جستجوی مقالات مرتبط با کلیدواژه « root planing » در نشریات گروه « پزشکی »

 This study compared human β-defensin 1 (hBD-1) salivary levels in patients with periodontitis before and after phase I periodontal therapy.

 This controlled before-and-after study included 16 patients in the intervention group and 28 participants in the control group. Patients in the intervention group had stage 3 grade B periodontitis with no systemic diseases and had not taken any medications in the last six months. The control group included participants with healthy periodontium. Before and after phase I periodontal therapy, salivary samples were collected from the intervention group. ELISA was used to measure hBD-1 levels.

Salivary levels of hBD-1 decreased after phase I periodontal treatment in periodontitis patients, approaching those in healthy individuals. However, this reduction was not statistically significant (P=0.389). In patients with a probing depth (PD) of at least 3 mm, salivary levels of hBD-1 decreased significantly (P=0.019) following the intervention. There was no significant correlation between changes in hBD-1 levels and clinical indices, such as clinical attachment loss (CAL), probing depth, or bleeding index (BI) (P˃0.05).

  The current study demonstrated promising results concerning a probable link between hBD-1 and periodontitis. However, more research with sufficiently large sample sizes and more robust study designs is necessary.

 Scaling and root planing (SRP) is an inevitable primary step in non-surgical periodontal therapy. Debridement carried out with manual instruments and ultrasonics results in the removal of tooth structure. Current research revolves around laser as an efficient adjunct to SRP. This study evaluated and compared the effectiveness of root surface calculus removal between ultrasonics and Er,Cr:YSGG laser.

 Twenty-eight single-rooted teeth extracted due to periodontal disease were selected for the study. The specimens were randomly assigned to two groups (n=14). Group I underwent ultrasonic instrumentation using a piezo ultrasonic scaler, and group II was subjected to laser instrumentation using Er,Cr:YSGG laser (Waterlase). The specimens were processed, fixed, viewed under a field emission scanning electron microscope and evaluated using the remaining calculus index (RCI) and loss of tooth substance index (LTSI).

 Ultrasonics-treated specimens revealed more remaining calculus (1.57±0.65) and lost tooth substance (1.71±0.61) compared to the Er,Cr:YSGG laser-treated specimens, with significantly lower RCI (0.71±0.61) and LTSI (1.00±0.56). There was a statistically significant difference (P<0.05) in the efficacy of root surface calculus removal between the two groups.

 Compared to ultrasonics, Er,Cr:YSGG laser demonstrated superior results by causing precise removal of root surface calculus without significantly affecting tooth structure and aiding in new attachment.

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.

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.

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).

Using diode 940 nm laser as an adjunctive treatment for SRP may be helpful and be suggested for periodontal treatment.

Obesity and periodontitis are two commonly occurring disorders that affect a considerable amount of the world’s population. Several studies have mentioned that there may be a link between the two. The purpose of this systematic review was to determine whether there was a difference in response to nonsurgical periodontal therapies (NSPTs) between obese and nonobese individuals.

An online search was assembled with a combination of Medical Subject Headings terms and free‑text words of the literature published up to December 2020, to identify interventional studies limited to an adult human population. Titles, abstracts, and finally full texts were scrutinized for possible inclusion by two independent investigators. Reduction in periodontal pocket depth was the primary parameter used to assess the outcome of NSPT.

The primary search yielded 639 significant titles and abstracts. After filtering, data extraction, and quality assessment, 34 full‑text studies were selected. All studies matching inclusion criteria, suggest a positive association between obesity and periodontal disease.

Although a possible correlation exists between periodontitis and obesity, as with other oral‑systemic disease implications, some controversy exists. While some studies have reported a distinct correlation between periodontitis and obesity, other papers have suggested only moderate or no association between the two conditions at all. These results advise of a difference between response to NSPT amid obese and nonobese individuals. However, with few quality studies and variable reported findings, there is limited evidence of any significant difference in clinical practice. However, it can be a positive warning that obesity is a risk factor toward the outcome of periodontal disease treatment.

 Limited evidence is available on the effect of milk as a mouthwash on treating dentin hypersensitivity. The present study aimed to compare the effect of milk as a mouthwash with one anti-hypersensitivity mouthwash in decreasing dentin hypersensitivity after non-surgical periodontal treatment.

