scholarly journals A Comparative Clinical Study of Er:YAG Laser and Hand Instruments in the Treatment of Moderate Chronic Periodontitis

Folia Medica ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 858-864
Author(s):  
Blagovesta Yaneva ◽  
Elena Firkova ◽  
Emiliya Karaslavova

Introduction: Moderate chronic periodontitis is the most common periodontal disease. The treatment of this condition should aim at achieving a biocompatible root surface and decontamination of the pocket, thereby restoring the health status. Aim: In the present study, the aim was to examine the clinical effectiveness of fibreless Er:YAG laser used for scaling and root planing and to compare it with a conventional treatment with Gracey curettes. Materials and methods: The study included 909 periodontal pockets which were treated in a split-mouth design with either Gracey curettes or with Er:YAG laser (1.5 W). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index were recorded. Results: There was a considerable decrease of PPD, CAL, BoP, and plaque presence values at 1 and 3 months after therapy in both treatment groups. Sites treated with Er:YAG laser demonstrated mean CAL gain of about 1.00 mm and 0.44 mm at the first and third month, respectively. In the control group, there was also significant gain of CAL of about 1.33 mm at the first and 0.30 mm at the third month. Significant difference was observed in all parameters between both groups in favour of the laser treatment. Conclusions: The results of the present study suggest that the Er:YAG laser shows clinical effectiveness in the treatment of moderate chronic periodontitis. It can be used as a single treatment modality for subgingival scaling and root planing resulting in greater improvements in all recorded data in contrast to conventional treatment.

Author(s):  
Upendra Prasad ◽  
Abhinav Deshpande ◽  
Praneeta Kamble ◽  
Abhishek Singh ◽  
Adiya Apon ◽  
...  

Introduction: Topical chemotherapeutic agents used in treatment of chronic periodontitis are antimicrobial agents which help in plaque control. The present study evaluates the efficacy of ornidazole gel with gold standard chlorhexidine gel when used as adjunct to scaling and root planing. Material and Methods: 90 patients diagnosed as chronic periodontitis, having pocket depth ?3 mm and in good systemic health were selected by systematic sampling method and divided in 3 groups. In all 3 groups scaling and root planing was done. In group A, Ornidazole gel application was done while in Group B Chlorhexidine gel application was done while Group C was control group. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline, 1 and 3 months while Probing pocket depth (PPD) and Clinical attachment level (CAL) were recorded at baseline and 3 months. Results: PI and GI showed significant reduction in all three groups after 1 and 3 months compared to baseline. On inter group comparison, both PI and GI showed no significant difference in reduction of scores after 1 month and 3 months (p>0.05). PPD and CAL values showed statistically significant reduction after 3 months when compared to baseline values. The intergroup comparison revealed statistically significant reduction in group A and B compared to control group C (p<0.05). Conclusion: Ornidazole showed comparable efficacy as Chlorhexidine when used as adjunct to scaling and root planing for treatment of chronic periodontitis.


Author(s):  
Reya Shree ◽  
Varun Dahiya ◽  
Pradeep Shukla ◽  
Prerna Kataria ◽  
Mona Dagar

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.


2017 ◽  
Vol 11 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Joseph D. Everett ◽  
Jeffrey A. Rossmann ◽  
David G. Kerns ◽  
Ibtisam Al-Hashimi

The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.


