ABSTRACT
BACKGROUND: The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis. METHODS: Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively. RESULTS: Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001). CONCLUSION: Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.
Subject(s)
Aggressive Periodontitis/therapy , Anti-Bacterial Agents/therapeutic use , Clarithromycin/therapeutic use , Periodontal Debridement/methods , Adult , Anti-Bacterial Agents/adverse effects , Clarithromycin/adverse effects , Combined Modality Therapy , Female , Humans , Male , Ultrasonic Surgical Procedures/methods , Young AdultABSTRACT
The purpose of this case series is to describe a restorative and surgical approach to treat the combined defect (CD)-gingival recession associated with noncarious cervical lesions (NCCL)-through connective tissue graft in combination with partial resin composite filling, restoring the crown zone plus 1 mm of the NCCL. A total of 10 patients were included. Bleeding on probing, probing depth, relative gingival recession, clinical attachment level, CD height, and dentin hypersensitivity were measured. The treatment provided statistically significant gain in clinical attachment level and shallow probing depths. The percentage of the combined defect coverage was 70% ± 20.2%. It can be concluded that this treatment protocol, in the presence of a partial resin composite restoration, can be used successfully to treat CD.
Subject(s)
Connective Tissue/transplantation , Dental Restoration, Permanent/methods , Gingival Recession/surgery , Tooth Cervix/pathology , Adult , Composite Resins , Female , Humans , Male , Middle Aged , Periodontal Index , Tooth Crown/surgery , Treatment OutcomeABSTRACT
Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.
