جستجوی مقالات مرتبط با کلیدواژه "periodontal pocket" در نشریات گروه "پزشکی"

 Periodontitis is a chronic inflammatory disease that affects the teeth’s supporting structures, leading to clinical attachment loss, pocket formation, and tooth loss if left untreated. Scaling and root planning (SRP) is the gold standard for removing bacterial biofilm and calculus from tooth surfaces. However, in most situations, including tooth fractures, there is a need for adjunctive therapies to complement and improve treatment outcomes. This study aimed to evaluate the efficacy of locally delivered metformin (MF) 1% gel as an adjunct to SRP in treating severe chronic periodontitis.

 A total of 36 volunteers were randomly assigned to two treatment groups, namely, SRP plus placebo gel and SRP plus 1% MF gel. Clinical parameters such as pocket probing depth (PD), clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline, 2, and 4 months. The data were analyzed using independent T-tests, one-way, and repeated measures analysis of variance (ANOVA) using SPSS 24 software.

 All groups exhibited improvements in periodontal parameters such as PD and CAL. While the mean reductions in PD and CAL were not statistically significant after 3 weeks of treatment between the two groups (P=0.193), the MF group demonstrated significantly greater improvements in PD, measuring 3.49 mm compared to 1.87 mm in the control group (P=0.007), as well as in CAL, which measured 2.98 mm versus 1.72 mm in the control group (P=0.014).

 The adjunctive use of locally delivered 1% MF gel could stimulate a significant reduction in PD and increases in CAL compared to the placebo gel, while there was no GR resulting from the local delivery of the drug. This suggests that the MF gel may offer benefits in the treatment of severe chronic periodontitis by enhancing periodontal healing without inducing GR.

The purpose of the case report was to describe missed diagnosis of a deep palatogingival groove (PGG) associated with an endodontic-periodontal lesion which was subsequently managed using a regenerative surgical procedure.

Clinical considerations:

 The PGG often predisposes the teeth to severe periodontal defects and pulp necrosis which complicates the diagnosis. This case illustrated a persistently sensitive tooth that was initially diagnosed as a combined endodontic-periodontal lesion, with an associated PGG identified at a later stage. The collaborative management of combined endodontic-periodontal lesion with endodontic therapy, ultrasonic debridement of groove, sealing with MTA and composite resin, and guided tissue regeneration resulted in substantial healing of the periradicular radiolucency at 24 months.

It is imperative to exercise caution during the biomechanical preparation of the root canal, when there is a reduced amount of dentin between the PGG and the root canal wall to prevent potential complications and ensure the integrity of the remaining tooth structure.

The role of bacteria in the initiation and progression of periodontitis has led to a great interest in using antibiotics to suppress pathogenic microbiota. Considering the drawbacks of systemic antibiotics’ application, local delivery systems directly in the periodontal pocket can be helpful. Therefore, the effect of an efficient tetracycline-loaded delivery system was investigated on the clinical parameters of periodontitis.

In this clinical trial with a split-mouth design, 10 patients with periodontitis with pocket depths≥5 mm were included. After scaling and root planing (SRP) for all the patients, one side of the mouth was randomly considered as the control group, and on the other side, chitosan/polycaprolactone (PCL) nanofibrous films containing tetracycline (5%) were placed in pockets of 5 mm and deeper. Clinical measurements of pocket probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) indices were made at the beginning and after 8 weeks of intervention. PPD, CAL, and BOP parameters were compared between the control and test groups before and after the intervention with paired t tests using SPSS 24. The significance level of the tests was considered at P<0.05.

The mean PPD, CAL, and BOP in both the control (SRP) and test (LDDs) groups decreased after 8 weeks. A significant difference was detected in reducing PPD, BOP, and CAL after 8 weeks in 5-mm pockets, and the mean values were higher in the test group than in the control (P<0.05).

The local drug delivery system using chitosan/PCL nanofibrous films containing tetracycline can effectively control periodontal diseases by reducing pocket depth and inflammation and improving CAL without offering side effects, although further evaluations are needed.

The formation of localized periodontal pockets on the distal surface of adjacent molars is known as one of the asymptomatic lesions associated with impacted wisdom teeth. In this study, the effect of different factors on the prevention of periodontal pocket formation on the distal surface of the second molar following impacted wisdom tooth removal surgery was investigated.

The present study was a review of the related literature published over the last 10 years. The main tool recruited for this purpose was a researcher-made checklist, developed based on the main objectives of the study. Accordingly, wisdom tooth occlusion, suture technique, flap type, and periodontal envelope, extracted from the articles, were recorded in the relevant checklist. The extracted information was finally imported into the SPSS (ver. 20) software package and analyzed, using descriptive and analytical statistics.

In total, 22 articles, reflecting on the effect of different factors on the prevention of periodontal pocket formation on the distal surface of the second molar following impacted wisdom tooth removal surgery, and meeting the inclusion criteria in this study were retrieved and then reviewed. Based on the preliminary analyses, 15 articles (68.18%) had mentioned periodontal pocket formation after impacted tooth surgery. As well, nine studies had referred to attachment loss in patients. In this review using surveys among patients undergoing surgery, had not demonstrated a significant relationship between periodontal pocket formation and attachment loss. Moreover, eight articles (36.36%) examined flap type employed during the surgery.

It was concluded that impacted wisdom tooth removal surgery had been thus far introduced directly in many studies as a factor affecting the reduction of periodontal complications, including periodontal pocket formation in adjacent teeth.

The present randomized clinical trial aimed to determine the additive clinical and microbiological benefits of diode laser (DL) with modified Widman flap (MWF) to manage chronic periodontitis.

Seventy-two sites in 36 healthy non-smoking patients diagnosed with chronic periodontitis were randomly assigned to the test group (MWF + active DL) or control group (MWF + sham DL). Clinical (probing pocket depth [PPD], clinical attachment level [CAL]) and microbiological (colony-forming units [CFUs]) measurements were recorded at baseline and 6- and 6-month postoperative intervals.

Compared to baseline, 6-month results showed significant changes in clinical and microbiological parameters in both groups. However, the intergroup comparison revealed significantly lower PPD (1.90±0.48 mm vs. 2.35±0.41 mm), CAL (4.43±0.57 mm vs. 4.93±0.58 mm), and CFUs for Porphyromonas gingivalis (6.32±0.18 vs. 8.88 ±1.88), Prevotella intermedia (7.62±1.86 vs. 8.12±1.78), and Aggregatibacter actinomycetemcomitans (6.43±1.44 vs. 7.24±1.22) in the test group after six months.

Within the limitations, the present study confirmed the useful role of DL with MWF to manage chronic periodontitis.

This study aimed to compare the sling and single interrupted sutures regarding dehiscence, probing pocket depth (PPD), and clinical attachment loss (CAL) of adjacent second molars after surgical extraction of impacted or semi-impacted mandibular third molars.

This randomized clinical trial, with a split-mouth design, involved 25 patients with similar bilateral impaction of their mandibular third molars. The same surgeon performed surgical procedures, including a triangular flap and osteotomy. After surgical extraction of third molars, the distal surface of the flap was sutured with sling sutures on one side and single interrupted sutures on the other side. The allocation of suture type to the side of the jaw was random, and the patient was blinded to it. Patients were examined for dehiscence after 7 and 14 days. The PPD and CAL were recorded at the baseline and after 17 weeks. Data were analyzed using the Wilcoxon signed-rank test and generalized estimating equation (GEE) regression model.

The sling suture was significantly superior regarding the improvement of PPD (P=0.041) and CAL (P=0.016). The dehiscence was significantly smaller in the single interrupted suture group 7 days postoperatively (P=0.059). This difference was not significant 14 says postoperatively (P=0.852).

The results of this study show that the sling suture was superior to the single interrupted suture regarding PPD and CAL. However, the technique of suturing does not seem to have a significant long-term effect on wound dehiscence.

Periodontal disease is considered to be a remarkable factor affecting the quality of life and systemic and oral health by causing various symptoms for patients. The objective of this research was the evaluation of periodontal status and its related factors including age, gender, educational level, oral hygiene, and diabetes mellitus (DM) in people aged 35-70 years in cohort population of Rafsanjan, Iran.

In this cross-sectional study, 7855 patients aged 35-70 years who referred to Rafsanjan Cohort Center in 2019 were selected through systemic sampling and were examined according to their gingival health indices such as bleeding on probing (BOP), periodontal pocket depth, and clinical attachment loss (CAL). Data were then analyzed by SPSS software using chi-square test and independent t-test. P-value less than 0.05 was set as significant level.

All three gingival health indices were higher in people in older age category significantly (P = 0.0001). BOP index was significantly higher in women (P = 0.0001); the other two indices were also more in women, although insignificantly. By education level increase, BOP, pocket depth, and CAL decreased (P = 0.0001, P = 0.0650, and P = 0.0001, respectively). Moreover, brushing decreased all indices although this decline was just significant for BOP and pocket depth (P = 0.0380 and P = 0.0001, respectively). Concerning DM, no significant difference was observed between diabetics and non-diabetics in CAL (P = 08910) and pocket depth (P = 0.3240). However, people with DM had significantly higher BOP (P = 0.0001).

Periodontal diseases were more likely in women with older age and lower educational level who had poorer oral hygiene. People with DM had higher BOP but CAL and periodontal pocket were not different between diabetics and non-diabetics.

Various treatment modalities, such as leucocyte platelet-rich fibrin (L-PRF), bone grafts,and membranes, have been used for the restoration of lost periodontal tissues. Titanium-preparedplatelet-rich fibrin (T-PRF) has attracted attention for its proper haemocompatibility, thick fibrinmeshwork, and long resorption time. The present study aimed to evaluate the effectiveness of T-PRFand L-PRF in the management of intra-bony defects based on clinical and radiographic criteria.

 Twenty-six subjects with 34 intra-bony 3- walled defects were divided into two groups (n=17)and treated with T-PRF or L-PRF. Clinical and radiographic measurements were recorded at baselineand 6- , 3- and 9- month intervals and tabulated on Microsoft Excel spreadsheets. For intra- and intergroupcomparisons, paired and unpaired t-tests were performed. P<0.05 was set as statistically significant

Intra-group comparisons revealed statistically significant differences (P<0.05) from baseline inboth groups regarding clinical measurements. On intergroup comparison, the T-PRF group exhibited asignificantly higher defect fill compared to the L-PRF group (P<0.05).

 Within the limits of the present study, T-PRF seems to be a better alternative to L-PRF inthe treatment of intra-bony defects.

Prevention of dental caries and periodontal disease is an important health priority. Oral health instruction can help to achieve this goal. This study sought to assess the effect of a short-term, targeted, well-structured comprehensive oral health instruction on the level of the knowledge and behavior of patients.
This study was conducted on 120 patients who were randomly divided into two groups of case and control (n=60). The control group received routine oral health instructions, while the case group received a two-session comprehensive, well-structured oral health instruction provided by trained dental hygienists. The level of the knowledge in the two groups was assessed before and after the intervention using a questionnaire. To assess the effect of the instructions on the oral health behavior of the patients, bleeding on probing (BOP) and periodontal pocket depth (PPD) were measured before and after the instructions. Data were analyzed using generalized estimating equations (GEE).
The level of knowledge, PPD, and BOP were not significantly different between the two groups at the baseline (P>0.05). There were significant differences in the level of knowledge (P=0.02), PPD (P=0.03), and BOP (P=0.03) between the two groups after the intervention such that the patients in the case group experienced a reduction in PPD by 2 mm, while BOP decreased by 45%, and knowledge was enhanced by 16% in the case group, compared to the control group, two months after the intervention.
Well-structured, targeted, comprehensive short-term oral health instructions can greatly enhance the knowledge and change the behavior of patients.

It is suggested that arch bars act as plaque-retentive ligatures and therefore exert effects on periodontal tissues health. The aim of the present study was to assess pocket probing depth prior to placing arch bars and following their removal.

Pocket probing depths were studied in the subjects who had arch bars for one month due to condylar fracture. Pocket depths were measured before placing arch bars, one month and 12 months after removing them. The mean of pocket depth was measured for each tooth. Periodontal probing depth was measured in six sites of each tooth .The mean pocket depth was calculated by the division of the sum of the pocket depths by the number of teeth for anterior and the posterior teeth in all subjects.

Eleven males and nine females were included in this study. No significant pocket depth differences was detected among the anterior and posterior of the mandible and maxilla before and after placing the arch bars. Results demonstrated a significant pocket depth increase in the anterior and posterior of both jaws one month following removal of the arch bars .The pocket depths were decreased following 12 months which were indicative of relative improvement at the sites.

Arch bars can affect periodontium and pocket depths increased one month after releasing the arch bars. However, a significant improvement was detected following 12 months that suggested a partial reversible change in the pocket depths.

Probing is the only reliable method for diagnosing periodontal diseases; however, it is a painful examination. The purpose of this study was evaluation of the effect of EMLA anesthetic gel on the level of pain upon probing in patients with chronic periodontitis referring to the periodontology department of the dental branch of Islamic Azad University of Tehran during 2013-2014. This double-blind split mouth clinical trial involved 20 eligible patients. All the teeth in two quadrants of each patient's mouth were randomly selected to be either treated with the anesthetic gel or the placebo and were probed in six points. Afterwards, the level of pain was measured using the VAS ruler. Thirty seconds after applying the gel and probing, the pain was measured again and registered. The levels of pain before and after using the gel were compared using the statistical tests. The levels of pain before and after using the placebo gel were 5.4±1.8 and 5.1±1.8, respectively and pain variations in this group equaled 0.25±0.9 (P= 0.4). The levels of pain before and after using the anesthetic gel were 5.65±1.7 and 2.1±1.2, respectively. Pain variations in this group equaled 3.55±1.3 and this difference was statistically significant (P<0.001). The results of the present study showed that EMLA anesthetic gel is effective in reducing the pain upon probing.

Deep periodontal pockets pose a great challenge for nonsurgical periodontal treatment. Scaling and root planing (SRP) alone may not suffice in cases where surgical therapy cannot be undertaken. Various recent studies have suggested the use of antimicrobial Photodynamic Therapy (aPDT) for the management of periodontal infections. The aim of this study was to evaluate the effects of using aPDT along with SRP, compared to SRP alone for the management of deep periodontal pockets.
Thirty patients with chronic periodontitis, who met the criteria of having periodontal pockets with depth ≥ 6 mm and bleeding on probing (BOP) in at least 2 different quadrants were included. After SRP, one quadrant was randomly selected for aPDT (test), while another served as control. Clinical parameters i.e. plaque index (PI), modified sulcular bleeding index (mSBI), probing depth (PD) and clinical attachment level (CAL) were measured at baseline, 1 month and 3 months post-treatment intervals.
All clinical parameters significantly improved in both groups after 1 and 3 months. At 1-month interval, inter-group difference in mean change was statistically significant (P aPDT appears to play an additional role in reduction of gingival inflammation when used along with nonsurgical mechanical debridement of deep periodontal pockets.

Over recent decades, halitosis has become a priority in oral hygiene maintenance. Bad breath is one of the primary reasons for referral to dentists in Iran. Although halitosis is mainly caused by endogenous factors such as microbial metabolism, it is a multifactorial condition.. This study aimed to identify the probable relationship of the presence of Fusobacterium species in periodontal pockets with halitosis and determine the risk factors for this condition..Patients and This case–control study included patients referred to a polyclinic in Shiraz, which is located in Fars province in the southwest of Iran. In total, 50 patients with halitosis confirmed by an organoleptic test and 50 patients without oral malodor were recruited. Samples were obtained from their periodontal pockets using absorbent paper points and cultured for characterization by biochemical tests.. In total, 26% (n = 13) and 8% (n = 4) samples were positive for Fusobacterium species in the halitosis and control groups, respectively, with F. nucleatum present in the greatest proportion in both groups. Halitophobia was significantly more frequent in the halitosis group than in the control group (P < 0.001). Sinusitis was the most common systemic disease. Moreover, the halitosis group patients exhibited a greater tendency to include curry powder, chili, and sausage in their diet compared with the control subjects (P < 0.05).. The results of the present study suggest that the presence of Fusobacterium species in periodontal pockets is an important risk factor for halitosis..

Connective tissue grafts with and without periosteum is used in regenerative treatments of bone and has demonstrated successful outcomes in previous investigations. The aim of present study was to evaluate the effectiveness of connective tissue graft with and without periosteum in regeneration of intrabony defects. In this single-blind randomized split-mouth clinical trial, 15 pairs of intrabony defects in 15 patients with moderate to advanced periodontitis were treated by periosteal connective tissue graft + ABBM (test group) or non-periosteal connective tissue graft + ABBM (control group). Probing pocket depth, clinical attachment level, free gingival margin position, bone crestal position, crest defect depth and defect depth to stent were measured at baseline and after six months by surgical re-entry. Data was analyzed by Student’s t-test and paired t-tests (α=0.05). Changes in clinical parameters after 6 months in the test and control groups were as follows: mean of PPD reduction: 3.1±0.6 (P< 0.0001); 2.5±1.0 mm (P< 0.0001), CAL gain: 2.3±0.9 (P< 0.0001); 2.2±1.0 mm (P< 0.0001), bone fill: 2.2±0.7 mm (P< 0.0001); 2.2±0.7 mm (P< 0.0001), respectively. No significant differences in the position of free gingival margin were observed during 6 months compared to baseline in both groups. Combinations of periosteal connective tissue graft + ABBM and non-periosteal connective tissue graft + ABBM were similarly effective in treating intrabony defects without any favor for any group. Connective tissue and periosteum can be equally effective in regeneration of intrabony defects.