Clinical efficacy of periodontal endoscopy-assisted subgingival scaling and root planning and its effect on psychology and quality of life in patients with periodontitis / 口腔疾病防治

Objective@#To investigate the clinical efficacy and effects of periodontal endoscope (PE)-assisted subgingival scaling and root planning (SRP) and traditional SRP on the psychological and quality of life of patients with periodontitis.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Patients with periodontitis who were treated in the Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University from April 2018 to December 2022 with residual periodontal pockets (PD ≥ 5 mm) 6 weeks after traditional SRP treatment were enrolled, and the residual periodontal pockets were further treated with PE-assisted SRP (PE+SRP). After 6 weeks of traditional SRP treatment and 3 months of PE+SRP treatment, clinical indicators, including plaque index (PLI), probing depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP), were measured, and periodontal tissue self-awareness scale scores, oral health impact profile-14 (OHIP-14) score and dental fear scale (DFS) score were collected. Moreover, visual analog scale (VAS) scores were collected after traditional SRP and PE-assisted SRP treatments.@*Results@#Twenty-three patients with periodontitis, including 832 sites of 486 affected teeth, were included in the clinical study. Three months after PE+SRP treatment, all clinical periodontal indicators, PLI (t = 9.254, P<0.001), PD (t = 50.724, P<0.001), CAL (t = 22.407, P<0.001) and BOP (t = 9.217, P<0.001), were significantly improved. Compared with traditional SRP (VAS: 2.48 ± 1.70), the pain caused by PE+SRP (VAS: 2.57±1.80) was not significantly different (t = 0,192, P = 0.850). There was no significant difference in the scores of the periodontal tissue self-awareness scale between the two groups (t = 1.485, P = 0.152). The OHIP-14 (SRP: 12.13±7.63; PE+SRP: 10.26 ± 5.25, t = -1.589, P = 0.126) and DFS (SRP: 40.70 ± 12.63; SRP+PE: 41.57 ± 12.61, t = 0.404, P = 0.690) scores were not significantly different.@*Conclusion@#All clinical periodontal indicators were significantly improved after PE-assisted SRP treatment of residual periodontal pockets, and compared with traditional SRP, PE-assisted SRP had no negative impact on the quality of life or psychological status of patients with periodontitis. Therefore, PE+SRP can be promoted in clinical practice.

Assessment of Subgingival Biofilm and its Relationship with the Status of Tumors in a Population with Breast Cancer

This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.

El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.

gDNA extraction from Candida albicans and Candida dubliniensis in subgingival samples in Argentina. Evaluation of different methods / Evaluación de diferentes métodos de extracción de gADN en Candida albicans y Candida dubliniensis en muestras subgingivales en Argentina

ABSTRACT The oral cavity constitutes a unique ecosystem with highly variable ecological niches that harbor a great variety of microorganisms, including yeasts. Molecular methods are currently considered the gold standard for identifying species, although they involve limitations associated with the disruption of yeast cell walls to release the genomic DNA (gDNA) for amplification. Aim: The aim of this study was to compare the performance of different methods for extracting gDNA from Candida albicans and Candida dubliniensis, subsequently amplifying DNA by PCR. Materials and Method: Fifty-two isolates (16 C. albicans and 36 C. dubliniensis) were obtained from subgingival biofilm of HIV+ patients with clinical signs of periodontal disease. The study evaluated 6 gDNA extraction methods and two PCR amplification methods. Furthermore, the presence of alleles of HWP1 gene was determined in C. albicans. Results: Comparisons of six methods show statistically significant differences (p<0.001) except for C. albicans in two of them. For C. dubliniensis, statistical differences were observed in all comparisons. Commercial methods were more efficient for concentrating gDNA than in-house methods, and both PCRs were effective. Ten heterozygous C. albicans isolates for this allele were positive for the HWP1-1 / HWP1-2 allele, one was homozygous for Wild Type HWP1-1 allele, and 5 were homozygous for novel/rare HWP1-2 allele. Conclusions: This study aims to provide simple, inexpensive strategies for phenotypic identification and molecular confirmation of Candida albicans and Candida dubliniensis for non-reference laboratories with low complexity and/or low budgets.

