Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial

Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following parameters were evaluated at baseline and at 3 months and 6 months after therapy: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC), and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At 3 months after therapy, the microbiological analysis showed a statistically significant reduction of F.n. and E.n. in the test group. At 6 months, statistically significantly higher numbers of E.c. and C.s. were detected in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PPD reduction and CAL gain, but it resulted in significantly higher reduction of bleeding scores than following scaling and root planing alone.     

Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial

The aim of this randomized, parallel, controlled clinical trial was to examine the clinical and biochemical efficacy of diode laser as an adjunct to scaling and root planing (SRP). Thirty chronic periodontitis patients were randomly assigned into two groups to receive SRP alone (control) or SRP followed by diode laser (test). Plaque index, gingival index, bleeding on probing, probing depth, and clinical attachment level were measured at baseline and at 1, 3, and 6 months after treatment. The gingival crevicular fluid levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), matrix metalloproteinase-1 (MMP-1), matrix metalloproteinase-8 (MMP-8) and tissue inhibitor matrix metalloproteinase-1 (TIMP-1) were analyzed by enzyme-linked immunosorbent assay. Test group showed significantly a better outcome compared to the control group in full-mouth clinical parameters. MMP-1, MMP-8, and TIMP-1 showed significant differences between groups after treatment compared to baseline (p?<?0.05). The total amount of IL-1β, IL-6, MMP-1, MMP-8, and TIMP-1 decreased (p?<?0.05) and IL-8 increased after treatment in both test and control groups (p?<?0.05). Diode laser provided significant improvements in clinical parameters and MMP-8 was significantly impacted by the adjunctive laser treatment at first month providing an insight to how lasers can enhance the outcomes of the nonsurgical periodontal therapy.     

The effect of low-level laser therapy on non-surgical periodontal treatment: a randomized controlled,single-blind,split-mouth clinical trial

The purpose of this split-mouth, single-blind, controlled clinical study was to evaluate the impact of low-level laser therapy (LLLT) as an adjunct to non-surgical treatment of chronic periodontitis. Twenty-five systemically healthy and non-smoking adults with chronic periodontitis who had at least two bilateral premolar teeth with probing pocket depth (PPD) of 7?≥?x?≥?5 mm were included in the study. In the periodontal examination of these patients, PPD, gingival index (GI), plaque index (PI), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at the baseline, first, third, and sixth months after treatment. Gingival crevicular fluid (GCF) samples were taken at the baseline, first week, and first month after treatment. The collected GCF samples were analyzed using the MAGPIX? system with a Bio-Plex Pro? Human Cytokine 27-plex kit. After non-surgical periodontal treatment, LLLT with an energy density of 7.64 J/cm² was performed four times: immediately after scaling and root planning (SRP) and on the first, third, and seventh day after treatment. In the first month, PPD levels were significantly (p?<?0.05) lower in the SRP?+?LLLT group than in the SRP group. At the third and sixth months, CAL, PPD, and GI were significantly (p?<?0.05) lower in the SRP?+?LLLT group than in the SRP group. Differences in GCF cytokines levels among the group were not statistically significant. Within the limitations of this study, it is indicated that LLLT as an adjunct to non-surgical periodontal treatment has a positive impact on clinical parameters.     

Systemic warming as an adjunct to resuscitation in peritonitis: a pilot, randomized controlled trial