Patients with generalized moderate-to-severe chronic periodontitis were selected randomly in the present study and underwent scaling and root planing (SRP). Seventy patients with severe dentin hypersensitivity after two days were assigned to two groups. In group A, the patients were asked to use milk as a mouthwash, and in group B, the patients were asked to use anti-hypersensitiv ity Misswake mouthwash. The patients’ hypersensitivity was measured during follow-up visits. The independent t-test was used to compare denim hypersensitivity between the two groups. Statistical significance was set at P<0.05.

  The results showed a significant decrease in dentin hypersensitivity in both groups on days 15 and 30. In the milk group, 11 and 29 patients fully recovered from dentin hypersensitivity on days 15 and 30, respectively. However, in the anti-hypersensitivity mouthwash group, 8 and 27 patients fully recovered from dentin hypersensitivity on days 15 and 30, respectively. Therefore, more patients benefited from the anti-hypersensitivity effects of milk as a mouthwash. However, the differences were not significant during the whole treatment sessions.

  Using milk as an inexpensive and available mouthwash can decrease dentin hypersensi tivity after SRP.

The current study tested netrin-1 as a reliable inflammatory marker of periodontal disease.

Gingival crevicular fluid (GCF) samples were taken at baseline from 30 systemically healthy individuals. Fifteen subjects had stage II grade A or B periodontitis, and 15 were periodontally and clinically healthy. Whole-mouth periodontal parameters [probing depth (PD), clinical attachment loss (CAL), plaque index (PI), and gingival index (GI)] were recorded. The GCF samples were re-collected, and clinical parameters were re-recorded after six weeks following full-mouth scaling and root planing (SRP) in the periodontitis group.

Netrin-1 GCF levels were significantly lower in periodontitis patients than periodontally healthy individuals at baseline with a significant increase in netrin-1 GCF levels after SRP (P<0.05).

Netrin-1 may have a significant role in the inflammatory process of chronic periodontitis; thus, it could be a promising anti-inflammatory marker in periodontal disease.

This study aimed to provide an overview about the efficacy of photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) versus SRP alone in non-surgical periodontal therapy.

Randomized clinical trials (RCTs) with a minimum duration of 3 months, evaluating PDT+SRP versus SRP alone in non-surgical periodontal treatment of patients diagnosed with aggressive or chronic periodontitis who had at least 2 teeth with probing depth (PD) ≥4 mm, and in vitro studies evaluating the effect of adjunctive PDT on proliferation or viability of human gingival fibroblasts (HGFs) were included. An electronic search of the literature was carried out mainly through PubMed, Cochrane Library, and Google scholar for relevant English articles published from January 2011 to January 2021 using the following keywords: "photodynamic therapy" and “periodontitis" or “periodontal diseases”.

Twelve articles were reviewed in this study. Analysis of the clinical attachment level (CAL), PD, gingival index (GI), plaque index (PI), bleeding on probing (BOP) and microbiological counts of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) and Porphyromonas gingivalis (P. gingivalis) demonstrated variable outcomes. Five articles revealed significant improvement of clinical parameters in the PDT groups compared with the control group (P<0.05); five studies reported significant improvement of CAL (P<0.05). However, three studies found no significant difference between PDT and control groups in terms of CAL (P>0.05).

PDT+SRP could help improve the periodontal parameters, compared with SRP alone. Further studies are required to reach a stronger conclusion regarding the superiority of one over the other.

Mechanical debridement of diseased root surfaces produces a smear layer that encompass microorganisms and residual cementum which may interfere with periodontal healing and regeneration of connective tissue attachment. Accordingly, this study aimed to determine impact of 940nm diode laser on adhesion of fibroblasts to root surface of extracted teeth from patients with chronic periodontitis.

Twenty extracted single-rooted teeth with hopeless prognosis were collected and debrided with hand curettes. Afterward, two specimens were obtained from each tooth by splitting them with a sterile diamond disk. Samples were submerged in fibroblast suspension and randomly divided into two groups. Group A comprised of 20 specimens subjected to scaling and root planing only and group B included 20 specimens which received SRP and and 940 nm diode laser irradiation. The adhesion of fibroblasts was investigated by MTT and cell morphology was assessed with scanning electron microscopy (SEM).

The extent of adhesion was higher in group B compared with group A, though this difference was not statistically significant. In the laser group, fibroblast cells showed more elongated morphology and a smaller number of rounded forms was found. But no significant difference was observed between the two groups.