RESUMEN La cavidad oral constituye un ecosistema único con nichos ecológicos muy variables, capaz de albergar una gran variedad de microorganismos, incluidas las levaduras. Los métodos moleculares son considerados actualmente los métodos de identificación definitivos ya que a diferencia de los anteriores, nos brindan una correcta sensibilidad y especificidad. Sin embargo, existen limitaciones asociadas con la ruptura de las paredes celulares de estas levaduras para liberar el ADN genómico (gADN) necesario para la amplificación. Objetivo: El objetivo de este estudio fue comparar el rendimiento de diferentes métodos de extracción de gADN de Candida albicans y Candida dubliniensis, amplificando posteriormente por PCR. Materiales y Método: Se estudiaron 52 aislamientos, 16/52 de Candida albicans y 36/52 de Candida dubliniensis obtenidos de biofilm subgingival de pacientes VIH+ con signos clínicos de enfermedad periodontal. Se evaluaron seis métodos de extracción de gADN y la posterior amplificación se realizó por dos técnicas de PCR. Además en C. albicans se determinó la presencia de alelos para el gen HWP1. Resultados: Las comparaciones de seis métodos son estadísticamente significativas (p<0,001) excepto para C. albicans en dos de ellos. Para C. dubliniensis se observaron diferencias estadísticas en todas las comparaciones. Los métodos comerciales mostraron una mayor eficiencia en la concentración de gADN que los métodos caseros y ambos fueron efectivos en las dos PCR. 10 aislados de C. albicans resultaron positivos para el alelo HWP1-1/HWP1-2, siendo heterocigotos para este alelo. Solo un aislamiento fue homocigoto para el alelo HWP1-1 de tipo salvaje y 5 eran homocigotos para el alelo HWP1-2 nuevo/raro. Conclusiones: Este estudio tiene como objetivo proporcionar estrategias simples y económicas para la identificación fenotípica y confirmación molecular de Candida albicans y Candida dubliniensis para laboratorios de no referencia con baja complejidad y/o bajo presupuesto económico.

Clinical application progress on the diode laser in nonsurgical periodontal treatment / 口腔疾病防治

@#Chronic periodontitis is a chronic inflammatory disease caused by plaque microorganisms, and removal of plaque and calculus is the gold standard for nonsurgical periodontal treatment. However, complete debridement is difficult, especially in some complex anatomical sites. Excessive scaling may result in the loss of healthy cementum and lead to dental hypersensitivity. Studies have shown that a diode laser can exhibit the best performance in an environment with blood because its wavelengths (630-1 064 nm) are close to the absorption peaks of heme and melanin and they have broad application prospects in the oral field. In nonsurgical periodontal treatment, diode lasers have three treatment modes: soft diode laser, antimicrobial photodynamic therapy and low-level laser therapy, which can be used alone or in combination. Although diode lasers cannot replace mechanical treatment to remove calculus, they can remove infected periodontal pocket epithelium, change the microcirculation to promote wound healing, reduce bleeding and relieve pain through photothermal effects and biological stimulation. The effect of diode laser treatment depends on the treatment dose. It is necessary to precisely control the output intensity and control the irradiation time to avoid thermal damage to the tissue. In the future, extensive research at the molecular level is needed to reveal the tissue response. At the same time, more high-quality, large-sample randomized controlled trials are needed to standardize the use of lasers for different stages and grades of periodontitis.

Distinguishing subgingival plaques of patients with chronic periodontitis and type 2 diabetes mellitus based on Raman spectroscopy / 中国医科大学学报

Objective The aim of this study is to combine Raman spectroscopy and machine learning techniques to distinguish subgin-gival plaques among three groups of subjects,including patients with chronic periodontitis(CP)and type 2 diabetes mellitus(T2DM),patients with CP alone,and healthy controls.Methods The Raman spectra of the subgingival plaques from 20 patients with CP and T2DM(group A),23 patients with CP alone(group B),and 23 healthy controls(group C)were obtained using a portable Raman spec-trometer.Eight common machine learning algorithms were applied to build models to distinguish the Raman spectra of the three types of subgingival plaques.Results The model identified as optimal for distinguishing the three types of subgingival plaques was linear discri-minant analysis(LDA).The optimal model to distinguish groups A and B is LDA,groups A and C is extra trees(ET),and groups B and C group is LDA.Conclusion The proposed classification model based on Raman spectroscopy and machine learning algorithms can dis-tinguish subgingival plaques among patients with CP and T2DM,with CP alone,and healthy controls.This technique can be used in future clinical practice as a screening or diagnostic tool.