Author(s):  
Sai M. Surve ◽  
Anirudh B. Acharya ◽  
Srinath L. Thakur

AbstractThe current understanding of the pathogenesis of periodontal disease has resulted in adjunctive use of various pharmacologic agents in periodontal therapy. The objective of this investigation was to assess the efficacy of atorvastatin and simvastatin (because of their pleiotropic properties) as an adjunct to dental scaling and root planing (SRP) by local delivery, i.e. placing them subgingivally, in the treatment of chronic periodontitis.Local delivery systems for atorvastatin and simvastatin were prepared in sodium alginate suspension to be administered with calcium chloride solution. Patients diagnosed with chronic periodontitis were grouped as group 1, receiving SRP only (control), group 2, receiving SRP with subgingival delivery of 1.2% simvastatin, and group 3, receiving SRP with subgingival delivery of 1.2% atorvastatin. Clinical parameters and interleukin (IL) 1α levels in the gingival crevicular fluid (GCF) were assessed.All three groups showed significant reductions in clinical parameters and IL-1α levels in the GCF (p<0.05). However, the test groups did not show any statistically significant difference when compared with control.Subgingivally delivered atorvastatin and simvastatin as an adjunct to SRP is efficacious but did not demonstrate any added benefit as compared with SRP alone.


2019 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP.Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained.Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP.Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.


2010 ◽  
Vol 11 (3) ◽  
pp. 9-16 ◽  
Author(s):  
Satish Gupta ◽  
Manohar L. Bhongade ◽  
Vikas Deo ◽  
Ritika Jaiswal

Abstract Aim Diabetic patients have more severe periodontal destruction, but periodontal therapy can improve metabolic control. Recently, interest has focused on the use of subantimicrobial dose doxycycline (SDD) as a treatment paradigm. Therefore, this study was undertaken to evaluate clinical efficacy of SDD with scaling and root planning (SRP) in chronic periodontitis patients with diabetes. Methods and Materials Twenty chronic periodontitis patients with diabetes mellitus were randomly allocated to either a test and a control group. Clinical measurements were recorded at baseline and at six months for probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR). After SRP, patients in the test group were instructed to take SDD 20-mg capsules twice a day while patients in the control group took a placebo twice a day. Both groups were on this regimen for a six-month period. Results A greater reduction in mean PPD was demonstrated in patients in the test group compared to the control group. The mean CAL increase observed in the test group was significantly greater (0.67 mm) than that in the control group. Conclusion It can be concluded that SRP, in conjunction with the SDD therapy described, is more effective then SRP alone in terms of CAL gain and PPD reduction in diabetic patients with severe periodontal disease. Clinical Significance Given the widespread prevalence of both chronic periodontitis and diabetes, the proposed treatment approach will prove to be of great value and contribute significantly to the overall health of the patients. Citation Deo V, Gupta S, Bhongade ML, Jaiswal R. Evaluation of Subantimicrobial Dose Doxycycline as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Diabetes: A Randomized, Placebo-Controlled Clinical Trial. J Contemp Dent Pract [Internet]. 2010 May; 11(3):009-016. Available from: http://www.thejcdp.com/journal/view/volume11- issue3-deo.


2013 ◽  
Vol 14 (6) ◽  
pp. 1080-1086 ◽  
Author(s):  
Md Jalaluddin ◽  
Shabeer Ahamed ◽  
Imran Khalid ◽  
Ninad Moon ◽  
TK Shafi ◽  
...  

ABSTRACT Background Local delivery of antimicrobial agents provides higher concentration of the drug in the periodontal site for longer periods than systemically delivered methods. In the present study an attempt is made to know the efficacy of controlled local drug delivery of doxycycline as an adjunctive treatment in the management of chronic periodontitis. Materials and methods A total of 12 patients, diagnosed as Chronic Periodontitis in the age of 25 to 55 years, were selected of both the sexes in this study. They were divided into Experimental group consisted of 30 sites who received complete scaling and root planing (SRP) followed by placement of Atridox gel and control group consisted of 30 sites who received only SRP. Clinical parameters were recorded at, baseline, days 30, 90 and 180. Parameters were plaque index, gingival index, gingival bleeding index and microbial analysis, probing pocket depth and Clinical attachment level (CAL). The microbiological analysis was done at baseline visit and at 90th day. Probing pocket depth and CAL were recorded only on day 0 and 180th day. Results In 180 days study, both the groups exhibited a significant improvement in periodontal status. Significant gain in attachment level was observed in both the group. Between both the groups the clinical parameters in the experimental groups exhibited better results as compared to the control group. Both the groups exhibited significant reduction in the number of spirochetes. Conclusion Combination therapy of SRP and 10% DH gel demonstrated better results at all levels suggesting that this therapy can play a significant role as an adjunct to SRP in the management of chronic periodontitis. How to cite this article Ahamed S, Jalaluddin Md, Khalid I, Moon N, Shafi TK, Ali FM. The Use of Controlled Release Locally Delivered 10% Doxycycline Hyclate Gel as an adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: Clinical and Microbiological Results. J Contemp Dent Pract 2013;14(6):1080-1086.