A diode laser with a wavelength of 940 nm has a negligible effect on adhesion of fibroblasts to the root surface of teeth extracted because of chronic periodontitis

Scaling and root planing (SRP) for the treatment of periodontitis may be less effective in some patients. This study evaluated the effectiveness of local doxycycline as an adjunct to SRP among smokers with periodontitis compared to SRP alone in randomized controlled trials (RCTs).

For this systematic review and meta‑analysis, PubMed and Scopus databases were searched till November 2018 for English publications. RCTs that compared the effect of local doxycycline adjunct to SRP among smokers with periodontitis were selected. Patient characteristics, disease characteristics, and outcome data on clinical attachment level (CAL) and periodontal probing depth at 1, 3‑ and 6‑month follow‑up was extracted. Quality of selected studies was assessed by the revised Cochrane Risk of Bias 2.0 tool. Random effects model and trial sequential analysis were performed. GRADE approach was used to assess the quality of evidence.P > 0.05 was considered as statistically significant.

Five trials were included in the review. Local use of doxycycline as an adjunct to SRP was effective in gain of 1.1 mm (0.47–1.74, P = 0.091) in CAL at 6 months calculated from two studies. The evidence was of low quality, and at least a total of 866 patients are required for conclusiveness.

Local doxycycline as an adjunct to SRP significantly improved clinical attachment in smokers with periodontitis and can be recommended. Studies are required with long‑term follow‑up and patient‑related outcome data.

Thisstudy aimed to compare the effect of one and two sessions of antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) on clinical and microbial parameters in patients with chronic periodontitis.

This study was conducted on 20 patients. The dental quadrants of patients were randomly assigned to SRP at baseline (group 1), SRP at baseline and one month (group 2), SRP plus aPDT at baseline (group 3) and SRP plus aPDT at baseline and one month (group 4). Probing depth (PD), clinical attachment level (CAL) gain, and bleeding on probing (BoP) were measured at baseline, and one and three months later. F. nucleatum counts were determined by PCR. ANOVA was used for the comparison of these variables between the groups.

In all the groups, PD reduction and CAL gain increased significantly at 1- and 3-month intervals compared to baseline (P=0.001). At three months, the difference in PD between groups 1 and 3 was statistically significant (P=0.014). CAL gain between groups 2 and 4 at one month (P=0.016) and three months (P=0.001) wasstatistically significant. Reduction in F. nucleatum counts was not significant between the four study groups (P>0.05).

A combination of two sessions of aPDT and SRP could improve CAL gain; however, further long-term studies are necessary in this regard.

In the course of periodontal diseases, polymorphonuclear leukocytes (PMNs) produce oxidative agents and free radicals, thus triggering oxidant-antioxidant disequilibrium in the saliva. Due to the reduction of antioxidant protective effect, oxidative stress is induced, destroying periodontal tissues. This study aimed to investigate the consequences of the non-surgical phase of periodontal therapy on the level ofsalivary antioxidantsin patients with generalized moderate-to-severe chronic periodontitis.

Un-stimulated salivary samples were collected from 43 patients with generalized moderate-to-severe chronic periodontitis for 5 minutes. Clinical parameters, including clinical attachment loss (CAL), bleeding on probing (BoP) and pocket depth (PD), were recorded in each tooth and subsequently, scaling and root planing (SRP) was carried out. After four weeks, salivary samples were collected once again, and the above-mentioned clinical parameters were recorded. Following centrifugation and freezing at a temperature of -80°C, salivary samples were examined simultaneously in a single day, and the level of their antioxidants was measured with ferric reducing ability of plasma (FRAP) method using a spectrophotometer.

The concentration of salivary antioxidants significantly increased four weeks following the non-surgical periodontal therapy (P<0.0001). Moreover, the clinical parameters of CAL, BoP and PD showed a significant decrease in 4 weeks as well (P<0.0001).

The level of salivary antioxidants in patients with generalized moderate to severe chronic periodontitis significantly increased after etiotropic periodontal therapy, indicating the possible beneficial influence of periodontal therapy on the level of salivary antioxidants in patients suffering from periodontitis.