Effect of Nd:YAP laser combined with periodontal basic treatment on periodontitis / 中国现代医生

Objective To investigate effect of Nd:YAP laser combined with periodontal basic treatment on periodontal indexes,subgingival microflora,adiponectin,matrix metalloproteinase-13(MMP-13),interleukin-6(IL-6)in gingival crevicular fluid in patients with periodontitis.Methods A total of 162 patients with periodontitis diagnosed and treated in the First People's Hospital of Huzhou from January 2020 to December 2021 were selected and divided into experimental group(n=55),basic group(n=54)and control group(n=53)by random number table method.The basic group received periodontal basic treatment,the control group was given Nd:YAP laser treatment,and the experimental group was given Nd:YAP laser combined with periodontal basic treatment.The clinical efficacy,probing depth(PD),bleeding index(BI),clinical attachment loss(CAL),plaque index(PLI),subgingival microflora,adiponectin,MMP-13 and IL-6 levels in gingival creval fluid and the incidence of complications were compared among three groups.Results At 6 weeks after treatment,there was significant difference in the total effective rate among three groups(P<0.05),and experimental group>control group>basic group.At 6 weeks after treatment,PD,CAL,BI,PLI,bacteroides,clostridium,lactobacillus,MMP-13 and IL-6 in three groups were significantly lower than before treatment,and adiponectin were significantly higher than before treatment(P<0.05).PD,CAL,BI,PLI,bacteroides,clostridium,lactobacillus,MMP-13 and IL-6 in experimental group were significantly lower than those in control group and basic group,and adiponectin was significantly higher than that in control group and basic group(P<0.05).There was no significant difference in the incidence of adverse reactions among three groups(P>0.05).Conclusion Nd:YAP laser combined with periodontal basic treatment has a good therapeutic effect on periodontitis,which can improve periodontal indexes,subgingival microflora,and adiponectin,MMP-13 and IL-6 in gingival crevicular fluid.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Evaluation of efficacy of subgingival administration of 1% chlorhexidine gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis - A clinical and microbiological study

Aim: The aim of the present study was to evaluate the clinical and microbiological effects of subgingival administration of 1% chlorhexidine gel (Chlorhexamed® 1% gel) in patients with chronic periodontitis. Settings and Design: The study was done in a parallel?arm design with a total of 30 patients with 60 sites suffering from chronic periodontitis. The patients were divided into control and experimental groups. Materials and Methods: The clinical parameters recorded were plaque index, gingival index, modified sulcular bleeding index, probing pocket depth and relative attachment level at baseline, 1 month and 3 month. Microbiological colony?forming units were assessed for Porphyromonas gingivalis, Fusobacterium nucleatum and Tannerella forsythia at baseline, 1 week, 1 month and 3 months. The control group received scaling and root planing (SRP) after baseline evaluation; however, the experimental group received the application of Chlorhexamed® gel within 48 hours after SRP. Then, the values obtained were subjected to statistical analysis. Results: Both groups showed significant improvement from the baseline to 3 months in all clinical and microbiological parameters. The experimental group showed better improvement in all parameters. Conclusion: The use of Chlorhexamed® gel has proven to be an efficacious adjunct with SRP in the treatment of chronic periodontitis.