2014 ◽  
Vol 41 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Bl. Yaneva ◽  
E. Firkova ◽  
E. Karaslavova

Summary Chronic periodontitis is a result of polymicrobial infection and its treatment aims removal of dental calculus and biofi lm from the periodontal pocket. Many hand and power-driven instruments are created for this purpose. In recent years, lasers are widely discussed tools for periodontal therapy. The aim of the present study is to evaluate the early microbiological and clinical effectiveness of the Er:YAG laser in the treatment of chronic periodontitis. 30 patients with moderate chronic periodontitis were enrolled in the study. Using a split-mouth design they were treated either with Er:YAG laser (chisel tip, 100 mJ, 15 Hz, 5-6 water spray)-test group or with Gracey curettes- control group. Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing and plaque presence were evaluated at baseline and one month after the therapy. Microbiological samples were taken from the deepest four pockets of each quadrant from 20 randomly selected patients (n = 80). They were evaluated using real time PCR for periodontal pathogens from the red complex (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia). One month after therapy in the control group PPD decreased from 4.59 mm to 3.36 mm, the CAL gain was 1.09 mm and the reduction of bleeding and plaque - from 87.9% to 33.7% and from 75.9% to 40.9%, respectively. In the test group PPD decreased from 4.58 mm to 3.15 mm, the CAL gain was 1.37mm and the reduction of bleeding and plaque was from 85.6% to 25.9% one month after the treatment. The results were statistically significant in favour of the laser group (p < 0.05). Microbiological analysis revealed that the pathogens from the red complex decreased 3 times in the control and 6 times in the test group. Therefore, the Er:YAG laser demonstrate pronounced early effectiveness in chronic periodontitis treatment and would be appropriate alternative of the conventional periodontal therapy.


2020 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.


2014 ◽  
Vol 87 (3) ◽  
pp. 186-191
Author(s):  
Ciprian Sarbu ◽  
Darian Rusu ◽  
Horia Călniceanu ◽  
Adrian Kasaj ◽  
Stefan Adrian Petrutiu ◽  
...  

Background and Aims: Oral mucosa and interproximal spaces of the teeth could favor the colonization of periodontopathogenic bacteria, which could be targeted by chemical antiplaque agents such as chlorhexidine, present in different oral hygiene products, thus improving the control of biofilm growth and delaying microbial accumulation. The study aimed to evaluate whether the use of a hydrophobic gel with good gingival adhesion for 14 days after the scaling and root planing of patients with chronic periodontitis would improve the treatment outcome, when compared with the use of a regular hydrophyllic gel.Material and Methods: Patients with moderate disease were included in two study groups. At baseline and 3 months after the treatment the following parameters were recorded: pocket depth, Approximal Plaque Index, Modified Gingival Index, Simplified Oral Hygiene Index, bleeding on probing. Patients received scaling and root planing in two sessions at 24 hours interval. After the treatment, patients in the test group applied the hydrophobic adhesive chlorhexidine gel once a day, every other day, while in the control group the gel was used twice daily.Results. Both treatments resulted in significant improvement in all clinical indices, except Approximal Plaque Index, which deteriorated significantly in both groups. Three months after mechanical treatment, the mean probing depth changed in the test group from 4.16±0.45 mm to 2.80±0.42 mm, and in the control group from 4.16±0.30 to 2.69±0.19.Conclusions: Both adjunctive anti-infective therapies induced clinical improvement 3 months from baseline. The differences between the two treatments were not statistically significant.


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