Supportive periodontal care with or without subgingival instrumentation: Microbiological results of a 2-year randomized clinical trial.

AIM: To compare the subgingival microbiota of patients receiving supportive periodontal care (SPC) with and without subgingival instrumentation, over 2 years. MATERIALS AND METHODS: This study was a randomized clinical trial that included 62 participants (50.97 ± 9.26 years old; 40 females) who completed non-surgical periodontal therapy. Participants were randomly assigned to receive oral prophylaxis with oral hygiene instructions alone (test) or in combination with subgingival instrumentation (control) during SPC. Pooled subgingival biofilm samples were obtained from four sites per patient at SPC baseline and at 3, 6, 12, 18, and 24 months. Real-time polymerase chain reaction was used for absolute quantification of Eubacteria and the target bacteria Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. Data were analysed using generalized estimating equations, taking into consideration the clustering of observations within individuals. RESULTS: No significant differences were found between the experimental groups regarding the mean counts of Eubacteria and target bacteria, as well as the periodontal parameters at the sampled sites. Although significant variability in bacterial counts was present during SPC, all counts after 2 years were not statistically different from those at baseline. Bacterial counts were associated with the presence of plaque, bleeding on probing, mean probing depth ≥3 mm, and follow-up period. CONCLUSIONS: SPC with or without subgingival instrumentation can result in comparable subgingival microbiological outcomes. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov: NCT01598155 (https://clinicaltrials.gov/study/NCT01598155?intr=supragingival%20control&rank=4#study-record-dates).

Effect of scaling on serum high-sensitivity C-reactive protein levels and periodontal parameters in systemically healthy women of reproductive age group with gingivitis.

OBJECTIVE: Varying levels of sex hormones across the menstrual cycle in young systemically healthy females may alter tissue responses to plaque, resulting in increased gingival inflammation. Also, higher severity and prevalence of gingivitis has been demonstrated in adult females than males, attributed to hormonal changes. Further, literature reported that Gingivitis raises the levels of systemic inflammatory markers such as C Reactive Protein. This interventional trial aimed to evaluate the effect of supragingival scaling on serum highsensitivity C-reactive protein (hsCRP) levels along with periodontal parameters in systemically healthy women of reproductive age group with natural gingivitis. MATERIAL AND METHODS: 57 women of reproductive age were enrolled into two groups. Test Group (n=30) comprised of systemically healthy women with gingivitis who received supragingival scaling. Control Group (n=27) included systemically and periodontally healthy females. Periodontal parameters [gingival index (GI), plaque index (PI), pocket probing depth (PPD), bleeding on probing (BOP)], and serum hsCRP levels were recorded at baseline for both the groups. Follow up of Test Group participants was done at 3 and 6 months. RESULTS: Serum hsCRP and periodontal parameters were significantly higher in Test Group than control group at baseline which decreased significantly after treatment in Test Group at 6 months follow up (p≤0.05). GI, BOP and hsCRP in Test Group at 6 months were reduced up to the baseline levels of systemically and periodontally healthy females. CONCLUSION: Treatment of gingival inflammation can help in lowering the systemic and local inflammation up to the levels of systemically and periodontally healthy females.

Laser and scanning electron microscopy evaluation of residual microislands of calculus.