Endoscope-assisted subgingival scaling and root planing in the treatment of periodontitis: systematic evaluation of effects / 口腔疾病防治

Objective @#To evaluate the clinical effect of endoscopic-assisted subgingival scaling and root planning (SRP) in the treatment of periodontitis. @*Methods@#PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were searched for randomized controlled trials (RCTs) related to endoscopy-assisted SRP. The search time limit was from the establishment of the database to September 15, 2021. The outcome indicators included in the study included the plaque index (PLI), probing depth (PD), attachment loss (AL), and bleeding index (BI). Review Manager 5.4 and Stata 12.0 software were used for the meta-analysis.@* Results@#A total of 111 studies were retrieved, and 5 quantitative studies were included after screening. Meta-analysis showed that for sites with 4 mm ≤ PD < 6 mm, 3 and 6 months after treatment, there was no significant difference in the PD value between the endoscope assisted group and the simple SRP group (P > 0.05); for sites with PD ≥ 6 mm, the PD value of the endoscope assisted group was smaller than that of the simple SRP group 3 and 6 months after treatment. The difference between the two groups was statistically significant (P < 0.05), but there was no significant difference in PLI, Al or BI between the two groups (P > 0.05). @*Conclusion@#Compared with simple SRP, the auxiliary use of endoscopy has a better effect on reducing PD in deep periodontal pockets (PD ≥ 6 mm). However, for clinical indicators such as PLI, AL, and BI, there was no difference between the therapeutic effects of the two methods.

Study on the effects of periodontal subgingival scaling under the mode of standardized residency training of stomatology general medicine / 中华医学教育探索杂志

Objective:To observe the effects of the periodontal subgingival scaling in different stages of standardized residency training of stomatology general medicine.Methods:Thirty residents in Affiliated Stomatology Hospital of Zhejiang University School of Medicine were recruited by stratified randomization and divided into three groups, including 1-month group, 3-month group and 6-month group. The residual ratio of clinical calculus was compared after periodontal subgingival scaling among groups. SPSS 23.0 was conducted for Kruskal-Wallis H test. Results:The mean residual ratio of clinical calculus in 3-month group and 6-month group were significantly lower than that in the 1-month group. In the 3-month group, the scaling could only achieve the effective results at the shallow pockets and anterior tooth area. Compared with the 1-month group, the 6-month group significantly decreased the residual ratio of clinical calculus for the sites with pocket depth of 4-6 mm, but there were still insufficiency to deal with the posterior tooth area.Conclusion:The 3-6 months residency training of periodontology could improve the effectiveness of the periodontal subgingival scaling. We should establish reasonable assessment and evaluation system according to different stages of residents, and the subgingival scaling training in the posterior areas and the distal interproximal sites should be reinforced in order to more effectively improve the quality of the standardized residency training.

High-throughput sequencing analysis of the microbiota of subgingival plaque in patients with periodontitis / 口腔疾病防治

Objective @# To detect the composition of the subgingival microbiota in generalized aggressive periodontitis (GAgP) and severe chronic periodontitis (SCP) patients tested by high-throughput sequencing (HTS) technologies, analyze its diversity and function by using bioinformatics, and observe changes in the subgingival microbiota before and after periodontal initial therapy.@* Methods@#Eleven patients with GAgP and 14 patients with SCP who visited the Department of Periodontics in Stomatological Hospital of Kunming Medical University from September 2018 to May 2019 were recruited, and subgingival plaque samples were collected at baseline and 6 weeks after initial therapy. Then, the genomic DNA was distracted and sequenced by the Illumina MiSeq high-throughput sequencing platform. QIIME (quantitative insights in microbial ecology), Mothur, SPSS and other software were used to analyze community information. LEfSe difference analysis (linear discriminant analysis effect size), network analysis, and the KEGG PATHWAY database (https://www.kegg.jp/kegg/pathway.html) were used to predict community function. @* Results @# At baseline, the dominant microbiota of GAgP and SCP patients were similar, including Bacteroidetes, Porphyromonas and Porphyromonas endodontalis. Six weeks after initial therapy, as the periodontal pocket became shallower, the variation trend of the microbiota of GAgP and SCP patients was similar. The relative abundance of gram-negative bacteria, such as Bacteroidetes, Porphyromonas and Porphyromonas endodontalis, decreased, while the relative abundance of gram-positive bacteria, such as Proteobacteria, Actinomyces and Rothia aeria, increased. Actinobacteria were significantly increased biomarkers of the subgingival microbiota in GAgP after treatment. Streptococcus is an important genus that connects the microbiota related to periodontitis and the microbiota related to periodontal health. Community function prediction result showed that initial treatment can reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients.@*Conclusion@#The subgingival microbiota of GAgP and SCP patients are similar. Streptococcus, as an early colonizer, may play an important role in promoting plaque biofilm formation and maturation in the process of subgingival flora from health to imbalance. Initial therapy can change the composition and structure of the subgingival microbiota, reduce community diversity, and reduce the functions of amino acid metabolism, methane metabolism, and peptidase in GAgP and SCP patients.

Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy / 口腔疾病防治

Objective @# To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. @*Methods@# Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.@*Results@# For sites of 4<PD ≤ 6 mm, there was no significant difference in PD- and BOP-positive rates or AL between the two groups at baseline. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). @*Conclusion @#When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

Effects of ultrasonic subgingival scaling and root planing with a periodontal endoscope on the root surface / 口腔疾病防治

Objective @# To evaluate the effects of root calculus residue and root cement preservation by ultrasonic subgingival scaling and root planing (SRP) with or without perioscopy.@*Methods @# Twelve teeth extracted due to severe periodontitis were randomly divided into three groups with four teeth in each group: ① Endoscope-assisted SRP group. The root surfaces of the affected teeth were cleaned with an EMS ultrasonic treatment instrument. ② Traditional SRP group. The affected teeth were treated by ultrasonic subgingival scaling and hand root planing with a Gracey curette. ③ Untreat group. The above operations were performed by the same senior physician. Under local anesthesia, each tooth was scraped for 10 minutes and then extracted. The residual amount of calculus on the root surface after plaque staining was observed and recorded. The thickness of the retained cementum at 1/3 of the root neck was measured.@*Results@# The residual rate of calculus on the root surface was the lowest in the endoscope-assisted SRP group, which was significantly different from the traditional SRP group and the untreated group (P < 0.001). Histological observation showed that the mean residual cementum thickness at 1/3 of the root neck increased gradually from the cemento-enamel junction (CEJ), 2.5 mm below the CEJ and 5 mm below the CEJ. Ultrasound SRP assisted by endoscopy caused less damage to the cementum and preserved the cementum better than traditional subgingival scaling (P < 0.001). @*Conclusion@# Compared with traditional SRP therapy, endoscope-assisted SRP treatment can remove subgingival plaque and calculus more effectively and can better preserve the cementum of the root surface.

Effect of the antimicrobial photodynamic therapy in the treatment of periodontitis in type 2 diabetes mellitus: a systematic review and meta-analysis / 口腔疾病防治

Objective@#This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis.@*Methods@#The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted.@*Results@#A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI（-0.45, -0.2）, P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI（-0.40, 0.10）,P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05).@*Conclusion@#aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.

Clinical study of periodontal endoscope-assisted subgingival scaling in the treatment of residual pocket / 华西口腔医学杂志

OBJECTIVES@#To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets.@*METHODS@#A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared.@*RESULTS@#A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (@*CONCLUSIONS@#Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.

Influence of mechanical debridement on the subgingival microbiome in chronic periodontitis / 口腔疾病防治

Objective@# To investigate the influence of mechanical debridement on the subgingival microbiome in chronic periodontitis by 16S rRNA high-throughput sequencing.@*Methods@#Patients with generalized moderate to severe chronic periodontitis were recruited into this study and received oral hygiene instruction and supragingival scaling. One week later, they received ultrasonic and manual subgingival scaling and root planning. Clinical parameters were recorded and subgingival plaques were sampled at baseline and 3 months and 6 months after treatment. The comprehensive profiles of the subgingival microbiome were analyzed by sequencing the V3-4 region of 16S rRNA with the Illumina MiSeq platform.@*Results @#Alpha diversity analysis showed that the richness and diversity of the subgingival community were consistent before and after treatment, but a significant difference in community structure was detected only between baseline and month 3 by principal coordinates analysis (PCoA). After 3 months, the clinical parameter as probing depth (PD) decreased significantly and the relative abundances of the genera related to periodontitis such as Porphyromonas, Treponema, Tannerella, and Filifactor decreased significantly. Meanwhile, the relative abundances of the genera associated with periodontal health increased, such as Capnocytophaga, Kingella. Six months later, however, less genera related to periodontitis decreased significantly from the baseline level, such as Filifactor. PD decreased significantly compared with baseline, but increased significantly compared with 3 months after treatment. @* Conclusion@#Mechanical debridement alone could relieve periodontal inflammation and balance microbial dysbiosis and the greater efficacy occurred 3 months after treatment.

