analyses

Abstract Objective To evaluate and compare the effects of laser monotherapy with non-surgical mechanical instrumentation alone in untreated periodontitis patients. Materials and methods A focused question was formulated based on the Population, Intervention, Comparison, Outcome, and Study design criteria (PICOS): in patients with untreated periodontitis, does laser mono-therapy provide adjunctive effects on pocket probing depth (PPD) changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. The results of the meta-analyses are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. Results The search yielded 1268 records, out of which 8 articles could be included. With respect to PPD changes, a meta-analysis including 5 articles (n = 148) failed to identify statistically significant differences in favor of laser monotherapy for PPD change (WMD = 0.14 mm; 95% CI: − 0.04/0.32; z = 1.51; p = 0.132) nor for clinical attachment level (CAL) (WMD = 0.04 mm; 95% CI: − 0.35/0.42; z = 0.19; p = 0.850). Data on cost-effectiveness are lacking. One study reported patient-related outcome measures (PROMS). Conclusions In untreated periodontitis patients, laser monotherapy does not yield superior clinical benefits compared with non-surgical mechanical instrumentation alone. Clinical relevance In untreated periodontitis patients, mechanical instrumentation with hand and/or ultrasonic instruments remains the standard of care.

scholarly journals Antimicrobial or Subantimicrobial Antibiotic Therapy as an Adjunct to the Nonsurgical Periodontal Treatment: A Meta-Analysis

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Ana Patricia Moreno Villagrana ◽  
José Francisco Gómez Clavel
Keyword(s):  
Chronic Periodontitis ◽  
Meta Analysis ◽  
Periodontal Treatment ◽  
Randomized Controlled Clinical Trials ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Post Hoc ◽  
Systemic Antibiotics ◽  
Periodontal Probing ◽  
Attachment Level

The use of antibiotics in nonsurgical periodontal treatment is indicated in cases in which scaling and root planing present important limitations. However, their use is controversial due to the secondary effects associated with them and the disagreements regarding their prescription. The aim of this study is to determine the effectiveness of systemic antibiotics in the management of aggressive and chronic periodontitis. The study was based on a search of randomized, controlled clinical trials. Common data were concentrated and evaluated by means of an analysis of variance (ANOVA), and a meta-analysis of the results was performed. The meta-analysis (, 95% confidence interval, post hoc Bonferroni) determined that the supplementation of nonsurgical periodontal therapy with a systemic antibiotic treatment—amoxicillin with clavulanic acid and metronidazole or subantimicrobial dose doxycycline—provides statistically significant results in patients with aggressive or chronic periodontitis under periodontal treatment, whilst increasing the clinical attachment level of the gingiva and reducing periodontal probing depth.

scholarly journals Efficacy of melatonin supplementation in the treatment of periodontitis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yuexiang Zhen ◽  
Hui Yue ◽  
Yiting Xiao ◽  
Qin Liu ◽  
Meilin Zhao
Keyword(s):  
Systematic Review ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Clinical Attachment Loss ◽  
Beneficial Effects ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Subgroup Analyses

Abstract Background: The aim of this systematic review and meta-analysis was to analyze the additive effects of the melatonin supplementation with nonsurgical periodontal therapy (NSPT) on periodontal status in patients affected by chronic periodontitis. Methods: In December 2020, We searched PubMed, EMBASE, Web of Science, CENTRAL databases and Google Scholar databases. Four RCTs were recruited with the same inclusion criteria. PD and CAL were the primary outcome measures. Subgroup analyses were performed according to health statuses and follow-up times, and Cochran’s Q and I-square ( I2 ) tests were used to assess heterogeneity.Results: This review included four RCTs. Four studies reported probing depth (PD) and 3 studies reported clinical attachment loss (CAL). Compared with the placebo groups, the melatonin groups showed a significant reduction in PD (weighted mean difference [WMD], -1.01; 95% confidence intervals [CI], -1.67 to -0.35; I2 = 76%) and CAL (WMD, -1.08; 95% CI: -1.36 to -0.79, I2 = 0%). Subgroup analyses revealed that the use of systemic melatonin + NSPT significantly reduced PD and CAL at the 2-, 3-, and 6-month follow-ups compared to NSPT alone, and stronger treatment effects of reducing PD were observed at shorter follow-ups than at longer follow-ups when adjunctive systemic melatonin was used.Conclusions: Melatonin supplementation in adjunct with nonsurgical periodontal therapy can moderately improve the efficacy of NSPT in reducing PD and greater CAL gain in patients with periodontitis. With the limited evidence available, it is evident that additional good quality RCTs are required to demonstrate additional beneficial effects of oral melatonin supplementation on periodontal clinical parameters after NSPT.

