慢性牙周炎维护治疗期临床纵向观察

目的:了解慢性牙周炎维护治疗期临床指标变化规律。方法:对牙周非手术基础治疗后进入维护治疗期的22名慢性牙周炎病人进行9个月的纵向观察。每3个月给予口腔卫生宣教,龈上下洁刮治和根面平整。并在基线和每次复查时记录临床检查指标,包括探诊深度(PD)、临床附着水平(CAL)、探诊出血(BOP)。结果:后牙较前牙更易出现牙周袋加深,>6 mm深袋的比例6个月后显著下降,CAL改善在邻面及舌侧更加明显,BOP比例持续下降。结论:非手术基础治疗配合定期维护,可使临床指标在较短期内获得明显改善。     

氯己定局部缓释系统辅助龈下刮治和根面平整效果的Meta分析

目的:比较并评价在慢性牙周炎治疗过程中,牙周袋内应用氯己定局部释药系统辅助龈下刮治和根面平整(scaling and root planing,SRP)的临床效果是否优于单纯SRP。方法:主要检索6个数据库,一些全文通过手工检索获得。收集至2009年5月公开发表的中英文牙周局部应用氯己定释药系统辅助龈下刮治和根面平整的随机对照试验,随访时间至少3个月。观察指标为术后牙周探诊深度(probing depth,PD)的减少和临床附着水平(clinical attachment level,CAL)的增加。结果:最终有7个研究纳入本系统评价。Meta分析结果显示,牙周局部应用氯己定释药系统辅助SRP与单纯SRP相比,可以使PD显著降低,而CAL在2个治疗组间无统计学差异。结论:在慢性牙周炎的治疗过程中,牙周局部应用氯己定释药系统辅助SRP可以使牙周探诊深度显著降低。     

半导体激光辅助治疗中重度慢性牙周炎的临床疗效分析

目的评价半导体激光辅助治疗中重度慢性牙周炎的临床疗效。方法采用随机、自身对照、单盲法。将10位中重度慢性牙周炎患者的左右侧牙列随机分为实验组和对照组,每个象限选取探诊深度(Probing depth,PD)≥6 mm的两个位点,共80个位点。初诊时进行龈上洁治,2周后,实验组龈下刮治(Scaling and root planing,SRP)+半导体激光(980 nm,2 W)照射30 s,对照组只进行SRP,比较治疗前及治疗后3个月PD、临床附着丧失(Clinical attachment loss,CAL)和探诊出血(Bleeding on probing,BOP)的变化。结果治疗前,两组各临床指标均无明显差异(P>0.05)。治疗后3个月,两组各临床指标均较治疗前明显降低(P<0.05),实验组PD(4.15±0.24)mm,CAL(5.45±0.28)mm,BOP阳性率20%,对照组PD(4.13±0.28)mm,CAL(5.15±0.30)mm,BOP阳性率42.5%。其中,实验组BOP阳性率明显低于对照组(P<0.05),两组PD和CAL的变化值无明显差别(P>0.05)。结论半导体激光辅助治疗中重度慢性牙周炎可以有效改善牙龈炎症,其长期疗效有待进一步研究。     

Superbond粘结系统作为牙周夹板对牙周组织影响的临床研究

目的:观察Superbond粘结系统作为牙周夹板固定重度牙周炎导致的松动前牙后对牙周组织的影响。方法:选择重度牙周炎导致的前牙松动病人64例,随机分为实验组(Superbond固定组)和对照组(钢丝结扎加树脂组),每组32例。牙周基础治疗后1个月牙周炎症得到控制,消除咬合创伤后固定。每3个月复查维护,观察12个月。比较固定前后所观察位点的牙周探诊深度(PD)、附着丧失(CAL)、龈沟出血指数(SBI)、菌斑指数(PLI)、牙龈指数(GI),并记录两种固定方法的美观性和舒适性。结果:实验组29例有效;对照组28例有效。实验组PD变浅(P<0.05),SBI、GI、PLI、AL固定后与固定前比较无显著性差异。对照组PD变浅(P<0.05)、SBI、PLI高于固定前(P<0.05),CAL、GI与固定之前比较无显著性差异(P>0.05)。实验组美观性和舒适性调查满意度高于对照组。结论:在选择合适病例的前提下,Superbond粘结系统作为牙周夹板固定松动前牙美观、舒适,可提高咀嚼力,对牙周组织影响小,不妨碍菌斑控制。     

Clinical effects of scaling and root planing with an adjunctive periodontal endoscope for residual pockets: a randomized controlled clinical study