BACKGROUND: Bacterial peritonitis is accompanied by a high risk of sepsis and endotoxin production resulting in physiological derangements and a high mortality rate. Localized and systemic warming improves tissue perfusion, oxygen tension, and outcomes after surgery. The purpose of this study was to examine the effectiveness of systemic warming as an adjunct to standard antibiotic and fluid resuscitation in patients with peritonitis. METHODS: In this pilot randomized controlled trial, patients presenting with an acute abdomen were randomized into control and warmed groups using sequential envelopes. Local Ethics Committee approval was obtained. Systemic warming was delivered using the Inditherm warming mattress set at 40 degrees C. Standard oxygen, fluid resuscitation, and antibiotics were delivered simultaneously. Acute Physiology and Chronic Health Evaluation (APACHE) II scores were recorded on admission and 24 h later or just prior to surgery, whichever was earlier. RESULTS: Thirty-three patients were recruited. The APACHE II scores on admission were comparable (median 9.0 [range 2-23] and 9.0 [0-20], respectively, for the control and warmed groups (p = 0.70; Mann-Whitney U test)). No patient showed any adverse effects of warming. There were statistically significant improvements in APACHE II scores (p = 0.028; Wilcoxon signed ranks test) and the magnitude of its change (p = 0.048; Mann-Whitney U test) in the warmed group compared with the control group. CONCLUSIONS: Systemic warming may reduce physiological derangements and improve the prognosis in patients with intra-abdominal crisis. The technique may be used safely as an adjunct to standard resuscitation in peritonitis.     

Platelet-rich fibrin as an alternative adjunct to tendon-exposed wound healing: A randomized controlled clinical trial

BackgroundThe use of platelet-rich fibrin (PRF) has attracted great interest in the treatment of oral and maxillofacial procedures, gingival recessions, and bone healing. However, PRF has been reported hardly to prepare wound bed before skin grafting. This randomized clinical study sought to identify the effect of PRF as an alternative adjunct to tendon-exposed wound healing.MethodsThirty-six patients with tendon-exposed wounds were treated by applying Integra or PRF (n = 18 per group). The take rate of Integra or PRF and pain levels assessed with the four-point verbal rating scale (VRS-4) for the first 5 days after application were measured for each condition. Data of texture change analysis were assessed and recorded for a duration of 3 months postoperatively.ResultsThe take rate was less in the Integra group than in the PRF group (92.39 vs 97.83 P < 0.001). After surgery, compared to the Integra group, the patients in the PRF group reported significantly lower pain scores (P < 0.001). Texture changes from the Integra group were rated higher than those from the PRF (P < 0.001).ConclusionThe use of PRF could be an option for tendon exposed areas where the wound is unfit for standard skin grafting or flap transfer.     

The use of diode laser in esthetic crown lengthening: a randomized controlled clinical trial

Lasers in Medical Science - This clinical trial assessed patient comfort, satisfaction, and the achievement and maintenance of ideal gingival margin levels using laser compared to conventional...     

Intravenous dexamethasone as an adjunct to improve labor analgesia: A randomized,double-blinded,placebo controlled clinical trial

ObjectiveTo study the role of intravenous (i.v.) dexamethasone as an analgesic adjunct in labor analgesia.DesignDouble-blinded randomized controlled trial.SettingLabor analgesia in a tertiary-care teaching hospital.PatientsEighty consenting ASA I-II parturients, age > 18 year, nulliparous, single gestation, cephalic presentation at ≥ 36 wk. of gestation, in early spontaneous labor (cervical dilatation ≤ 5 cm) requesting epidural analgesia.InterventionsThe patients were randomized to two groups. The Dexa group received 8 mg of dexamethasone i.v. in 50 ml normal saline approximately 45 min before the procedure. Placebo group patients received 50 ml normal saline only. All patients underwent epidural labor analgesia per hospital protocol. After an initial bolus, they received continuous background infusion of 5 ml/h of 0.1% of levobupivacaine with 2 μg/ml of fentanyl, with the provision of patient controlled boluses of 5 ml of the same drug combination with a lockout interval of 12 min if needed.MeasurementsPrimary outcome measure: hourly average consumption of neuraxially administered levobupivacaine-fentanyl combination. Secondary outcomes and observations: pain score, maternal satisfaction, sensory and motor block characteristics, hemodynamic parameters of mother, fetal heart rate, duration of second stage of labor, mode of delivery, Apgar scores at 1 and 5 min, and adverse effects.Main resultsAverage hourly drug consumption was significantly lower in Dexa group as compared to Placebo group (10.34 ± 1.79 ml/h vs. 11.34 ± 1.83 ml/h; mean difference 1.007, 95% CI 0.199–1.815; P = 0.015). The median number of bolus doses was 4 (interquartile-range [IQR] 3–5.75) and 5 (IQR 3–6) in the Dexa and Placebo groups, respectively (P = 0.162). There was no significant difference between groups with regard to pain scores, maternal satisfaction and hemodynamics, mode of delivery, and adverse effects.ConclusionsI.v. dexamethasone significantly decreased hourly average drug consumption of levobupivacaine-fentanyl combination through the epidural route, demonstrating the epidural drug dose sparing effect during labor analgesia.     