BACKGROUND: Recent studies suggest a role for microscopic crystalline particles of residual dental calculus in the pathogenesis of periodontitis. The purpose of this ex vivo study was to compare the effectiveness of scaling and root planing (SRP) alone versus SRP combined with 24% ethylenediamine-tetra acetic acid (EDTA) gel in removing calculus from extracted teeth and to determine the optimal length of time for application of the EDTA. METHODS: Specimens consisted of 32 extracted teeth with heavy root calculus. A 4-mm diameter site was prepared on the root surface of each tooth which then underwent SRP. EDTA was applied to four timed groups: 30 s; 60 s; 120 s; and 180 s. Photomicrographs were taken at 40× magnification using white light (WL) and laser fluorescence (LF). Photomicrographs were analyzed using ImageJ. Specimens were also evaluated with scanning electron microscopy (SEM). RESULTS: The mean area of residual calculus after SRP was 45%-53% (45.6% ± 19.6% WL, 53.8% ± 19.7% LF). Burnishing with EDTA for one minute following SRP reduced calculus to only 14%-18% (13.9% ± 12.5% LF, 18.2% ± 11.1% WL). Use of EDTA for greater than 1 min showed no further calculus removal. SEM revealed the surface of remaining calculus was altered by burnishing with EDTA. CONCLUSION: SRP alone or SRP + 24% EDTA gel failed to remove all calculus. SRP alone removed >60% of calculus from root surfaces. Adjunctive use of 24% EDTA gel burnished on the root surface removed most of the calculus residual after SRP. Calculus remaining after EDTA burnishing exhibited a significantly altered morphologic appearance.

Platelet-Rich Plasma (PRP) and Injectable Platelet-Rich Fibrin (i-PRF) in the Non-Surgical Treatment of Periodontitis-A Systematic Review.

The gold standard in the non-surgical treatment of periodontitis is scaling and root planing (SRP). In recent years, the use of autogenous platelet concentrates has spread over many specialties in dentistry and, thus, has also been gaining popularity in periodontal treatment. Its two main fractions are platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), which, since 2014, can also be used via injection as injectable platelet-rich fibrin (i-PRF). The authors conducted a comprehensive systematic review in accordance with the PRISMA 2020 guidelines. It involved searching PubMed, Embase, Scopus, and Google Scholar databases using the phrases ("Root Planing" OR "Subgingival Curettage" OR "Periodontal Debridement") AND ("Platelet-Rich Plasma"). Based on the authors' inclusion and exclusion criteria, 12 results were included in the review, out of 1170 total results. The objective of this review was to ascertain the impact of utilizing PRP and i-PRF in SRP. The results revealed that both the incorporation of PRP and i-PRF were found to be significantly associated with are duction in gingival pocket depth and again in clinical attachment level; however, i-PRF demonstrated superiority in improving clinical parameters. Furthermore, i-PRF demonstrated notable bactericidal efficacy against Porphyromonas gingivalis. On the other hand, PRP proved inferior to an Nd:YAG laser in clinical parameter improvement; however, it demonstrated significant efficiency as well. This literature review led the authors to the conclusion that autologous platelet concentrates might be competent agents for improving the therapeutic outcomes of SRP.

Effect of an extraoral scavenging device on eliminating droplets and aerosols generated in ultrasonic supragingival scaling: A randomised clinical trial.

OBJECTIVES: Ultrasonic scaling is extensively applied as part of the initial therapy for periodontal diseases, which has been restricted since the outbreak of the COVID-19 pandemic due to droplets and aerosols generated by ultrasonic devices. An extraoral scavenging device (EOS) was designed for diminishing droplets and aerosols in dental clinics. The objective of this study is to evaluate the effect of EOS on eliminating droplets and aerosols during ultrasonic supragingival scaling. METHODS: This single-blinded, randomised controlled clinical trial enrolled 45 patients with generalised periodontitis (stage I or II, grade A or B) or plaque-induced gingivitis. The patients were randomly allocated and received ultrasonic supragingival scaling under three different intervention measures: only saliva ejector (SE), SE plus EOS and SE plus high-volume evacuation (HVE). The natural sedimentation method was applied to sample droplets and aerosols before or during supragingival scaling. After aerobic culturing, colony-forming units (CFUs) were counted and analysed. RESULTS: Compared with the level before treatment, more CFUs of samples throughout treatment could be obtained at the operator's chest and the patient's chest and the table surface when using SE alone (p < 0.05). Compared with the SE group, the SE + EOS group and the SE + HVE group obtained decreasing CFUs at the operator's chest and the patient's chest (p < 0.05), while no significant difference was determined between these two groups. CONCLUSIONS: The EOS effectively eliminated splatter contamination from ultrasonic supragingival scaling, which was an alternative precaution for nosocomial contamination in dental clinics.