目的 比较牙周内窥镜辅助龈下刮治和根面平整（SRP）与传统SRP对慢性牙周炎患者基础治疗后残留牙周袋的临床疗效。方法 将牙周基础治疗后口内每个区至少有1个位点探诊深度（PD）≥5 mm的患者纳入研究,随机分为内窥镜组和SRP组,分别对残留牙周袋位点进行内窥镜辅助SRP治疗和传统SRP治疗。在治疗前（基线）、治疗后3、6个月检查PD、探诊出血（BOP）和附着丧失（AL）,采用SPSS 20.0统计学软件对数据进行统计分析。结果 与基线相比,治疗后3、6个月内窥镜组及SRP组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05）。治疗后6个月与3个月相比,内窥镜组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05）,而SRP组差异无统计学意义（P>0.05）。与SRP组相比,内窥镜组治疗后3及6个月PD≥5 mm位点百分比、PD均降低,治疗后6个月AL、BOP阳性位点百分比降低（P<0.05）。结论 牙周内窥镜辅助SRP对于基础治疗后的残留牙周袋（PD≥5 mm）的临床疗效优于传统SRP,尤其具有更好的远期预后。     

米诺环素对慢性牙周炎辅助治疗的疗效观察

目的 评价牙周袋局部应用米诺环素软膏联合刮治和根面平整治疗慢性牙周炎的疗效。方法 64名患中到重度慢性牙周炎的男性吸烟者随机分成SRP和SRP+M两组。对SRP组患者施行刮治和根面平整,对SRP+M组患者在刮治和根面平整的基础上,牙周袋局部应用米诺环素软膏。记录两组患者在基线、3个月和6个月时的菌斑指数（PlI）、牙龈指数（GI）、探诊出血（BOP）、探诊深度（PD）及附着丧失（AL）的变化并进行统计学分析。结果 治疗过程中有6例患者被排除,有效病例数为58例,每组29例。牙周治疗3个月和6个月后,两组患者的PlI、GI和BOP均无统计学差异（P>0.05）,但PD和AL有统计学差异（P<0.05）。治疗后3个月SRP组PD下降1.32 mm,AL减轻1.14 mm;而SRP+M组PD下降1.98 mm,AL减轻1.87 mm。对于基线检查PD≥7 mm的深牙周袋,治疗后3个月SRP组PD下降2.21 mm,AL减轻1.23 mm;而SRP+M组PD下降3.48 mm,AL减轻2.62 mm。治疗后6个月PD和AL状况与3个月相比变化不大。与SRP组相比,SRP+M组临床症状改善更明显。结论 龈下局部应用米诺环素软膏辅助治疗慢性牙周炎可取得较好的疗效,特别是对于有深牙周袋、吸烟的牙周炎患者,机械治疗联合局部应用缓释抗菌素较单纯机械治疗的疗效更好。     

二次牙周龈下刮治与牙周翻瓣术短期临床疗效比较

目的比较二次牙周龈下刮治和根面平整（scaling and root planning,SRP）与牙周翻瓣术治疗慢性牙周炎的短期临床疗效。方法选取牙周基础治疗3个月后牙周探诊深度为5～7mm的前牙或前磨牙共52颗作为研究对象,随机分为2组,二次SRP组行龈下刮治和根面平整术,翻瓣组进行改良Widman翻瓣术。分别在治疗前、治疗后3个月和6个月,检查记录探诊出血（bleeding on probing,BOP）、探诊深度（probing depth,PD）、牙龈退缩（gingival recession,GR）及临床附着水平（clinical attachment level,CAL）,并比较分析。结果二次SRP组和翻瓣组患牙的BOP阳性率、PD、GR、CAL治疗前分别为91.30%、（5.60±0.99）mm、（0.37±0.49）mm、（5.98±1.17）mm和92.13%、（5.87±1.02）mm、（0.30±0.47）mm、（6.03±1.30）mm,治疗后6个月分别为17.39%、（2.87±0.78）mm、（2.00±0.62）mm、（5.07±1.01）mm和11.23%、（2.53±0.51）mm、（2.36±0.68）mm、（4.89±0.84）mm,2组治疗后6个月各项指标与治疗前比较差异均有统计学意义（P〈0.01）。治疗后6个月2组间BOP阳性率、PD及CAL比较差异无统计学意义（P〉0.05）,但翻瓣组GR明显高于二次SRP组（P〈0.05）。结论对于前牙或前磨牙,二次SRP与牙周翻瓣术可达到相同的治疗效果,翻瓣术后牙龈退缩较二次牙周龈下刮治和根面平整后明显。     