Correction to: Efficacy of pulsed Nd:YAG laser in the treatment of patients with knee osteoarthritis: a randomized controlled trial

Lasers in Medical Science - The institutional affiliation of Dr. Aly Elsayed Mohamed Elsayed should be as follow     

Efficacy of pulsed Nd:YAG laser in the treatment of patients with knee osteoarthritis: a randomized controlled trial

The purpose of this study was to investigate the effects of pulsed Nd:YAG laser plus glucosamine/chondroitin sulfate (GCS) in patients with knee osteoarthritis (KOA) by examining changes in pain and knee function, as well as synovial thickness (ST) and femoral cartilage thickness (FCT). Sixty-seven male patients participated, with a mean (SD) age of 53.85 (4.39) years, weight of 84.01 (4.70) kg, height of 171.51 (3.96) cm, and BMI of 28.56 (1.22). Group 1 was treated with high-intensity laser therapy (HILT), GCS, and exercises (HILT?+?GCS?+?EX). Group 2 was treated with GCS plus exercises (GCS?+?EX), and group 3 received placebo laser plus exercises (PL?+?EX). The outcomes measured were pain level and functional disability using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively. ST and FCT were measured by ultrasound examination. Statistical analyses were performed to compare differences between baseline and after 6 weeks of treatment and then after 3 months of follow-up. Statistical significance was set at p?<?0.05. VAS and WOMAC were significantly decreased in all groups after 6 weeks, with nonsignificant differences between 6 weeks and 3 months of follow-up. ST was significantly decreased in the HILT?+?GCS?+?EX group posttreatment, with nonsignificant decreases in the GCS?+?EX and PL?+?EX groups, as well as nonsignificant differences to FCT in all groups. Overall, pulsed Nd:YAG laser combined with GCS and exercises was more effective than GCS?+?EX and exercises alone in the treatment of KOA patients.     

Effect of adjunctive diode laser in the non-surgical periodontal treatment in patients with diabetes mellitus: a systematic review and meta-analysis

Lasers in Medical Science - This study aimed to systematically review and analyze the present randomized clinical trials (RCTs) regarding the clinical efficacy of a diode laser (DL) adjuvant to...     

Efficacy of high-intensity laser therapy in patients with adhesive capsulitis: a sham-controlled randomized controlled trial

Lasers in Medical Science - Adhesive capsulitis is an idiopathic condition characterized by painful shoulder stiffness, impairs quality of life, and causes disability. The purpose of the study is...     

Autologous platelet-rich fibrin as an adjunct to non-surgical periodontal therapy—A follow up clinical pilot study

The aim was to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) as an adjunct to scaling and root planing (SRP) in moderate periodontal pockets. The split-mouth study involved 32 sites from 16 patients. Baseline parameters were recorded followed by complete full-mouth SRP. The test and control sites were randomly selected and autologous PRF was placed in the test site and other site served as control. The blinded examiner recorded clinical parameters at baseline, 60 days, and 90 days. No statistical significance was found at baseline in probing depth (PD) and clinical attachment level (CAL). Statistically, significant improvement was observed within test and control groups at 90 days compared to baseline values. A statistically significant difference in test sites was found in terms of reduction in PD and clinical attachment gain (CAG) compared to the control sites at the end of the study period (p value <0.05). This split-mouth pilot study emphasized a statistically significant improvement in pocket depth reduction and CAL gain when PRF was used as an adjunct to SRP in moderate periodontal pockets.