Research progress on the relationship between Fusobacterium nucleatum and periodontitis / 口腔疾病防治

@#Periodontitis is an infectious disease caused by a variety of microorganisms. Fusobacterium nucleatum is closely related to periodontitis with a high detection rate. Fusobacterium nucleatum is able to coaggregate with other microorganisms and attach and invade epithelial cells with the help of adhesins. It can also promote the occurrence and development of periodontal diseases and even systemic diseases by destroying periodontal tissues with virulence factors and metabolites and inducing a host immune response. However, at present, drugs assisting periodontal nonsurgical treatment clinically cannot target specific periodontal pathogens, such as Fusobacterium nucleatum, which may lead to problems such as dysbacteriosis or drug resistance. Therefore, studies on the pathogenic mechanism of Fusobacterium nucleatum provide new ideas for the prevention and treatment of periodontitis. The idea is to develop materials, drugs, or probiotics that target adhesins, virulence factors, and metabolites or cut off each pathogenic pathway of Fusobacterium nucleatum to inhibit its proliferation and inflammatory responses in deep periodontal pockets and achieve a balance with other oral microorganisms, and the host is beneficial for the control of periodontitis.

Clinical efficacy of Nd:YAG laser adjunct to subgingival scaling and root planning for treating severe chronic periodontitis / 西安交通大学学报(医学版)

【Objective】 To evaluate the efficacy of Nd: YAG laser therapy adjunct to subgingival scaling and root planning (SRP) for treating severe chronic periodontitis. 【Methods】 We selected patients with severe chronic periodontitis whose teeth were distributed in 4 quadrants of the mouth, with probing depth (PD) of 5-8 mm, attachment loss (AL)≥5 mm and bleeding on probing (BOP). These teeth were randomly divided into three groups: SRP group, SRP+L group (Nd: YAG laser after SRP treatment), and L+SRP group (SRP after Nd: YAG laser treatment). We recorded parameters including BOP, PD and AL of the three groups at baseline and 8 weeks after treatment and made statistical analysis. 【Results】 At 8 weeks after treatment, BOP, PD and AL of the three groups were improved than those in the baseline (P<0.05). BOP positive percentage of SRP+L group and L+SRP group significantly reduced compared with SRP group (P<0.05). PD of SRP+L group significantly decreased compared with SRP group and L+SRP group (P<0.05), for sites with PD=7 mm, SRP+L group was significantly decreased compared with SRP and L+SRP groups (P<0.05). AL of SRP group significantly decreased compared with SRP+L group and L+SRP group (P<0.05). 【Conclusion】 Severe periodontal treatment with Nd:YAG laser adjunct to SRP is more effective in reducing BOP and PD, and for deeper pockets PD is significantly decreased in SRP+L group, but there is no advantage in the improvement of AL.

Frecuencia de Pseudomonas aeruginosa en bolsas periodontales de pacientes con Periodontitis Crónica / Frequency of Pseudomonas aeruginosa in periodontal pockets of patients with Chronic Periodontitis