大黄提取物治疗伴糖尿病重度牙周炎的疗效观察

目的: 观察大黄提取物局部应用治疗伴糖尿病重度牙周炎的临床疗效。方法: 将50例伴糖尿病的重度牙周炎患者随机分为对照组（龈下刮治和根面平整术）和实验组（龈下刮治和根面平整术+术后局部应用大黄提取物软膏）。2组患者均在治疗前、治疗后6周、治疗后12周检查牙周探诊深度(probing pocket depth, PD)、临床附着水平(clinical attachment level, CAL)、探诊出血指数(bleeding on probing, BOP)。采用SPSS 20.0软件包对实验数据进行统计学分析。结果: 相比治疗前,2组患者在治疗后6周和治疗后12周, PD、CAL、BOP均有下降,实验组低于对照组,有统计学差异。表明2组患者经过治疗后牙周状况都有明显改善,实验组改善优于对照组。整个实验过程中未发生药物不良反应。结论: 大黄提取物局部应用辅助治疗伴糖尿病的重度牙周炎有良好的临床疗效。     

慢性牙周炎基础治疗后维护期疗效纵向观察及分析

目的观察慢性牙周炎患者基础治疗后维护期的疗效,并分析牙位和位点因素对牙周袋探诊深度变化的影响。方法对牙周基础治疗后进入维护期的22例慢性牙周炎患者进行9个月的纵向观察。每3个月给予口腔卫生宣教,龈上洁治、龈下刮治和根面平整。在基线(基础治疗完成后)和每次复查时记录牙周袋探诊深度、临床附着丧失和探诊出血情况。结果维护治疗期间,牙周袋探诊深度、临床附着丧失、探诊出血等临床指标均有进一步改善。牙周袋深度前牙减少(0.52±1.02)mm,后牙减少(0.37±1.26)mm,差异有统计学意义(P<0.05);邻面位点与非邻面位点相比,邻面位点的牙周袋深度减少更显著(P<0.05);6 mm及以上的位点牙周袋深度减少(1.88±2.19)mm,4~5 mm的位点牙周袋深度减少(1.12±1.32)mm,差异有统计学意义(P<0.05)。结论慢性牙周炎患者基础治疗后每3个月进行维护治疗,可使牙周临床指标进一步改善,牙位与位点因素均对牙周袋深度的变化有影响。     

Diode激光辅助治疗对老年人牙周炎的疗效观察

目的:比较Diode激光辅助牙周基础治疗(实验组)与单纯的牙周基础治疗(对照组)对老年人牙周炎的治疗效果.方法:选择20位老年牙周炎患者共70颗牙,左右对称,随机确定一侧为实验组,对侧牙为对照组.口腔卫生宣教和龈上洁治后2周为基线,治疗2周、4周、8周后记录龈沟出血指数(SBI)、牙周袋深度(PD)和附着水平(CAL),并进行统计分析比较.结果:实验组和对照组的SBI在2周、4周、8周后与基线比较均有明显改善(P＜0.05).PD改善方面,仅实验组在4周后较基线有明显降低(P＜0.05).不管实验组还是对照组,CAL治疗后与基线比较均没有明显改善(P＞0.05).两组之间比较,SBI、PD和CAL的改善均没有明显差异(P＞0.05).结论:Diode激光辅助牙周基础治疗和单纯的牙周基础治疗均对改善老年患者的龈沟出血指数和牙周袋深度有效,但Diode激光辅助牙周基础治疗与单纯的牙周基础治疗相比没有显著提高治疗效果.     

Subgingival utilization of a 1% chlorhexidine collagen gel for the treatment of periodontal pockets. A clinical and microbiological study.

This study evaluates the effect of subgingival irrigation with a 1% chlorhexidine collagen gel in periodontal pockets as an adjunct procedure to scaling and root planing (SRP). Thirty-seven sites with probing depth (PD) of 5-7 mm and BANA positive in 6 patients with chronic periodontal disease were selected. Sites were assigned to different treatment groups consisting of SRP only (group 1), SRP + irrigation with collagen gel (group 2), or SRP + irrigation with collagen gel containing 1% chlorhexidine (group 3). Subgingival irrigation was performed after initial SRP and at 7, 14 and 21 days. Clinical measurements including PD, plaque index (PI), gingival index (GI), gingival recession (GI), bleeding on probing (BOP) and clinical attachment level (CAL) were performed at the selected sites at baseline, 60 and 90 days and the BANA test was performed on plaque samples from the same sites at baseline and 90 days. There was an improvement in clinical parameters in all groups with a significantly greater decrease in GI and bleeding in the chlorhexidine group. There was a greater reduction of BANA positive sites in groups 2 and 3. The authors concluded that 1% chlorhexidine collagen gel is a promising adjunct to SRP in the treatment of adult periodontitis.     