Effectiveness of photodynamic therapy on the treatment of chronic periodontitis: a systematic review during 2008-2023.

Objective: This study investigated the effect of photodynamic therapy on chronic periodontitis patients and then evaluated the microbial, immunological, periodontal, and clinical outcomes. The significant effects of photodynamic therapy obtained by in vitro and in vivo studies have made it a popular treatment for periodontal diseases in recent years. Photodynamic therapy is a novel bactericidal strategy that is stronger, faster, and less expensive than scaling and root planing. Method: This study registered on PROSPERO (CRD42021267008) and retrieved fifty-three randomized controlled trials by searching nine databases (Medline, Embase, Scopus, Open Gray, Google Scholar, ProQuest, the Cochrane Library, Web of Science, and ClinicalTrials.gov) from 2008 to 2023. Of 721 records identified through database searches following title and full-text analysis, and excluding duplicate and irrelevant publications, 53 articles were included in this systematic review. Fifty of the 53 eligible studies fulfilled all the criteria in the Joanna Briggs Institute's (JBI's) Checklist for RCTs; the remaining articles met 9-12 criteria and were considered high quality. Results: The present study showed that photodynamic therapy in adjunct to scaling and root planing has the potential to improve periodontal parameters such as clinical attachment loss or gain, decrease in bleeding on probing, and probing pocket depth. In addition, photodynamic therapy decreases the rate of periodontal pathogens and inflammation markers, which, in turn, reduces the progression of periodontitis. Conclusion: Photodynamic therapy is considered a promising, adjunctive, and low-cost therapeutic method that is effective in tissue repair, reducing chronic periodontitis, reducing inflammation, and well-tolerated by patients.

Evaluation of acceptance and preference of topical lidocaine application versus articaine injection anesthesia after nonsurgical periodontal treatment: A randomized clinical trial.

BACKGROUND: To compare acceptance and preference of topical lidocaine gel anesthesia with articaine injection anesthesia in patients with moderate periodontitis undergoing scaling and root debridement. METHODS: Ninety-one patients completed this randomized multicenter split-mouth controlled study and underwent two separate periodontal treatment sessions on different days, one with a topical intrapocket lidocaine gel application and the other with an articaine injection anesthesia in a different order depending on randomization. Parameters measured were the patients' preference for topical lidocaine gel anesthesia or injection anesthesia with articaine (primary efficacy criterion), their maximum and average pain, and their intensity of numbness as well as experience of side effects; the probing depth; and the dentists' preference and their evaluations of handling/application, onset and duration of anesthetic effect, and patient compliance. RESULTS: After having experienced both alternatives, 58.3% of the patients preferred the topical lidocaine gel instillation into the periodontal pockets. The safety profile of the lidocaine gel differed positively from the safety profile of articaine injection in type and frequency of adverse drug reactions. The dentists' acceptance and preference regarding either anesthetic method studied were balanced. CONCLUSIONS: Instillation of lidocaine gel into the periodontal pocket is a preferred alternative to injection anesthesia for most of the patients and an equivalent alternative for dentists in nonsurgical periodontal therapy.

The effect of virtual reality glasses on dental anxiety during scaling and root planing in patients with periodontitis: A randomized controlled clinical trial.