La periodontitis crónica es una patología caracterizada por la destrucción de los tejidos de soporte del diente. Existe evidencia científica de la presencia en bolsas periodontales de Pseudomonas aeruginosa, bacteria que altera la microbiota subgingival. Ha sido asociada al fracaso en el tratamiento de la periodontitis y podría constituir un riesgo para la salud general de los pacientes. El objetivo de esta investigación fue determinar la frecuencia de P. aeruginosa en bolsas periodontales de pacientes con periodontitis crónica que acudieron a la cátedra de Periodoncia de la Universidad Autónoma de Asunción. El estudio fue observacional descriptivo de corte transversal, para el mismo fueron seleccionados pacientes con periodontitis crónica que cumplían con los criterios de inclusión. Las piezas dentariasseleccionadas para la toma de muestras fueron aisladas con rollos de algodón estéril, y una vez removida la placa bacteriana supragingival, se retiró la placa subgingival de las bolsas periodontales por medio de curetas de Gracey y se introdujeron en tubos de ensayo que contenían medio de Stuart, para luego llevar las muestras hasta el laboratorio de microbiología para su análisis. Del total de 14 muestras, solo una dio positivo a P. aeruginosa representando el 7,14%. El microrganismo aislado resultó resistente a los antibióticos utilizados como coadyuvantes en el tratamiento de la periodontitis crónica,al igual que en otros trabajos encontrados en la literatura internacional. La presencia de estas bacterias dificulta el control de la enfermedad periodontal y podría significar un riesgo para desarrollar infecciones oportunistas, especialmente en los pacientes inmunodeprimidos

Chronic periodontitis is a pathology characterized by the destruction of tooth supporting tissues. There is scientific evidence of the presence in periodontal pockets of Pseudomonas aeruginosa, a bacterium that alters the subgingival microbiota and that has been associated with failure to treat periodontitis and could constitute a risk to patient general health. The objective of this research was to determine the frequency of P. aeruginosa in periodontal pockets of patients with chronic periodontitis who attend the Chair of Periodontology at the Autonomous University of Asunción. Descriptive, cross-sectional observational study, in which patients with chronic periodontitis who met the inclusion criteria were selected. The pieces selected for sampling were isolated with sterile cotton rolls, and once the supragingival bacterial plaque had been removed, the subgingival plaque was removed from the periodontal pockets by means of Gracey curettes and placed in test tubes containing Stuart medium, then the samples were taken to the microbiology lab for analysis. Of the total of 14 samples, only one was positive for P. aeruginosa, representing 7.14%. The isolated microorganism was resistant to the antibiotics used as adjuvants in the treatment of chronic periodontitis, as in other studies found in the international literature. The presence of these bacteria makes it difficult to control periodontal disease and could pose a risk for developing opportunistic infections, especially in immunosuppressed patients

A preliminary study on bacterial composition in the subgingival plaque of woman with periodontitis during pregnancy and menopause

Aim: The aim of the present study was to explore the bacterial composition in subgingival plaque of females with periodontitis during pregnancy and menopause stages using 16S ribosomal RNA (rRNA) gene pyrosequencing approach.Methodology: Subgingival plaque was collected from four woman volunteers (healthy, periodontitis, periodontitis at pregnancy and periodontitis at menopause). The microbial community composition was analyzed by 454/Roche GS FLX chemistry pyrosequencing approach using the variable (V1-V3) region of the 16S rRNA gene. Pyrosequencing reads were sorted to get the clean reads that were annotated against the EzBioCloud data base for taxonomic classification. Operational Taxonomic Units (OTUs) were assigned and shared, and subsequently identified using CLCOMMUNITY software. Results: Pyrosequencing yielded 13,939 sequences comprising of 13 phyla, 124 genera, and 372 species. The predominant microbial phyla in subgingival plaque of all woman volunteers included Firmicutes, Actinobacteria, Fusobacteria, Bacteroidetes, and Proteobacteria. In the healthy volunteer, Streptococcus (52.4%) formed the predominant genus while in woman with periodontitis Streptococcus (24.6%) and Fusobacterium (11.7%) predominated. In the periodontitis volunteer with pregnancy, the predominant genus included Streptococcus (25.8%) and Fusobacterium (22.4%), whereas volunteer with menopause, the gingivitis was associated with genus Alloprevotella (19.5%), Leptotrichia (14.3%), Fusobacterium (12.3%), and Porphyromonas (12.0%). Interpretation: This study proves on preliminary basis that the subgingival microbiome of woman with periodontitis at pregnancy or menopause tend to differ from that of healthy woman, and these species included certain periodontal pathogens such as Fusobacterium nucleatum and Porphyromonas gingivalis