Certain salivary biomarkers that are considered unique in relation to the physiological aspects of periodontitis can be helpful in the diagnosis of periodontitis by considering quantitative changes in such biomarkers. This study was undertaken to answer the question to what extent non-surgical periodontal treatment can affect concentrations of salivary biomarkers in patients suffering from chronic periodontitis.

Eighteen patients with generalized moderate-to-severe chronic periodontitis were recruited for this study by considering periodontal parameters of gingival index (GI), probing pocket depths (PPD), clinical attachment levels (CAL) and a number of radiographic parameters. Salivary samples were analyzed at baseline and at one-month interval after non-surgical periodontal treatment consisting of scaling and root planing. Concentrations of salivary biomarkers, including cortisol, immunoglobulin A (Ig A), IL-6, interferon-γ, soluble intercellular adhesion molecule-1 (sICAM) and ALP, were determined with the use of an ELISA kit. Data were subjected to statistical analyses using paired t-test, with SPSS 15. Statistical significance was set at P<0.05.

Mean levels of IgA and interferon-γ decreased significantly after treatment (P<0.05); however, cortisol concentrations increased significantly after treatment. In addition, the decrease in IL-6, sICAM-1 and ALP levels were not significant (P>0.05).

The results showed that the salivary levels of IgA and interferon-γ decreased and those of cortisol increased significantly subsequent to scaling and root planing.

The tooth root surfaces are modified by different agents for better removal of the smear layer, formation of fibrin clots and attachment of blood cells. This in vitro study compared removal of the smear layer, formation of fibrin clots and attachment of blood cells after exposing periodontally compromised root surfaces to ER:YAG and CO2 laser beams.

Eighteen dentin block samples were prepared from freshly extracted periodontally compromised teeth that were deemed hopeless, and divided into 3 groups; exposed to Er:YAG laser beams, exposed to CO2 laser beams and the control group. The samples were evaluated using scanning electron microscopy and micrographs were taken. Smear layer removal and blood cell attachment were scored. Data were analyzed with SPSS using Kruskal-Wallis and Mann-Whitney tests.

In the Er:YAG laser group, the smear layer was removed completely. In the specimens exposed to blood, better fibrin clot formation and blood cell attachment were observed in the Er:YAG laser group. In the CO2 laser group, the smear layer was also removed; however, there were no significant differences between the CO2 laser and control groups in fibrin clot formation and blood cell attachment.

Application of Er:YAG laser to the root dentin appears to result in the formation of a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies are necessary to support these results.

Atorvastatin (ATV), which belongs to the statin class of drugs, is the formidable inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. This clinical trial evaluated and compared the clinical and radiographic changes in chronic periodontitis (CP) patients, obtained through 1.2% ATV as an adjunct to scaling and root planing (SRP) in the treatment of intrabony defects (IBDs).

Twenty CP patients, with a minimum of one pair of bilateral IBDs, were randomly selected for this split-mouth study. Group 1 included 20 sites treated with SRP and subgingival delivery of a placebo gel, whereas an equal number of sites in group 2 were treated by SRP along with subgingival delivery of 1.2% ATV gel. The plaque index (PI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD) and clinical attachment level (CAL) were evaluated at baseline and 3- and 6-month intervals, while the IBD was assessed at baseline and 6-month interval using cone-beam computed tomography (CBCT). Paired t-test was used to determine statistical significance.

A greater reduction in the mean PPD and gain in CAL was found in group 2 compared to group 1 at 3- and 6-month intervals. Furthermore, a significantly greater bone fill was obtained in group 2 (1.70±0.54 mm) compared to group 1 (0.22±0.43 mm) after six months.

ATV, as an adjunct to SRP, enhanced periodontal regeneration, as a noninvasive way to treat periodontal IBDs.

 Albumin is a protein whose serum levels decrease in inflammatory conditions such as periodontal diseases. This study was undertaken to evaluate changes in serum albumin levels in patients with and without periodontal diseases prior and subsequent to non-surgical periodontal treatment and its relationship with clinical parameters of periodontal disease.

 Twenty patients diagnosed as having chronic periodontitis and 20 periodontally healthy subjects, referring to Tabriz Faculty of Dentistry, were selected. Serum albumin levels and clinical variables of periodontal disease (probing pocket depth, gingival index, bleeding index, clinical attachment level and plaque index) were determined before treatment and three months subsequent to non-surgical periodontal treatment. Data were subjected to descriptive statistical analyses (mean ± SD). Serum levels of albumin and clinical parameters were compared between the two groups with independent-samples t-test. Paired-samples t-test was applied to compare the variables before and after treatment in the case group. Statistical significance was defined at P<0.05.