OBJECTIVES: This study aimed to evaluate the effect of virtual reality distraction (VRD) on dental anxiety during scaling and root planing (SRP) in periodontitis patients. MATERIALS AND METHODS: This randomized controlled split-mouth study included 60 patients who scored 9 or above on the dental anxiety scale (DAS) and required SRP in at least two quadrants with at least five teeth and two sites with a probing depth of ≥4 mm. Randomly chosen quadrants were treated using virtual reality glasses, and other quadrants were treated without glasses at the same visit. During VRD, a video of nature scenes was projected onto the screen in front of the patient's eyes. DAS and a visual analogue scale about patient feelings were applied at the end of the procedure. RESULTS: With VRD, the scale value of pain and discomfort level (VASP) was significantly reduced (p = 0.01, d = 0.57). Starting treatment without glasses significantly decreased VASP in both control and test sides (p = 0.00, d = 0.85; p = 0.00, d = 0.80, respectively) and increased the sensation of immersion and realism (p = 0.03, d = 0.45; p = 0.02, d = 0.46, respectively). Intraoperative and postoperative DAS values were significantly lower in patients who started treatment without VRD (p = 0.04, d = 0.34; p = 0.02, d = 0.44, respectively). Of the patients, 63.3% preferred VRD in the subsequent treatment. While patient preference did not correlate with sex, it correlated with age (r = -0.48, p = 0.01). CONCLUSIONS: The VRD and initiating SRP procedure with VRD affected the pain and discomfort level in anxious periodontitis patients. In addition, the anxiety level was also affected by starting the procedure with glasses.

Clinical and microbiologic effect of local application of curcumin as an adjunct to scaling and root planing in periodontitis: Systematic review.

BACKGROUND: The main aim of periodontal therapy is to halt the progression of periodontitis. Curcumin, one of the main components of Curcumin longa, has been well known to possess antimicrobial, anti-inflammatory, and even anticarcinogenic properties. This systematic review assessed the impact of local application of curcumin in the pocket on the clinical and microbiologic parameters as an adjunct to scaling and root planing in periodontitis patients. METHODS: The electronic literature search retrieved 61 studies from PubMed, MEDLINE, and ScienceDirect. After screening titles, abstracts, and keywords and reading through these articles, we identified 9 articles meeting all inclusion criteria, which were included for systematic review. RESULTS: There was a significant difference in both clinical parameters in a short duration of a month after curcumin chips were placed as an adjunct to scaling and root planing as compared to the control. Local application of curcumin also results in slight to significant reduction in the red complex microorganisms. CONCLUSION: This review suggested that local application of curcumin can be considered as a viable adjunct to mechanical debridement in periodontitis. However, further studies need to be conducted to establish its optimum dose, delivery method, and frequency in achieving the best clinical outcomes.

Subgingival scaling and root planing during minimally invasive periodontal surgery: A randomized controlled split-mouth trial.

BACKGROUND: The purpose of this randomized, controlled split-mouth study was to evaluate a videoscope as a visual adjunct to scaling and root planing when utilized in combination with minimally invasive surgery. METHODS: Twenty-five pairs (89 interproximal surfaces) of periodontally hopeless teeth planned for extraction were scaled and root planed with minimal surgical access using surgical loupes (control) or adjunctive use of a videoscope (test). Teeth were extracted with minimal trauma, stained with methylene blue, and photographed with a digital microscope for analysis. The primary outcome of residual calculus was calculated as a percentage of the total interproximal area of interest. Secondary outcomes included treatment time, as well as residual calculus according to probing depth, tooth location, and treatment date. Data were analyzed using Student's paired t-tests, two-way analyses of variance, and Spearman's correlation tests. RESULTS: Residual calculus area was 2.61% on control and 2.71% on test surfaces with no significant difference between groups. Subgroup analysis showed no difference in residual calculus between groups at moderate or deep sites. Treatment time per surface was significantly longer in the test group compared to the control group. Treatment order, tooth location, and operator experience did not significantly affect the primary outcome. CONCLUSIONS: Though the videoscope provided excellent visual access, it did not improve the efficacy of root planing for flat interproximal surfaces during minimally invasive periodontal surgery. Small amounts of calculus remain after instrumentation even with minimal surgical access and when root surfaces appear visually clean and tactilely smooth.

Should supragingival scaling be performed separately prior to subgingival scaling and root planning in nonsurgical periodontal therapy? A systematic review of randomized trials.