The adjunctive use of a controlled-release chlorhexidine chip following treatment with a new ultrasonic device in supportive periodontal therapy: a prospective, controlled clinical study

OBJECTIVE: The aim of this randomised, split-mouth, controlled clinical trial was to evaluate the effectiveness of a controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP) with a newly developed ultrasonic device in supportive periodontal therapy (SPT). MATERIALS AND METHODS: Twenty patients with moderate-to-severe chronic periodontitis, displaying at least four sites with probing depth (PD) > or = 5 mm and persistent bleeding on probing (BOP), were recruited for the study. The target sites were randomly treated with either a newly developed piezo-driven ultrasonic device Vector--or ultrasonic system (VUS) + CHX chip or VUS alone without adjunctive antimicrobial treatment. The clinical parameters, plaque index (PI), gingival index (GI), BOP, PD and clinical attachment level (CAL) were recorded at baseline and after 1, 3 and 6 months. RESULTS: At baseline, there were no significant differences between test and control sites for any of the investigated parameters. The average reduction of PD and improvement in CAL was greater in the VUS + CHX chip sites than in sites treated with the VUS alone at 1, 3 and 6 months (P < 0.05). The mean reductions on PD and CAL were 0.7 and 0.6 mm for the control sites and 2.2 and 1.9 mm for the test sites, respectively. Also, the mean reduction in BOP scores were higher in the VUS + CHX chip sites compared to VUS alone at 1, 3 and 6 months (P < 0.05). PI scores were not significantly different between VUS + CHX chip sites and VUS alone sites at any visit. CONCLUSION: These data suggest that CHX chip application following SRP with the tested ultrasonic device is beneficial in improving periodontal parameters in patients on SPT.     

Boric Acid Irrigation as an Adjunct to Mechanical Periodontal Therapy in Patients With Chronic Periodontitis: A Randomized Clinical Trial

Background: The purpose of this single‐masked, randomized, controlled clinical trial was to evaluate the effects of boric acid irrigation as an adjunct to scaling and root planing (SRP) on clinical and microbiologic parameters and compare this method with chlorhexidine irrigation and SRP alone in patients with chronic periodontitis (CP). Methods: Forty‐five systemically healthy patients with CP are included in this study. They were divided into three groups: 1) SRP + saline irrigation (C); 2) SRP + chlorhexidine irrigation (CHX); and 3) SRP + boric acid irrigation (B). To determine an ideal concentration of boric acid, a preclinical analysis was conducted. At baseline, 1 month, and 3 months after treatment, clinical measurements, including plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were performed, and subgingival plaque samples were taken. Quantitative analysis of Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), and Treponema denticola (Td) was performed using real‐time polymerase chain reaction (PCR) procedures. Results: The concentration of boric acid is 0.75% in this study. All clinical parameters showed statistically significant reduction at all time points compared to baseline in all groups (P <0.001). Whole‐mouth PD and CAL reduction was similar in all groups at all time points after treatment (P >0.05). The PD and CAL reductions for moderately deep pockets (PD ≥5 and <7) were greater in the B group compared to other groups between baseline and 1 month (P <0.05). For deep pockets (PD ≥7), reductions were similar in the B and CHX groups (P >0.05). BOP (percentage) was significantly lower in the B group compared with the CHX and C groups in the first month after treatment (P <0.001). GI and PI scores were significantly lower in the B and CHX groups compared with the C group at all time points after treatment (P <0.05). The amounts of Pg, Tf, and Td were significantly reduced in all treatment groups after 1 month (P <0.05). No statistically significant differences were detected among the groups for microbiologic parameters at any time points after treatment (P >0.05). Conclusions: The results of this study suggest that boric acid could be an alternative to chlorhexidine, and it might be more favorable because boric acid was superior in whole‐mouth BOP as well as PD and CAL reduction for moderate pockets in early time periods.     