scholarly journals Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Holger F. R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick
Keyword(s):  
Test Group ◽  
Nonparametric Tests ◽  
Periodontal Therapy ◽  
Periodontal Pocket ◽  
Control Group ◽  
Clinical Variables ◽  
Air Polishing ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Attachment Level

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.

scholarly journals Efficacy of systemic antibiotics in nonsurgical periodontal therapy for diabetic subjects: a systematic review and meta-analysis

2018 ◽  
Vol 68 (4) ◽  
pp. 207-220 ◽  
Author(s):  
Maria Luisa S. Souto ◽  
Emanuel S. Rovai ◽  
Juliana A. Ganhito ◽  
Marinella Holzhausen ◽  
Leandro Chambrone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Nonsurgical Periodontal Therapy ◽  
Systemic Antibiotics

scholarly journals Bio-Inspired Systems in Nonsurgical Periodontal Therapy to Reduce Contaminated Aerosol during COVID-19: A Comprehensive and Bibliometric Review

2020 ◽  
Vol 9 (12) ◽  
pp. 3914
Author(s):  
Andrea Butera ◽  
Carolina Maiorani ◽  
Valentino Natoli ◽  
Ambra Bruni ◽  
Carmen Coscione ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Bacterial Load ◽  
Periodontal Therapy ◽  
Clinical Practices ◽  
Immunological Parameters ◽  
Aerosol Generation ◽  
Global Pandemic ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Bibliometric Review

Background: On 30 January 2020, a public health emergency of international concern was declared as a result of the new COVID-19 disease, caused by the SARS-CoV-2 virus. This virus is transmitted by air and, therefore, clinical practices with the production of contaminant aerosols are highly at risk. The purpose of this review was to assess the effectiveness of bio-inspired systems, as adjuvants to nonsurgical periodontal therapy, in order to formulate bio-inspired protocols aimed at restoring optimal condition, reducing bacteremia and aerosols generation. Methods: A comprehensive and bibliometric review of articles published in English. Research of clinical trials (RCTs) were included with participants with chronic or aggressive periodontal disease, that have compared benefits for nonsurgical periodontal therapy (NSPT). Results: Seventy-four articles have been included. For probing depth (PPD) there was a statically significant improvement in laser, probiotic, chlorhexidine groups, such as gain in clinical attachment level (CAL). Bleeding on probing (BOP) reduction was statistically significant only for probiotic and chlorhexidine groups. There were changes in microbiological and immunological parameters. Conclusions: The use of bio-inspired systems in nonsurgical periodontal treatment may be useful in reducing risk of bacteremia and aerosol generation, improving clinical, microbiological and immunological parameters, of fundamental importance in a context of global pandemic, where the reduction of bacterial load in aerosols becomes a pivotal point of clinical practice, but other clinical trials are necessary to achieve statistical validity.

scholarly journals Effect of hyperlipidemia on response to nonsurgical periodontal therapy: Statin users versus nonusers

2016 ◽  
Vol 10 (01) ◽  
pp. 069-076 ◽  
Author(s):  
Aditi Sangwan ◽  
Shikha Tewari ◽  
Harpreet Singh ◽  
Rajinder Kumar Sharma ◽  
Satish Chander Narula
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Clinical Attachment Level ◽  
Nonpharmacological Therapy ◽  
Probing Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Attachment Level

ABSTRACT Objective: To evaluate the response to nonsurgical periodontal therapy among hyperlipidemic subjects and whether statin use by hyperlipidemic subjects influences the response. Materials and Methods: This study was conducted on 107 chronic periodontitis subjects (35 normolipidemic [NL] controls, 36 hyperlipidemics on nonpharmacological therapy and 36 hyperlipidemics on statins). Periodontal (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]) and biochemical (plasma triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-DL-C [HDL-C] levels) examination was done at baseline and 3 months after nonsurgical periodontal treatment. Results: Both the NL and statin groups exhibited significantly greater improvement in GI as compared to the hyperlipidemic group on nonpharmacological therapy (P = 0.004 and 0.006, respectively). Mean change in PD correlated negatively with baseline TC (r = −0.306) and LDL-C (r = −0.360) while mean change in GI positively correlated with baseline HDL-C (r = 0.219). Regression analyses revealed that mean change in PD was negatively associated with LDL-C (β = −0.358, P < 0.001) while mean change in GI was positively associated with HDL-C (β = 0.219, P = 0.023). Conclusions: While higher baseline lipid levels were somewhat detrimental to the resolution of inflammation postperiodontal treatment, the inclusion of statin therapy among hyperlipidemic subjects seemed to improve clinical response as compared to those devoid of the drug. The findings of the study are suggestive of a possible adjunctive role of statins in periodontal treatment that warrants future studies.

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