Low-level laser therapy has an additional effect with open flap debridement on the treatment of stage III periodontitis: a split-mouth randomized clinical trial.

OBJECTIVE: The purpose of this randomized, controlled, split-mouth trial was to clarify the clinical efficacy of using low-level laser therapy (LLLT) as an adjunct to open flap debridement in the treatment of periodontitis. METHOD AND MATERIALS: The study was conducted on 10 patients with stage III periodontitis. Clinical parameters were recorded for 70 sites of periodontal pockets at baseline and after 3 months and included Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), and relative attachment level (RAL), and evaluated postoperative pain and dental hypersensitivity. After open flap debridement, the sites were randomly divided into test sites receiving the low-level diode laser (wavelength 808 nm) and control sites treated with laser-off. The Wilcoxon test and Mann-Whitney U-test were used for intra- and inter-group comparisons, respectively, and the Friedman test to test between different periods. RESULTS: Both treatments produced a reduction in GI, BOP, and PD, an increased RGR, and a gain in RAL between baseline and 3 months after surgery. There were significant improvements in GI, PD, and RAL after 3 months; postoperative pain after 24 hours and after 3 days; and dental hypersensitivity after 1 week and 1 month of the surgery, which significantly decreased in the test group. CONCLUSION: Both groups were clinically effective in treating stage III periodontitis, with a significant preference in reduction of GI and PD and gain of RAL, and decreased postoperative pain (after 24 hours and 3 days) and dentinal hypersensitivity (after 1 week and 1 month) for open flap debridement+LLLT. CLINICAL RELEVANCE: The use of LLLT as an adjunct to open flap debridement improved the clinical indices, postoperative pain, and dentinal hypersensitivity better than open flap debridement alone in the treatment of stage III periodontitis.

Clinical outcomes of performance of dental students using erythritol powder by means of air polishing with ultrasonic debridement with students' assessment: Part II.

OBJECTIVE: Assessment of a dental student's clinical performance is essential for providing feedback for improving education. This study evaluated the ability of undergraduate dental students to treat periodontal patients with two techniques, ultrasonic debridement with polishing (UD+P) and the erythritol powder air polishing with ultrasonic instrumentation (EPAP+UD) in a split-mouth design. METHODS: The study was conducted on undergraduate students with patients suffering from gingivitis and stage I periodontitis with grade A. The evaluation consisted of two parts: first, assessment of the student by clinical indices (full mouth plaque index (FMPI), calculus index (CI), remaining calculus index (RCI), modified gingival index (MGI) and papillary bleeding index (PBI)) at baseline, immediately and after 2 weeks. In addition to assessing treatment time for each student; and second, obtaining student feedback about the two methods used. RESULTS: Five undergraduate fourth years' students, and thirteen patients participated. Statistically significant decreases in FMPI, CI, MGI and PBI between baseline and 2 weeks post-treatment were noted in both test and control groups. At 2 weeks of inter-group comparisons, there was a statistically significant difference in FMPI and MGI indices, and immediately after the treatment, there was also a significant reduction in FMPI and CI. Treatment time was significantly less for the EPAP+UD method, and it got 10-time method preferring in comparison with the control group (UD+P) by students. CONCLUSION: The undergraduate dental student has the capacity to treat the periodontal patient using both approaches with a preference for the EPAP+UI approach over UI+P. In addition, this EPAP+UI is a promising method of education.

Clinical effectiveness of a topical subgingival application of injectable platelet-rich fibrin as adjunctive therapy to scaling and root planing: a double-blind, split-mouth, randomized, prospective, comparative controlled trial.

OBJECTIVE: The purpose of this randomized, controlled, split-mouth clinical trial was to clarify the clinical efficacy of using injectable platelet-rich fibrin (i-PRF) as an adjunctive subgingival irrigation to scaling and root planing (SRP) in the treatment of periodontitis. METHOD AND MATERIALS: The study was conducted in 15 patients suffering from stage II to III with grade B to C periodontitis with bilateral periodontal pockets (≥ 5 mm) on a minimum of two teeth without degree II or III of furcation involvement or tooth mobility. The evaluated clinical parameters were: Plaque Index (PI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession at baseline and after 3 months. After full-mouth supra- and subgingival SRP, the sites were randomly divided into test sites receiving the subgingival application of i-PRF and controls treated with saline. The Wilcoxon test and Mann-Whitney U test were used for intra- and inter-group comparisons, respectively. RESULTS: In total, 726 sites were treated (388 test group and 338 control group) with no uneventful healing effects. Statistically significant decreases in PI (P = .001), BOP (P = .001 for both groups), PPD (P = .001 and P = .000 for test and control groups, respectively), CAL (P = .015 and P = .001 for test and control groups, respectively) between pretreatment and 3 months posttreatment were noted in both test and control groups. For inter-group comparisons, there was no statistically significant difference in all clinical indices (P > .05). CONCLUSION: In this study, both groups were clinically effective as nonsurgical periodontal treatments, without any clinical benefits of using i-PRF.

Clinical outcomes of using erythritol powder by means of air polishing with ultrasonic debridement in the treatment of initial periodontal pockets in hand of dental students: A split-mouth, randomized, comparative, controlled study. Part I.

OBJECTIVE: The purpose of this trial was to evaluate the clinical efficacy and patient acceptance of using the erythritol powder air polishing with mechanical debridement in non-surgical periodontal therapy. METHODS: The trial was conducted as a split-mouth design study of 6 weeks' duration including 13 patients with gingivitis and stage I periodontitis with grade A. Each patient received ultrasonic debridement and polishing (UD+P) on one side, whereas the contralateral side was treated by erythritol powder air polishing and ultrasonic instrumentation (EPAP+UI) when required. Clinical variables were as follows: papillary bleeding index (PBI), bleeding on probing (BOP), full mouth plaque index (FMPI), calculus index (CI), modified gingival index (MGI), probing pocket depth (PPD), the time needed and rate the pain for each group. RESULTS: The FMPI, MGI, CI, PBL and BOP parameters improved significantly for both treatment procedures; however, there were no statistically significant differences between the two groups at any of the examinations intervals, except for MGI and CI which showed a significant reduction at 2 weeks compared with baseline. PPD was significantly decreased in EPAP+UI group. Perceived pain intensity was lower for EPAP+UI group than UD+P group without any significant difference during follow-up periods between the two groups. Seven patients favoured air polishing. The treatment's time was (24.92 ± 9.260 and 34.08 ± 9.106) minutes for the test and control side, respectively. CONCLUSION: This study generally revealed no significant differences in clinical outcomes between two groups for gingivitis and stage I periodontitis treatment. However, EPAP+UI had higher patient's preference and less time-consuming compared with UD+P.