The effect of subgingival controlled-release delivery of chlorhexidine chip on clinical parameters and matrix metalloproteinase-8 levels in gingival crevicular fluid

BACKGROUND: The present study evaluated the efficacy of controlled-release delivery of chlorhexidine gluconate (CHX) on clinical parameters and on gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels in chronic periodontitis patients. METHODS: Twenty patients with chronic periodontitis were screened for 6 months. Two interproximal sites were selected from mesial surfaces of anterior teeth with probing depths of 6 to 8 mm that bled on probing in each patient. There were at least 2 teeth between the selected sites. CHX chip was inserted into a randomly selected site following scaling and root planing (SRP+CHX), while the other selected site received only SRP in each patient. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), and papilla bleeding index (PBI) were recorded at baseline and at 1, 3, and 6 months. GCF MMP-8 levels were analyzed at baseline; 2 and 10 days; and at 1, 3, and 6 months by immunofluorometric assay (IFMA). RESULTS: At baseline, there were no statistically significant differences in the mean PD, CAL, PBI, and PI scores between SRP+CHX and SRP alone groups. At 1, 3, and 6 months, all clinical parameters in each group significantly decreased (P <0.0167) when compared to baseline. The reduction of PD and improvement in CAL were higher in the SRP+CHX group compared to SRP alone at 3 and 6 months. However, the differences between the 2 groups were not statistically significant. PBI and PI scores were not significantly different between SRP+CHX and SRP alone groups at any visit. GCF MMP-8 levels were similar in both groups at baseline. Intragroup analysis showed significant decreases in the GCF MMP-8 level for the SRP+CHX group between baseline and 1, 3, and 6 months (P<0.01). Intergroup analysis demonstrated significantly lower mean levels of GCF MMP-8 at 1 month in the SRP+CHX group compared to the SRP alone group (P <0.05). CONCLUSIONS: These data suggest that CHX chip application following SRP is beneficial in improving periodontal parameters and reducing GCF MMP-8 levels for 6 months' duration. The use of a chairside MMP-8 dipstick periodontitis test might be a useful adjunctive diagnostic tool when monitoring the course of CHX chip treatment.     

Short-term clinical and immunologic effects of scaling and root planing with Er:YAG laser in chronic periodontitis

BACKGROUND: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis. METHODS: Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P <0.05). RESULTS: Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P <0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P <0.05); and BOP decreased for SRPL, L, and SRP groups (P <0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P <0.05). PD decreased in treated groups (P <0.001), and differences were found between SRPL and C groups (P <0.05). CAL gain was significant only for the SRP group (P <0.01). GR increased for SRPL and L groups (P <0.05). No difference in IL-1beta was detected among groups and periods. CONCLUSION: Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.     

A randomized clinical trial on the clinical and microbiological efficacy of a xanthan gel with chlorhexidine for subgingival use

Background

The main indication of the adjunctive use of local antimicrobials lies around situations in which the outcome of non-surgical mechanical treatment results in a limited number of residual pockets. The purpose of this investigation was to evaluate the clinical and microbiological effects of the subgingival application of a xanthan-based 1.5% chlorhexidine (CHX) gel (Xan–CHX), adjunctive to scaling and root planing (SRP) in localized periodontitis.

Methods

Periodontitis patients with four to ten residual (after conventional SRP) or relapsing (during supportive periodontal treatment) pockets were recruited and randomized to receive SRP plus the subgingival application of (Xan–CHX) or SRP plus a placebo gel. Supragingival plaque, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level were evaluated with a computerized probe at baseline, and after 1, 3, and 6 months. Subgingival samples were also collected for the microbiological analysis. Statistical analysis used ANOVA and chi-square tests.

Results

Overall, the clinical results were better in the test group, with significant changes in BOP (between baseline and 3 months) and with a significant increase in the proportion of shallow pockets (1–3 mm) at 6 months. These results did not result in significant intergroup differences. The microbiological impact was limited in both treatment groups.

Conclusion

The adjunctive use of Xan–CHX may improve, although to a limited extent, the clinical outcomes (BOP and PPD), in chronic periodontitis patients with “residual” or “relapsing” pockets, but no significant differences were detected between groups. No side effects, neither clinical nor microbiological, were detected after the use of the test product.

Clinical relevance

Adjunctive use of slow-released chlorhexidine might be considered in the management of periodontal disease and gingival inflammation to reduce the need for periodontal surgery.     