OBJECTIVE: To systematically evaluate randomized controlled trials (RCTs), with at least 6 months of follow-up, on whether professional mechanical plaque removal (PMPR) including supragingival scaling should be performed prior and separately from subgingival scaling and root planning (SRP) in nonsurgical periodontal therapy (NSPT), in terms of clinical and patient-reported outcomes (PROs) (CRD42020219759). METHODS: The MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science electronic databases, as well as grey literature sources, were searched by two independent reviewers up to May 2023. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and GRADE for assessing the certainty of evidence. Random-effects pairwise meta-analyses compared the changes in probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BoP) of a stepwise NSPT approach (PMPR prior and separately from SRP) and conventional one-step NSPT through mean differences (MDs) and associated confidence intervals (95% CI). RESULTS: Two RCTs were included, including data of 77 participants with severe periodontitis. One RCT presents high risk of bias and the other has some concerns. No significant differences were found between the stepwise approach and performing both steps simultaneously for any clinical outcomes, with overall very low certainty on evidence. No adverse effects were detected and there was no data on PROs. CONCLUSIONS: There is very-low certainty evidence of no significant difference on PPD and BoP reductions and CAL gain between supragingival scaling performed prior and separately from SRP and conventional one-step NSPT.

Systemic benefits of periodontal therapy in patients with obesity and periodontitis: a systematic review

Abstract This systematic review aimed to answer the focused question: "What are the benefits of subgingival periodontal therapy on blood hematological and biochemical index, biomarkers of inflammation and oxidative stress, quality of life, and periodontal pathogen counts in patients with obesity and periodontitis?". A systematic literature search was performed in six databases: PubMed, Embase, LILACS, Web of Science, Cochrane and SCOPUS and other sources, and a manual search was conducted as well. Inclusion criteria were randomized and non-randomized clinical trials, and before-and-after studies on patients with obesity subjected to periodontal therapy. The results were synthesized qualitatively. Risk of bias within studies was assessed using RoB 2 and ROBINS-I tools. The certainty of evidence was evaluated following the GRADE approach. Three randomized controlled trials and 15 before-and-after studies were included. Randomized controlled trials were considered to have a low risk of bias, as compared to before-and-after studies assessed as having low, serious, and critical risks of bias. Non-surgical periodontal therapy plus azithromycin, chlorhexidine, and cetylpyridinium chloride reduced blood pressure and decreased serum levels of HbA1c, hsCRP, IL-1β, and TNF-α. Salivary resistin level also decreased in patients with obesity and periodontitis after therapy and chlorhexidine mouth rinse. Before-and-after data suggest an improvement in total cholesterol, LDL, triglycerides, insulin resistance, C3, GCF levels of TNF-α, chemerin, vaspin, omentin-1, visfatin, 8-OHdG, and periodontal pathogen counts after therapy.

Evaluation of 940-nm diode laser effectiveness on pocket depth, clinical attachment level, and bleeding on probing in chronic periodontitis: A randomized clinical single-masked split-mouth study.

Background: Diode lasers can be used in the treatment of periodontal diseases as they have an anti-bactericidal effect, and regulate oral tissue inflammatory responses. This study aimed to evaluate the adjunctive effects of Diode 940 nm laser on mechanical periodontal debridement. Materials and Methods: In this split-mouth single-blind randomized clinical trial, 12 patients were selected. Forty-four oral segments were enrolled in the scaling and root planing (SRP) group and SRP + Laser group with a 1:1 allocation ratio following a simple randomization procedure (coin flip). Clinical parameters (pocket depth, clinical attachment loss [CAL], and bleeding on probing [BOP]) were measured at baseline. After the SRP, a 940 nm Diode laser (1 Watt power and continuous wave mode) was used in the SRP + Laser group as an adjunctive treatment. The clinical parameters were remeasured 2 months posttreatment. Statistical analysis was carried out using an unpaired t-test with a 5% significant level by SPSS. Results: Although all clinical parameters had more improvements in the SRP + Laser group, the differences were not significant between the two study groups (P > 0.05). Only in individual tooth evaluations, CAL changes in first and second premolars and BOP changes in second premolars show statistically significant improvement in the SRP + L group compared to the SRP group (P < 0.05). Conclusion: Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment.