The mean serum albumin level of chronic periodontitis patients (3.62±0.11 mg/dL) exhibited a significantly lower value compared to subjects who were periodontally healthy (4.17±0.29 mg/dL), with the serum albumin levels increasing significantly three months postoperatively (3.78±0.33 mg/dL), approaching the level in subjects who were periodontally healthy (P<0.05).

Decreases and increases in serum albumin levels under the effect of periodontal disease and its treatment indicated an inverse relationship between the albumin levels of serum and chronic periodontitis.

There is a two‑way relationship between periodontal disease and diabetes. The purpose of this study was to evaluate the clinical and metabolic effects of a xanthan‑based chlorhexidine (CHX) gel used as an adjunct to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis.
Sixty‑eight diabetic patients with moderate to advanced periodontitis and glycated hemoglobin (HbA1c) ≥6% were selected. The test group (n = 34) received scaling and root planning (SRP) plus xanthan‑based CHX gel. The control group (n = 34) received single SRP. Fasting blood sugar (FBS) and HbA1c tests were done at the baseline and after 3 and 6 months. Data from the study were analyzed using descriptive statistics (mean ± standard deviation and frequency), ANOVA test by SPSS.15 software (SPSS Inc. Chicago, IL, USA). P Patients in test group exhibited a decrease in FBS from the baseline (227 ± 64.97) to the 3 and 6 months follow‑up (208 ± 61.95 and 201 ± 61.33; P Considering the limitations of this study, the application of CHX gel might improve the effects of nonsurgical periodontal treatment in diabetic patients with periodontitis.

The periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects.
Thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A (n = 30) was taken as control and no instrumentation was performed. Part B (n = 30) was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser. Part C (n = 30) was treated by piezoelectric ultrasonic scaler. Part D (n = 30) was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average (Ra) value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope (SEM). The means across the groups were statistically compared with control using Dunnett test.
Among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness (mean Ra value of 4.14 μm) as compared to ultrasonic scaler (1.727 μm) and curette group (1.22 μm). However, surface with smear layer were found to be maximum (50%) in curette treated samples and minimum (20%) in laser treated ones. Maximum cracks (83.34%) were produced by ultrasonic scaler, and minimum (43.33%) by curettes. Crater formation was maximum (50%) in laser treated samples and minimum (3.33%) in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes.
Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects.

Scaling and root planing (SRP) is one of the most commonly used procedures during periodontal treatment. The aim of this study was to evaluate the root surface roughness after SRP with erbium: yttrium aluminum garnet (Er:YAG) laser compared to ultrasonic and hand instruments.
In this experimental study, 56 extracted sound single-rooted teeth with moderate level of calculus were selected and randomly divided into four groups: SRP was performed with Er:YAG laser (100 mJ pulse, 1W, 10Hz, VSP and contact mode, with 50% water and air) in group one, hand instrument in group two and ultrasonic tool in group three. Group four was considered as the control group. After SRP, all samples were cut by Servocut cutting machine into pieces with 3×3×2mm dimensions. The samples were mounted in acrylic resin. The surface roughness of the samples was evaluated with profilometry, and the data were analyzed using one-way ANOVA and Tukey’s test in SPSS software.
Surface roughness was higher in laser and lower in ultrasonic group compared to other groups. There was a significant difference in surface roughness between laser and ultrasonic groups (P=0.043), but there was no significant difference in surface roughness among other groups (P>0.05).
The results of this study showed that surface roughness after SRP with Er:YAG laser was not higher than that after manual SRP, but the former value was higher than that after SRP with ultrasonic instrument.

Systemic antibiotics in conjunction with scaling and root planing (SRP), can offer an additional benefi t over SRP alone in the treatment of periodontitis, in terms of clinical attachment loss (CAL) and pocket depth change, and reduced risk of additional CAL loss. However, antibiotics are not innocuous drugs. Their use should be justifi ed on the basis of a clearly established need and should not be substituted for adequate local treatment. The aim of this review is to discuss the rationale, proper selection, dosage and duration for antibiotic therapy so as to optimize the usefulness of drug therapy.Key Words: