One‐stage full‐mouth disinfection versus quadrant and full‐mouth root planing

Objective: The aim of this study was to test the hypothesis that the one‐stage full‐mouth disinfection (FMD) provides greater clinical and microbiological improvement compared with full‐mouth scaling and root planing (FM‐SRP) within 24 h and quadrant scaling and root planing (Q‐SRP) in patients with generalized chronic periodontitis. Material & Methods: Twenty‐eight patients were randomized into three groups. 25 patients completed the study and were the basis for analysis. The Q‐SRP group was scaled quadrant‐wise at 1‐week intervals. The other groups received a one‐stage full‐mouth scaling with (FMD) and without (FM‐SRP) chlorhexidine. At baseline, after 1, 2, 4 and 8 months clinical parameters were recorded and microbiological analysis was performed. Results: All three treatment modalities resulted in significant clinical improvement at any time. There were only group differences after 1 and 2 months: in the FM‐SRP group was a significantly higher reduction of probing depth and bleeding on probing compared with the other two groups. The bacteria could be reduced in every group although this reduction was only significant for Prevotella intermedia in the FMD group 8 months after treatment. Conclusion: All three treatment modalities lead to an improvement of the clinical and microbiological parameters, however, without significant group differences after 8 months.     

Single‐ or multiple‐session viscosupplementation protocols for temporomandibular joint degenerative disorders: a randomized clinical trial

The aim of the study was to compare the effectiveness of two single‐session protocols, either adopting high‐ (protocol A) or medium‐molecular weight hyaluronic acid (protocol B), with the reference five‐session protocol of temporomandibular joint (TMJ) lavage plus viscosupplementation (protocol C) in the management of chronic TMJ degenerative disorders. A randomized clinical trial (RCT) with ten participants per treatment group was designed, with multiple observation points, ending at 6 months after treatment. Pain levels on a 10‐point VAS scale were selected as the primary outcome variable to rate treatment effectiveness, along with a number of secondary outcome parameters. Findings showed that Group C patients had the highest decrease in pain levels. Nonparametric permutation analyses revealed that the global effect of treatment was significantly different between the three protocols (P = 0·024). Pairwise comparisons showed that the differences of treatment effect between the two single‐session interventions were negligible (global P‐value = 0·93). On the contrary, the five‐session protocol was significantly superior to both single‐session protocols (global P‐values ranging from 0·003 to 0·012). In conclusion, in a population of age‐, sex‐, and psychosocial aspects‐matched study groups, the standard of reference five‐session protocol proved to be superior at 6 months as far as the decrease in pain levels was concerned, whilst there were no differences between the two single‐session interventions. The absence of differences in treatment effect as for some other secondary clinical outcome variables may suggest that there is further space for future investigations attempting to reduce the number of multiple interventions for TMJ viscosupplementation.     

Comparison of two full‐mouth approaches in the treatment of peri‐implant mucositis: a pilot study

Objectives: The aim of the present study was to test the hypothesis that an additional full‐mouth disinfection results in a greater clinical and microbiological improvement compared with sole mechanical debridement within one session in patients with peri‐implant mucositis and treated chronic periodontitis. Material and methods: The study included 13 partially edentulous patients (mean age 51.5 years) with treated chronic periodontitis and 36 dental implants with mucositis (bleeding on probing and/or a gingival index ≥1 at least at one site at baseline, absence of peri‐implant bone loss during the last 2 years before baseline). After randomized assignment to a test and a control group, patients received a one‐stage full‐mouth scaling with or without chlorhexidine. Clinical and microbiological examination was performed at baseline, after 1, 2, 4 and 8 months. Additional microbial samples were taken 24 h after treatment. Microbiological analysis was performed by real‐time polymerase chain reaction. Results: Both treatment modalities resulted in significant reductions of probing depth at implant sites after 8 months, with no significant group differences. The bacteria at implants and teeth could be reduced in every group 24 h after treatment; however, this reduction was not significant after 8 months. Conclusions: Both treatment modalities led to an improvement of the clinical parameters and a temporary reduction of the microflora at implants with mucositis, but without significant inter‐group differences after 8 months. To cite this article:
Thöne‐Mühling M, Swierkot K, Nonnenmacher C, Mutters R, Flores‐de‐Jacoby L, Mengel R. Comparison of two full‐mouth approaches in the treatment of peri‐implant mucositis: a pilot study.
Clin. Oral Impl. Res. 21 , 2010; 504–512.
doi: 10.1111/j.1600‐0501.2009.01861.x