Dental scaling and lower risk of spontaneous intracranial hemorrhage.

Background: -Spontaneous intracranial hemorrhage (ICH) has high fatality while has few proven treatments. We aim at investigating the association between dental scaling (DS) and the risk of ICH. Methods: -In this cohort study, two cohorts were matched by propensity score based on potential confounders. Data from ICH between January 2008 and December 2014 in Taiwan were analyzed. The subjects underwent DS at least 6 times between January 1, 2002, and December 31, 2007, while the matched controls did not undergo any DS during the same period. Cumulative incidences and hazard ratios (HRs) were calculated after adjusting for competing confounders. Results: -Each cohort consisted of 681,126 subjects. Compared with the non-DS cohort, the regular-DS cohort had a significantly lower incidence of ICH (0.8% vs 1.2%; P < 0.0001), and the adjusted hazards ratio (aHR) of 7-year ICH was 0.61 (95% confidence interval, CI, 0.59-0.63; P < 0.0001). The 30-39-year age group of the regular-DS cohort had the lowest HR (0.57; 95% CI, 0.52-0.61; P < 0.0001) of 7-year ICH when compared with similar controls. Compared with the controls, the regular-DS cohort also had significantly lower HR (0.82; 95% CI, 0.81-0.82; P < 0.0001) of 7-year hypertension. Compared with those without DS, the lowest risk of intracerebral hemorrhage was observed in the male participants with regular DS (0.43; 95% CI, 0.40-0.47; P < 0.0001). Conclusions: -Regular DS was consistently associated with lower ICH risk in subjects aged 30-59 years, which may benefit from the decreased HBP risk. DS had a potential role in the prophylaxis for ICH, a condition with a high disability or mortality.

Five-year radiological findings from a randomized controlled trial of four periodontitis treatment strategies.

Radiographic findings from long-term studies of periodontitis treatment have rarely been reported. Although bone destruction is a prominent feature of periodontitis, the long-term effect on alveolar bone levels of different treatment strategies, with or without adjunctive metronidazole (MTZ), has not been reported. We investigated the 5-year radiographic outcome of therapy in patient groups treated with conventional scaling and root planing (SRP) or same-day full-mouth disinfection (FDIS), with or without adjunctive MTZ. Following a 3-month oral hygiene phase, 184 periodontitis patients were randomly allocated to one of four treatment regimens: (i) FDIS+MTZ; (ii) FDIS+placebo; (iii) SRP+MTZ; or (iv) SRP+placebo. Following active treatment, patients received biannual maintenance. In total, 161 patients (87.5%) completed the 5-year follow-up examination, at which the radiographic bone level (RBL), clinical attachment level, probing pocket depth, presence of plaque, and bleeding were recorded again. At the 5-year follow up examination, minor radiological bone loss was observed in the intervention groups FDIS+placebo, SRP+MTZ, and SRP+placebo; by contrast, the FDIS+MTZ group did not show any change in RBL. Full-mouth disinfection did not generally perform better than conventional SRP performed over a period of 2 to 4 weeks.

Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis.

AIMS: To evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. METHODOLOGY: Individuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro­aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. RESULTS: The mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). CONCLUSION: Combined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.

The Effect of Non-Surgical Periodontal Treatment on Patients with Combined Refractory Arterial Hypertension and Stage III, Grade B Periodontitis: A Preliminary Prospective Clinical Study.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP), and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted for statistical analysis (α = 0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD, and CAL, which were statistically significant at 90 and 180 days (p < 0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p < 0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

The effects of regular dental scaling on the complications and mortality after stroke: a retrospective cohort study based on a real-world database.

