scholarly journals Comparison of two treatment modalities for treatment of dentinal hypersensitivity following periodontal therapy.

Author(s):  
Kevin Saraiya ◽  
Deepk Dave ◽  
Kesha Vaghani

Brief Background To evaluate and compare efficacy of 1.23% Acidulated Phosphate Fluoride (APF) gel with iontophoresis and topically applied calcium sodium phosphosillicate in the treatment of dentinal hypersensitivity. Materials and Methods In this clinical study, a total of 72 participants with dentinal hypersensitivity (DH) after periodontal treatment were included. 36 participants were assigned to the test group, treated with 1.23% APF gel iontophoresis and 36 participants were in the control group, treated with topical application of calcium sodium phosphosillicate. The VAS score was measured using tactile, air blast and cold-water test at baseline, 2 weeks and 2 months. Results Inter group comparison showed, statistically significant reduction in difference from baseline to 2 weeks follow-up and baseline to 2 months follow-up in VAS score in test group as compared to control group (p<0.001) except for difference from baseline to 2 weeks in air blast test where test and control group showed same reduction. Difference from 2 weeks to 2 months showed no statistically significant reduction in both groups. Intra group comparison showed, statistically significant reduction in baseline to 2 weeks and baseline to 2 months in both groups and from 2 weeks to 2 months no statistically significant reduction in VAS score in both groups. Summary and Conclusions Within the limitation of the study, it can be concluded that iontophoresis with 1.23% APF gel is more effective. Key Words: 1.23 % APF gel;Calcium Sodium Phosphosilicate;Chronic periodontitis; Dentinal hypersensitivity, Periodontal therapy; VAS score

2019 ◽  
Author(s):  
Pei-Hui Ding ◽  
Anna Dai ◽  
Hua-Jiao Hu ◽  
Jia-Ping Huang ◽  
Jia-Mei Liu ◽  
...  

Abstract Background: Dentine hypersensitivity (DH) could occur or intensify after non-surgical periodontal therapy because of the exposure of dentine tubules. It has been demonstrated that nano-sized particles could seal these the dentine tubules. This randomized controlled trial aimed to investigate the efficacy of dentifrice containing nano-carbonate apatite (n-CAP) in reducing dentine hypersensitivity (DH) after non-surgical periodontal therapy. Methods: 48 periodontitis patients with DH were included in this clinical trial. After non-surgical periodontal therapy, patients included were randomized to test and control group and the respective dentifrices were applied at chairside, after which they were instructed to brush teeth with the allocated dentifrices twice a day at home. Periodontal parameters were recorded at baseline and the last follow-up. DH was measured by air-blast test and recorded by visual analogue scale (VAS) and Schiff sensitivity scale at baseline, after polishing (0 week) and 2/4/6 weeks. Results: 45 participants completed the follow-up. Periodontal parameters were improved and comparable between groups. Significant reduction in DH was observed in both groups at all time-points compared to baseline in terms of VAS and Schiff score. The test group achieved significantly greater relief from hypersensitivity compared with the control group after 4-week at-home use (for VAS, test group: 0.66 ± 0.68 versus control group: 0.84 ± 0.78, p = 0.005; for Schiff score, test group: 0.69 ± 0.71 versus control group: 0.97 ± 0.77, p < 0.001). Conclusions: Home-use of n-CAP based dentifrice provided a significantly better alleviation of DH following non-surgical periodontal therapy after 4 weeks compared to the control product. Trail registration: Chinese Clinical Trials Registry (No. ChiCTR-IPR-17011678, http://www.chictr.org.cn/, registered 16 June, 2017)


2018 ◽  
Vol 12 (1) ◽  
pp. 952-959
Author(s):  
Carmine Verrusio ◽  
Mirko Medaglia ◽  
Roberto Lo Giudice ◽  
Francesco Puleio ◽  
David Rizzo ◽  
...  

