Clinical and microbiological evaluation of surgical and nonsurgical treatment of aggressive periodontitis

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.

Resumo O presente estudo teve como objetivo avaliar os efeitos clínicos e microbiológicos de terapia periodontal cirúrgica e não cirúrgica no tratamento da periodontite agressiva generalizada (PAgG). Dezesseis pacientes portadores de PAgG foram incluídos neste estudo clínico, prospectivo, randomizado, de boca dividida. Os quadrantes superiores de cada paciente foram alocados em dois grupos: um grupo de terapia não-cirúrgica (NST) e um grupo de terapia cirúrgica (ST). Os parâmetros clínicos avaliados foram: índice de placa (PI), sangramento à sondagem índice (BoP), profundidade de sondagem (PD), nível clínico de inserção (CAL) e posição da margem gengival (GMP). Também foram determinadas as concentrações de Porphyromonas gingivalis (Pg) e Aggregatibacter actinomycetemcomitans (Aa) no biofilme subgengival. Os parâmetros clínicos e microbiológicos foram avaliados no início, 3, 6 e 12 meses após o tratamento. A terapia cirúrgica foi capaz de promover maior redução de PD em comparação com NST em bolsas profundas aos 12 meses (p<0,05) e em dentes posteriores aos 6 meses (p<0,05). Além disso, houve maior recessão gengival nos dentes posteriores do grupo ST no 6° mês (p<0,05). Entretanto, ST não promoveu ganho adicionais de inserção (CAL) em nenhum período do avaliação. A avaliação microbiológica não mostrou diferença estatística nos níveis de Aa e Pg, para ambos os grupos, em todos os períodos de acompanhamento. O tratamento cirúrgico promoveu benefícios clínicos similares ao tratamento não cirúrgico em pacientes com PAgG. Além disso, ambas as terapias não conseguiram reduzir os níveis Aa e Pg após terapia.

Evaluation of periodontal response to nonsurgical therapy in pre- and post-menopausal women with periodontitis

The influence of sex steroid hormones on periodontium can be lowered with good plaque control. Aims: The aim of the present study was to evaluate periodontal status in pre- and post-menopausal women with periodontitis following nonsurgical therapy. Settings and Design: Interventional pre–post clinical trial. Subjects and Methods: Periodontal status was measured by periodontal index (PRI), and oral hygiene status was measured by plaque index (PI). Both the parameters were measured at baseline, i.e. before scaling and root planing and after 3 months intervals posttreatment. Statistical Analysis Used: IBM SPSS version 21. Results: The mean PRI scores in premenopausal group were 5.68 ± 0.64 and 2.53 ± 0.13 and PI scores were 1.84 ± 0.17 and 0.91 ± 0.13, respectively, at baseline and 3 months. The mean PRI scores in postmenopausal group were 6.08 ± 0.47 and 2.54 ± 0.12 and PI scores were 1.86 ± 0.25 and 1.00 ± 0.24, respectively, at baseline and 3 months. Conclusions: There was more desirable response to nonsurgical periodontal therapy in both the groups but not much variation in between two groups.

The Adjunctive Effect of 30% Minocycline-Containing Polycaprolactone Strips on Nonsurgical Periodontal Therapy / 대한치주과학회지

This study was undertake to assess the effect of 30% minocycline containing polycaprolactone strip to adult periodontitis patient with respect to utility as a monotherapy, effectiveness of this drug device compared to scaling and root planning, and their ability to enhance scaling and root planning. 48 teeth of 12 adult patients who had at least one teeth qualifying pocket> or =4mm at each quadrant were enrolled in this study by split mouth design. All patients received supragingival scaling and oral hygiene instruction 2 weeks prior to the study. At baseline(time 0), enrolled tooth at each quadrant randomly assigned following one of 4 treatment modalities: root planing only(RP); root planing and placement of minocycline strip into pocket for a week(RP+MC); placement of minocycline strip into pocket for a week with out root planing(MC); 2 consecutive placement of minocycline strip into pocket for 2 weeks by one week(MCx2). Each teeth was evaluated at baseline and months 1, 3 and 6. Clinical indices included plaque index, bleeding on probing, probing pocket depth and clinical attachment level. Among 4 groups, RP+MC group showed the lowest percent site of bleeding on probing at 1, 3 and 6 months. Compared to baseline, all group showed significant reduction of pocket depth at 1, 3 and 6 months. The average pocket depth reduction in RP+MC sites was significantly greater than in the sites receiving RP, MC, and MCx2 at 3 months and in sites receiving MC and MCx2 at 6 months. The reduction in clinical attachment at the sites receiving RP+MC was significantly greater than in the sites receiving RP, MC, and MCx2 at 3 months. Between MC and MCx2 groups, no statistically significances was shown in reduction of pocket depth and clinical attachment level at all period examined. This result suggest that the use of 30% minocycline containing strip may improve periodontal health and may be an effective adjunct to conventional nonsurgical therapy in the treatment of adult periodontitis.