Journal of the International Academy of Periodontology最新文献

Aim: Cervical dentin hypersensitivity (CDH) is defined as an acute pain of short duration that occurs in dentin exposed to the oral environment. The aim of this study was to evaluate the effi cacy of three desensitizing toothpastes (Sensodyne® Rapid-Relief, Colgate® Sensitive Pro-Relief, Nano P®) for immediate and intermediate-term relief of CDH, when compared with a control toothpaste (Cocoricó®).

Materials and methods: Eight patients were enrolled in this clinical study. One hundred thirty-eight hypersensitive teeth were randomized into four groups according to the com- position of the desensitizing toothpaste tested: Group I) strontium acetate and calcium carbonate; II) calcium carbonate and arginine 8%; III) calcium phosphate nanoparticles; and IV) a control toothpaste. A split mouth design was used for one application each of the desensitizing dentifrices. Assessment of CDH was done by evaporative and cold stimuli at baseline, immediately, 24 hours and 30 days after the treatment.

Results: The toothpastes presented similar effectiveness and statistically significant improvement in 30 days compared to baseline. Group III showed statistically significant relief for cervical dentin hypersensitivity immediately after the treatment.

Conclusions: The only toothpaste that presented immediate relief effect was the paste containing calcium phosphate nanoparticles in the form of hydroxyapatite.

In order to complement non-surgical therapy in periodontitis, there are multiple options of antimicrobials, such as metronidazole, chlorhexidine, minocycline, doxycycline and tetracycline, which can be locally delivered into the mucosa. These drugs are used in periodontal pockets and can inhibit or eliminate periodontopathogenic microorganisms as well as modulate the inflammatory response of tissues. However, limited data are available concerning the relationship between effect, efficacy and clinical status of the periodontium. This review aims to evaluate the effect and the efficacy of five types of local drug delivery systems in clinical parameters of periodontology. Researched papers using MEDLINE via PubMed, and LILACS databases related to five types of local drug delivery systems as chlorhexidine gluconate, doxycycline hyclate, metronidazole gel, minocycline ointment and tetracycline fibers, were reviewed aiming to address the mechanism of action and the evidence of clinical effectiveness of adjunctive use of these antimicrobials following surgical and/or non-surgical therapies. Inclusion criteria defined that articles must be randomized controlled trials performed in humans and published between 1996 and 2014. The adjunctive use of local drug delivery systems with controlled release properties may provide a defined, but limited, beneficial response on periodontal pockets. Furthermore, local drug delivery as an active treatment or maintenance therapy depends on clinical findings, responses to treatment described in the literature, desired clinical outcomes, and patients' dental and medical histories, including their past usage of antimicrobials.

Aim: To compare the effect of cinnamon extract, chlorhexidine mouthwash and placebo on dental plaque level and gingivitis.

Materials and methods: One hundred five healthy dental and medical students aged 21 to 25 years participated in the study. The subjects were randomly divided into three groups: i.e., the cinnamon group, the chlorhexidine gluconate mouthwash group and the placebo (distilled water) group. Data were collected at baseline, the 15th and the 30th day. Plaque was disclosed using erythrosine disclosing agent and scores were recorded using the Quigley and Hein plaque index modified by Turesky-Gilmore-Glickman. Gingival scoring was done by the gingival index of Löe and Silness. Statistical analysis was carried out to compare the effect of all three treatments groups; p ≤ 0.05 was considered statistically significant.

Results: The chlorhexidine group showed the maximum decrease in both plaque and gingival scores, followed by cinnamon extract, but the result was statistically insignificant. The plaque and gingival scores remained almost unchanged in the distilled water group. Conclusion: The results of the present study indicate that cinnamon may prove to be an effective agent owing to its ability to reduce plaque level and gingivitis.

Objective: The aim of this in vitro study was to investigate the colonization and penetration of specific bacteria on nanosilver-impregnated GTR (guided tissue regeneration) membranes.

Methods: Three sets of GTR membranes were used in this study: 1) GTR-C: Plain GTR membrane as a negative control; 2) GTR-NS: GTR membrane impregnated with silver nanoparticles as the test group; 3) GTR-DOX: GTR membrane impregnated with 25% (w/w) doxycycline hydrochloride acting as a positive control. Stress-strain characteristics were calculated to determine the physical properties of the control and impregnated membranes. Qualitative observation of microbial adherence and bacterial penetration through GTR membranes were performed by using four organisms (Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum and Porphyromonas gingivalis) reported to have strong adherent capabilities to collagen membranes.

Results: The mean bacterial adherence scores were significantly greater (p < 0.001) in the GTR-C group when compared to GTR-DOX and GTR-NS groups. GTR-NS showed lower adherence scores than GTR-DOX across all four microorganisms; this difference, however was not statistically significant. The difference in colony forming units (CFUs) was highly significant (p < 0.001), suggesting greater penetration in GTR-C membranes when compared to GTR-NS and GTR-DOX groups. Though the mean CFUs were lower in GTR-DOX than in GTR-NS across all four microorganisms, this difference was statistically significant only for S. mutans and F. nucleatum.

Conclusion: The incorporation of silver nanoparticles may be of value when controlling membrane-associated infection. Studies with different nanosilver particle sizes should be conducted to further evaluate the beneficial properties of nanosilver against periodontal pathogens.