Objective: The aim of this study is to compare the efficacy of rotary instruments vs hand scalers in non-surgical periodontal therapy, studying the variation of periodontal health indexes. Materials and Methods: Forty patients (age between 30 and 70 years) with advanced chronic periodontitis, that were recruited for the study, were divided into two groups; control group and test group. Control patients were treated with hand scalers while test group patients were treated with rotary instruments. Periodontal indexes were evaluated at baseline and after 3 months. Results: Nonsignificant differences were found at 12 weeks follow up for all the parameters between test and control groups. Conclusions: Within their limits, the results indicate that different instruments can be effective in removing calculus and endotoxins. This requisite is mandatory for a proper periodontal healing. The reasons for clinicians to use diamond-coated instruments are related to a faster procedure, and the clinical evidence of a smooth root surface. The clinicians’ ability remains one of the most important variables that could affect periodontal therapy.


2020 ◽  
Author(s):  
Pei-Hui Ding ◽  
Anna Dai ◽  
Hua-Jiao Hu ◽  
Jia-Ping Huang ◽  
Jia-Mei Liu ◽  
...  

Abstract Background: Dentine hypersensitivity (DH) could occur or intensify after non-surgical periodontal therapy because of the exposure of dentine tubules, but currently no gold standard exists to treat DH. It has been demonstrated that nano-sized particles presented potential for dentine tubules blocking and remineralization. This randomized controlled trial aimed to investigate the efficacy of dentifrice containing nano-carbonate apatite (n-CAP) in reducing dentine hypersensitivity (DH) after non-surgical periodontal therapy. Methods: 48 periodontitis patients with DH were included in this clinical trial. After non-surgical periodontal therapy, patients included were randomized to test and control group and the respective dentifrices were applied at chairside, after which they were instructed to brush teeth with the allocated dentifrices twice a day at home. Periodontal parameters were recorded at baseline and the last follow-up. DH was measured by air-blast test and recorded by visual analogue scale (VAS) and Schiff sensitivity scale at baseline, after polishing (0 week) and 2/4/6 weeks. Results: 45 participants completed the follow-up. Periodontal parameters were improved and comparable between groups. Significant reduction in DH was observed in both groups at all time-points compared to baseline in terms of VAS and Schiff score. The test group achieved significantly greater relief from hypersensitivity compared with the control group after 4-week at-home use (for change of VAS, test group: 2.27 ± 2.47 versus control group: 1.68 ± 2.24, p = 0.036; for change of Schiff, test group: 0.94 ± 0.92 versus control group: 0.61 ± 0.83, p < 0.001). The 6-week results showed borderline significance between groups in terms of change of Schiff (p = 0.027) and no significance in terms of change of VAS (p = 0.256). Conclusions: Home-use of n-CAP based dentifrice had some benefit on alleviation of DH following non-surgical periodontal therapy after 4 weeks compared to the control product. Trial registration: Chinese Clinical Trials Registry (No. ChiCTR-IPR-17011678, http://www.chictr.org.cn/, registered 16 June, 2017) Keywords: dentin hypersensitivity; dentifrices; randomized controlled trial; periodontitis


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.


1990 ◽  
Vol 73 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Dennis A. Turner ◽  
Jay Tracy ◽  
Stephen J. Haines

✓ The long-term outcome following carotid endarterectomy for neurological symptoms was analyzed using a retrospective life-table approach in 212 patients who had undergone 243 endarterectomy procedures. The postoperative follow-up period averaged 38.9 ± 2.1 months (mean ± standard error of the mean). The endpoints of stroke and death were evaluated in these patients. Patient groups with the preoperative symptoms of amaurosis fugax, transient ischemic attack, and prior recovered stroke were similar in terms of life-table outcome over the follow-up period. Sixty-two percent of symptomatic patients were alive and free of stroke at 5 years. The late risk of stroke (after 30 days postoperatively) averaged 1.7% per year based on a linear approximation to the hazard at each life-table interval (1.3% per year for ipsilateral stroke). The trend of late stroke risk was clearly downward, however, and could be fitted more accurately by an exponential decay function with a half-life of 33 months. Thus, the risk of stroke following carotid endarterectomy for neurological symptoms was highest in the perioperative period, slowly declined with time, and occurred predominantly ipsilateral to the procedure. The definition of a prospective medical control group remains crucial for a critical analysis of treatment modalities following the onset of premonitory neurological symptoms. In the absence of an adequate control group for this series, the calculated perioperative and postoperative stroke risk from this study was compared to data obtained from the literature on stroke risk in medically treated symptomatic patients. This uncontrolled comparison of treatment modalities suggests the combined perioperative and postoperative stroke risk associated with carotid endarterectomy to be modestly improved over medical treatment alone.


Author(s):  
Bellia Loredana ◽  
Ruggiero Roberta ◽  
Nicolò Michele

Mechanical surface treatment and removal of the above and subgingival biofilm (Tartar ablation; SRP) are considered the most suitable tools for the treatment of periodontal inflammatory diseases, with the aim of destroying bacterial bioflim, reducing bacteria, and slowing down recolonization by pathogenic microorganisms. Often, however, the only S&RP are not enough, as there are patients who are experiencing relapses. Recently, laser therapy has been suggested as a potential tool to improve the outcome of periodontal non-surgical treatment. The objective of the following study was to evaluate the clinical healing of periodontal pockets treated with mechanical therapy, scaling and root planing, and diode laser application, compared to that obtained with non-surgical mechanical therapy alone. The study was designed as a randomized controlled clinical trial. Patients in the control group (13 patients) underwent conventional non-surgical therapy only, while patients in the test group (17 patients) were associated with conventional non-surgical treatment, a laser irradiation session. At baseline and after 6 months, the parameters of probing depth (PD), bleeding on probing (BOP), gingival recession (REC) were assessed The main variable of this study was the PD (probing depth) FMPS and FMBS at follow-up improved in both groups. The FMPS baseline test group 32.59 ± 6.74 - follow up 12.00 ± 3.16. The baseline of the control group showed 33.00 ± 9.55, the follow up 13.15 ± 4.85 The FMBS baseline test group found 24.29 ± 5.01 while at follow 9.65 ± 2.69. The baseline control group 30.31 ± 7.74, Follow up 11.08 ± 2.33. There is a statistical significance. (P.VALUE 0.0001) There were no significant differences between the groups in terms of PD, CAL and BOP at baseline and at follow-up. PD Test group 4,89±1,58 3,95±0,85 0,0001 Control group 5,02±1,57 4,01±0,86 CAL (mm)Test group 0,89±2,29 0,77±1,91 Control group 0,28±1,38 0,24±1,14 REC Test group 0,19±0,49 0,19±0,51 Control group 0,06±0,29 0,57±029 BOP Test group 51,2% 23,5% Control group 54,0% 20,9% The results showed differences in both baseline and follow-up for REC. Test group 0,19±0,49 0,19±0,51-Control group0,06±0,29 0,57±029 In intra-group analyzes, there are differences between baseline and follow-up for all values, except for REC in the control group. The diode laser can be used as an appropriate device for periodontal treatments, but it can offer additional and significant benefits if used according to appropriate protocols and parameters, and especially if associated with non-surgical, manual and ultrasound periodontal instrumentation, always site-specific , as it is a tool that does not replace traditional methods.


1989 ◽  
Vol 9 (3) ◽  
pp. 165-168 ◽  
Author(s):  
Giusto Viglino ◽  
Adolfo Colombo ◽  
Antonio Scalamogna ◽  
Pier L. Cavalli ◽  
Luisella Guerra ◽  
...  

