scholarly journals Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: A 6-year follow-up case report

2014 ◽  
Vol 08 (03) ◽  
pp. 407-411 ◽  
Author(s):  
Rafael Scaf de Molon ◽  
Yeon Jung Kim ◽  
Ary dos Santos-Pinto ◽  
Joni Augusto Cirelli

ABSTRACTExtensive intraosseous lesions represent a clinical challenge for the periodontist. Sites with bone defects have been shown to be at higher risk of periodontitis progression in patients who had not received periodontal therapy. Thus, the aim of this case report was to describe a novel approach for the treatment of 1-walled intraosseous defect by combining nonsurgical periodontal therapy and orthodontic movement toward the bone defect, avoiding regenerative and surgical procedures. A 47-year-old woman underwent the proposed procedures for the treatment of her left central incisor with 9 mm probing depth and 1-walled intraosseous defect in its mesial aspect. Initially, basic periodontal therapy with scaling and root planning was accomplished. Two months later, an orthodontic treatment was planned to eliminate the intraosseous lesion and to improve the interproximal papillary area. Orthodontic root movement toward the osseous defect was performed for 13 months with light forces. After 6 years postoperative it was concluded that combined basic periodontal therapy and orthodontic movement was capable of eliminating the intraosseous defect and improve the esthetics in the interproximal papillary area between the central incisors.

2021 ◽  
Author(s):  
Yuexiang Zhen ◽  
Hui Yue ◽  
Yiting Xiao ◽  
Qin Liu ◽  
Meilin Zhao

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.


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.


2020 ◽  
Vol 9 (12) ◽  
pp. 3914
Author(s):  
Andrea Butera ◽  
Carolina Maiorani ◽  
Valentino Natoli ◽  
Ambra Bruni ◽  
Carmen Coscione ◽  
...  

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.


2016 ◽  
Vol 10 (01) ◽  
pp. 069-076 ◽  
Author(s):  
Aditi Sangwan ◽  
Shikha Tewari ◽  
Harpreet Singh ◽  
Rajinder Kumar Sharma ◽  
Satish Chander Narula

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.


2012 ◽  
Vol 23 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Rafael Scaf de Molon ◽  
Érica Dorigatti de Avila ◽  
João Antonio Chaves de Souza ◽  
Andressa Vilas Boas Nogueira ◽  
Carolina Chan Cirelli ◽  
...  

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.


2020 ◽  
Vol 5 (12) ◽  
pp. 582-586
Author(s):  
  Dr. Sharma Manohar H ◽  
Dr. Gujjari Sheela Kumar ◽  
Dr. Medha Sharma ◽  
Dr. Nair Uma P

2019 ◽  
Vol 30 (6) ◽  
pp. 577-586 ◽  
Author(s):  
Camila Camarinha da Silva Cirino ◽  
Hugo Felipe do Vale ◽  
Márcio Zaffalon Casati ◽  
Enilson Antonio Sallum ◽  
Renato Corrêa Viana Casarin ◽  
...  

Abstract The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.


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