Drug-induced gingival overgrowth (DIGO) is an oral clinical manifestation associated with certain medications such as immunosuppressants that are administered to organ transplant patients to prevent graft rejection. In patients with cardiac transplants, management of DIGO is critical. In such patients, plaque biofilm accumulation at the gingival interface might be detrimental as it may lead to transient bacteremia as well as systemic inflammation resulting in thromboembolic events. This case report describes the management of DIGO in a cardiac transplant recipient by change of immunosuppressant medication, non-surgical periodontal therapy and laser-assisted gingivectomy.

Background: The present clinical trial was designed to investigate the effectiveness of subgingivally delivered satranidazole (SZ) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

Methods: Sixty-four subjects with probing depth (PD) ≥ 5 mm and who were diagnosed with type 2 diabetes were selected. Thirty-two subjects each were randomly assigned to SRP + placebo (Group 1) and SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index (PI), gingival index (GI), clinical attachment level (CAL) and PD at baseline, 1 month, 3-months and 6 months.

Results: At 6 months, Group 2 had greater mean reduction (4.73 mm) in PD as compared to Group 1 (2.09 mm; p < 0.05) and also a greater mean CAL gain (3.92 mm versus 1.64 mm; p < 0.05).

Conclusion: The use of 3% SZ gel, when used as an adjunct to non-surgical periodontal therapy in subjects with periodontitis, achieves significantly better clinical results than initial periodontal treatment alone.

Objective: The purpose of this case report is to present the clinical course of full mouth rehabilitation in an 1 8-year-old female patient with ectodermal dysplasia who was treated with implant-supported fixed partial dentures for the mandible and the maxilla.

Case report: Fourteen dental implants (8 in the maxilla and 6 in the mandible) were placed simultaneously after full mouth extraction and alveoloplasty surgery. After 6 months of healing, prosthetic rehabilitation was started for screw-retained fixed partial dentures. The patient was followed for one year and a peri-implant maintenance regime established for six-month recalls. The patient was satisfied with the prosthesis both esthetically and functionally. Furthermore, the patient reported significant improvements in oral function and psychosocial activities.

Conclusion: The use of dental implants to support full mouth prosthetic rehabilitation for adolescents with ectodermal dysplasia may provide a considerable improvement in function and esthetic compared to conventional removable prosthetic options. This has the potential to enhance the quality of life for these patients.

Objective: The main aim of this study was to develop a simplified quantitative denture plaque index that could help dentists to motivate denture patients to maintain optimal oral hygiene. The secondary aim was to assess specific areas of dentures more prone to accumulate plaque and subjects' oral hygiene habits related to their dentures.

Methods: One hundred subjects who wore maxillary and/or mandibular complete dentures for at least one year were included in the study as a powered sample. Fifteen females and 85 males, age range 45-75 years, were recruited. The study was carried out at King Saud University (KSU), College of Dentistry. A plaque disclosing solution was used to assess the plaque covered areas of denture. A quantitative percentage (10 x 10%) score index was developed by assessing plaque scores from digital images of intaglio surfaces of the dentures. The weighted kappa method was used to assess inter-examiner agreement in the main study.

Results: The new denture plaque index was identified as ASKD-DPI (Almas, Salameh, Kutkut, and Doubali-Denture Plaque Index). It ranged from 0 - 100%, and reflected the percentage of the intaglio surfaces of maxillary and mandibular complete dentures that contained plaque. It also classified quantitative percentages: 30 subjects ranged from 0 - 30% (low DPI), 50 subjects ranged from 31 - 70% (moderate DPI), and 20 subjects ranged from 71 - 100% (high DPI) denture plaque score.

Conclusions: A simplified denture plaque index (ASKD-DPI) technique was developed and tested in this study. ASKD-DPI may be used for evaluating denture plaque scores, monitoring denture hygiene, and measuring compliance of patients regarding plaque control for complete dentures.

Objective: In a secondary data analysis, this pilot study evaluated the relationship between subgingival biofilm morphotypes and chronic periodontitis progression in treated adults.

Methods: Periodontal parameters in 47 adults with chronic periodontitis were assessed by a calibrated examiner at baseline and a mean 4.5 years after a non-surgical periodontal therapy regimen. Microbial and inflammatory cell morphotypes in subgingival biofilm specimens from each patient were evaluated with phase-contrast microscopy at baseline, and at post-treatment intervals. Chronic periodontitis progression in patients was defined as ≥ 2 teeth exhibiting ≥ 3 mm interproximal clinical periodontal attachment loss from baseline evaluations. Bivariate and odds ratio analysis assessed baseline and post-treatment variables relative to chronic periodontitis progression.

Results: Eight (17%) patients had chronic periodontitis progression. No baseline clinical, radiographic or microbiological variables, and no post-treatment clinical variables demonstrated statistically significant relationships with chronic periodontitis progression. Elevated post-treatment counts of subgingival spirochetes, medium to large-sized motile rods, and crevicular leukocytes, both alone and concurrently, appeared more frequently in patients experiencing chronic periodontitis progression. A post-treatment occurrence of high concurrent counts of subgingival spirochetes and crevicular leukocytes exhibited the strongest association with chronic periodontitis progression (odds ratio = 10.1; 95% Cl = 2.2, 45.4; p = 0.004), which was greater than with either morphotype alone.

Conclusions: Joint morphotype analysis of subgingival spirochetes and crevicular leukocytes, as simplified biomarkers of pathogenic biofilm infection and host inflammatory responses in periodontal pockets, may be diagnostically useful in assessing risk of progressive disease in treated chronic periodontitis patients.