A novel approach to the use of subgingival controlled-release chlorhexidine delivery in chronic periodontitis: a randomized clinical trial

Background: We aimed to analyze clinical, microbiologic, and serologic effects of chlorhexidine (CHX) chips used as a subgingival controlled‐release delivery device before and immediately after scaling and root planing (SRP). Methods: Twenty‐four patients presenting with ≥12 teeth with probing depth (PD) ≥5 mm and bleeding on probing were assigned in test or control groups. After prophylaxis, CHX chips (test) or placebo chips (control) were placed in pockets with PD ≥5 mm. Ten days later, SRP was performed in all teeth with PD ≥4 mm in a single appointment. Immediately after SRP, new chips were inserted in all pockets with PD ≥5 mm. Parameters were assessed at baseline; beginning of SRP; and 1, 3, and 6 months after treatment. Subgingival samples were obtained at baseline; beginning of SRP; and at 1 month after treatment. Periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola were analyzed. Serum levels of high sensitive C‐reactive and lipopolysaccharide‐binding proteins were measured. The changes of the parameters between and within the groups were tested by Mann‐Whitney U test (P <0.05). Results: All clinical and serologic parameters improved in both groups over time. There was a significant difference in clinical attachment level (CAL) gain from baseline to 6 months between groups (1.17 mm in the test group versus 0.79 mm in the placebo group) (P <0.05). The treatment with CHX chips showed a greater reduction of the microorganisms of the “red complex” after 1 month (P = 0.02). Conclusion: The use of CHX chips before and immediately after SRP improved CAL and reduced the subgingival microorganisms of the red complex in the treatment of chronic periodontitis.     

Clinical evaluation of partial- and full-mouth scaling in the treatment of chronic periodontitis

BACKGROUND: Full-mouth scaling (FMS) is claimed by some researchers to be superior to standard scaling and root planing (SRP). The aim of the present study was to evaluate clinical outcomes of two modalities of non-surgical periodontal therapy for patients with chronic periodontitis. METHODS: In a prospective, randomized, controlled clinical study, 37 subjects with chronic periodontitis were treated by SRP in two quadrants at 4-week intervals (N=20) or by FMS (N=17). Clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP) were recorded at premolar and molar teeth at baseline and after 6 and 12 months. RESULTS: Both therapies resulted in significant improvements of all clinical variables. After 12 months, CAL at pockets with PDs of 4 to 6 mm was reduced significantly from 4.5+/-0.8 mm to 3.4+/-1.0 mm with SRP and from 4.7+/-0.9 mm to 3.8+/-1.1 mm with FMS (P<0.001). PD decreased from 4.4+/-0.6 mm to 3.3+/-0.9 mm in the SRP group and from 4.5+/-0.7 mm to 3.5+/-1.0 mm in the FMS group (P<0.001). BOP was reduced from 63.6%+/-45.3% to 29.0%+/-42.6% in the SRP group and from 59.6%+/-43.8% to 28.6%+/-38.3% in the FMS group (P<0.001 and P=0.001, respectively). There were no significant differences between the groups with respect to CAL gain, PD, and BOP reduction. CONCLUSION: Both therapy modalities have the same positive influence on clinical outcome at premolar and molar teeth with PDs of 4 to 6 mm.     

Clinical Effectiveness of Diode Laser Therapy as an Adjunct to Non‐Surgical Periodontal Treatment: A Randomized Clinical Study

Background: The aim of this randomized clinical study is to evaluate the effect of a 980‐nm diode laser as an adjunct to scaling and root planing (SRP) treatment. Methods: Thirty‐five patients with chronic periodontitis were selected for the split‐mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. Results: The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18‐week (P <0.05) and 6‐ to 18‐ week (P <0.05) periods, whereas no difference was found between LG and CG in the remaining clinical parameters (P >0.05). Conclusion: The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980‐nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).     

派丽奥治疗套筒冠修复后再发牙周炎的临床研究

目的评价派丽奥牙科用软膏局部应用治疗套筒冠修复后再发牙周炎的临床效果.方法用随机、单盲、自身对照的方法,以单纯基础治疗为对照.记录基线、用药后1周、4周及8周菌斑指数(PLI);牙龈指数(GI);龈沟出血指数(SBI);牙周探诊深度(PD).并进行数据分析.结果实验组较对照组PLI在用药后1周有显著差异;其余各观察时段PLI无显著差异(P＞0.05).而GI和SBI两组间在用药后1周无显著性差异(P＞0.05);但用药后4周及8周有差异(P＜0.05).PD在用药后1周两组间有差异(P＜0.05);在用药后4周及8周有显著差异(P＜0.01).结论派丽奥局部辅助用药能提高套筒冠修复后再发牙周炎的治疗效果.