BACKGROUND: Previous observational studies have shown that people with dental scaling (DS) had decreased risk of stroke. However, limited information is available on the association between DS and poststroke outcomes. The present study aimed to evaluate the effects of regular DS on the complications and mortality after stroke. METHODS: We conducted a retrospective cohort study of 49,547 hospitalized stroke patients who received regular DS using 2010-2017 claims data of Taiwan's National Health Insurance. Using a propensity-score matching procedure, we selected 49,547 women without DS for comparison. Multiple logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of poststroke complications and in-hospital mortality associated with regular DS. RESULTS: Stroke patients with regular DS had significantly lower risks of poststroke pneumonia (OR 0.58, 95% CI 0.54-0.63), septicemia (OR 0.58, 95% CI 0.54-0.63), urinary tract infection (OR 0.68, 95% CI 0.66-0.71), intensive care (OR 0.81, 95% CI 0.78-0.84), and in-hospital mortality (OR 0.66, 95% CI 0.62-0.71) compared with non-DS stroke patients. Stroke patients with regular DS also had shorter hospital stays (p < 0.0001) and less medical expenditures (p < 0.0001) during stroke admission than the control group. Lower rates of poststroke adverse events in patients with regular DS were noted in both sexes, all age groups, and people with various types of stroke. CONCLUSION: Stroke patients with regular DS showed fewer complications and lower mortality compared with patients had no DS. These findings suggest the urgent need to promote regular DS for this susceptible population of stroke patients.

Effectiveness of photodynamic therapy adjunct to oral debridement in improving clinical, microbiological, and pain in necrotizing ulcerative gingivitis.

To evaluate the efficacy of photodynamic therapy (PDT) as adjunctive to oral debridement (OD) in the improvement of clinical, microbiological, and pain in patients with necrotizing ulcerative gingivitis (NUG). Patients with NUG were split into two groups: Group-OD + PDT received PDT with OD, while Group-OD underwent OD alone. Clinical inflammatory parameters including full mouth plaque scores (FMPS), full mouth bleeding scores (FMBS), and probing depth (PD) were assessed. Fusobacterium nucleatum and Prevotella intermedia were analyzed using the polymerase chain reaction technique. Pain examination was done using various pain scales. Group PDT + OD showed more reduction in FMPS, FMBS, and greater reduction in F. nucleatum and P. intermedia count compared to group OD at 12 weeks follow up (p < 0.01). Group PDT + OD showed significantly lower pain scores at 12 weeks (p < 0.05). PDT was more effective in improving clinical parameters, and reducing bacterial counts and pain in NUG patients than dental scaling alone.

Effect of Different Scaling Methods on the Surface Topography of Different CAD/CAM Ceramic Compositions.

This study evaluated the effect of ultrasonic and manual scaling using different scaler materials on the surface topography of computer-aided designing and computer-aided manufacturing (CAD/CAM) ceramic compositions. After scaling with manual and ultrasonic scalers, the surface properties of four classes of CAD/CAM ceramic discs: lithium disilicate (IPE), leucite-reinforced (IPS), advanced lithium disilicate (CT), and zirconia-reinforced lithium silicate (CD) of 1.5 mm thickness were evaluated. Surface roughness was measured before and after treatment, and scanning electron microscopy was used to evaluate the surface topography following the performed scaling procedures. Two-way ANOVA was conducted to assess the association of the ceramic material and scaling method with the surface roughness. There was a significant difference in the surface roughness between the ceramic materials subjected to different scaling methods (p < 0.001). Post-hoc analyses revealed significant differences between all groups except for IPE and IPS where no significant differences were detected between them. CD showed the highest surface roughness values, while CT showed the lowest surface roughness values for the control specimens and after exposure to different scaling methods. Moreover, the specimens subjected to ultrasonic scaling displayed the highest roughness values, while the least surface roughness was noted with the plastic scaling method.