To evaluate acceptability, safety, and efficacy of a y set with two short branches (TAs) filled with electrolytic chloroxidizer solution during the dwell time, 60 patients were randomly allocated to be treated with the traditional y set (TCs) or with the T AS. Twenty-three were new patients whereas the remaining 37 were patients already on continuous ambulatory peritoneal dialysis (CAPD) with the TCs. The follow-up was 416.5 months in the control group and 387.4 months in the test group. During the study period there were 6 peritonitis episodes in each group with an incidence of 1 episode every 69.4 patient-months in the control group and 1 episode every 64.6 patient-months in the test group. Twenty-four patients (80%) in the control group and 27 (90%) in the test group were free from peritonitis. The probability to remain free from peritonitis was respectively 87% and 83% in the test group and in control group after 12 months, 70% and 78% after 21 months. seventy -nine percent of the patients who used both systems preferred the T AS for better handling, lower encumbrance, and major safety. One patient preferred the TCs, three patients did not find any differences between the two devices.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Li Xinyu ◽  
Alan Yan

Category: Bunion Introduction/Purpose: To investigate the significance of using an intraoperative first metatarsal traction test in hallux valgus correction surgery in decision making of the procedure choice and operation designs. Methods: From Jun 2015 to Jun 2016, correction surgery performed in patients with hallux valgus 40 cases with 68 feet. We used the intra-operative first metatarsal traction test to judge the grade of laxity of the 1st TMT and the factual IMA and thus help to make the decision of the level of osteotomy and or fusion. We adopted distal Chevon osteotomy (11 cases 16.2%) when the congruence of the surface of the 1st MPJ remains more than ½ under tension with the traction test. Proximal Scarf osteotomy (54 cases 79.4%) was used when the congruence was less than ½. While if there was a complete incongruent dislocation, Lapidus procedure (3 cases 4.4%) was carried out. We measured IMA and HVA in the patients preoperative, intraoperative, 3 days after operation and at 6 months’ follow-up. Same measurements were done on the 40 patients from the same time without traction test Results: Retrospective review of the 2 groups showing significant improvement (p<0.001) but more reliable larger correction of IMA angles in the intraoperative traction test group. The patients of the intraoperative traction test group had average higher satisfaction rate with more reliable improvement of symptoms and less postoperative complications. Significant improvement (P<0.001) and postoperative AOFAS score average of 93.2 was recorded in traction test method group vs. a 84.3 in control group. The traction test group largely retained the correction in half year follow up which is significant when comparing to the control Conclusion: The intraoperative traction test of first metatarsal objectively guided the decision making of procedure choice and operation design optimization. The traction test gave a reliable assessment of the laxity of first TMT thus avoiding inadequate correction of Hallux Valgus with improper surgical designs. The test can be potentially used as an objective intraoperative guidance in avoidance of inadequate correction with inappropriate surgical choices and thus maintain the correction in the long term with patient satisfaction


Author(s):  
Zerina Hadžić ◽  
Ivan Puhar

Introduction: C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.Methods: Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.Results: Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.Conclusion: Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis.


2019 ◽  
Author(s):  
Yue Yan ◽  
Yalin Zhan ◽  
Xian'e Wang ◽  
Jianxia Hou

Abstract Background: Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes the obvious growth tendency in the whole world, increased by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and tricky problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes. Root planning, in order to eliminate the “infected cementum”, is an important step in treatment of periodontitis since 1970s. Along with the understanding of endotoxin’s feature on root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments wouldn’t remove the cementum excessively, which are more time-saving and labor-saving compared to hand instruments as well. Hence, an increasing number of dentists prefer to scaling with ultrasonic instruments only. However, the necessity of root planing has still been emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which taking the implementation of root planing as the only variable and more in line with the clinical situation, hoping to provide some reference to dentists. Methods/design: Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. Control group: ultrasonic subgingival debridement. In a 24-weeks follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (visual analog scale for pain and sensitivity) will be observed and documented. Discussion: This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial will potentially contribute to an advanced treatment strategy of periodontitis with ideal clinical outcome. Trial registration: The study has been registered in International Clinical Trials Registry Platform (ICTRP) under the identifier number ChiCTR1800017122. Registered on 12 July 2018. Keywords: Peridontitis, Non-surgical periodontal therapy, Ultrasonic subgingival debridement, Root planing


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