Background
Despite the body of evidence supporting the clinical benefits of metronidazole (MTZ) and amoxicillin (AMX) in the treatment of young patients with periodontitis, the microbiological ...outcomes of this antibiotic protocol have been less explored. This study evaluated the microbiological effects of adjunctive MTZ+AMX in the treatment of young patients with periodontitis.
Methods
Subjects with periodontitis Stages III or IV and ≤30 years old were randomly allocated to receive scaling and root planing (SRP) with placebo (n = 15) or with MTZ (400 mg) and AMX (500 mg) three times a day for 14 days (n = 15). Nine subgingival biofilm samples per subject (three samples from each probing depth (PD) category: ≤3, 4–6, and ≥7 mm) were collected at baseline and 3‐, 6‐, and 12‐months post‐treatment and individually analyzed for 40 bacterial species by checkerboard DNA–DNA hybridization.
Results
Thirty subjects (15/group) with mean ages 27.6 ± 3.5 (control) and 26.8 ± 3.9 (test) were included. At 12 months post‐therapy, the antibiotic group harbored lower proportions of red complex (1.3%) than the placebo group (12.5%) (p < 0.05). SRP + MTZ+AMX was more effective than mechanical treatment in reducing levels/proportions of several pathogens and increasing proportions of Actinomyces species (p < 0.05). Levels/proportions of Aggregatibacter actinomycetemcomitans were only reduced in the antibiotic group (p < 0.05). This group also exhibited greater reduction in the number of sites with PD ≥5 mm and higher percentage of subjects reaching the clinical end point for treatment (≤4 sites with PD ≥5 mm) than the control group (p < 0.05).
Conclusion
SRP+MTZ+AMX allowed for establishing a long‐term healthier subgingival biofilm community and periodontal clinical condition, than SRP only.
This study aims to evaluate the clinical efficacy of curcumin versus chlorhexidine as adjuncts to scaling and root planing (SRP) for periodontitis treatment. We searched PubMed, EMbase, Cochrane ...Library, and ClinicalTrials.gov from inception to February 18, 2021 and identified studies with relevant randomized controlled trials (RCTs) using curcumin or chlorhexidine as an adjunct to SRP. Nine RCTs involving 420 patients/sites were included. A meta‐analysis with a random‐effects model revealed that curcumin and chlorhexidine, as an adjunct to SRP, reduced probing pocket depth (PPD) at similar levels during a 3‐, 4‐, 6‐, and 12‐week follow‐up. No significant differences were observed in reducing clinical attachment loss (CAL) between curcumin and chlorhexidine as an adjunct to SRP at 4 weeks and 6 weeks. Furthermore, gingival index (GI) and plaque index (PI) were similar using curcumin versus chlorhexidine as an adjunct to SRP at the 4‐week‐, 6‐week‐, and 12‐week follow‐up. Based on the available evidence in RCTs, compared with chlorhexidine as an adjunct to SRP, curcumin has a similar effect on reducing PPD, CAL, GI, and PI. The quality of evidence is low, limited by the number of studies and their limitations. Further studies are needed to firmly establish the clinical efficacy of curcumin.
Abstract
Radiographic findings from long‐term studies of periodontitis treatment have rarely been reported. Although bone destruction is a prominent feature of periodontitis, the long‐term effect on ...alveolar bone levels of different treatment strategies, with or without adjunctive metronidazole (MTZ), has not been reported. We investigated the 5‐year radiographic outcome of therapy in patient groups treated with conventional scaling and root planing (SRP) or same‐day full‐mouth disinfection (FDIS), with or without adjunctive MTZ. Following a 3‐month oral hygiene phase, 184 periodontitis patients were randomly allocated to one of four treatment regimens: (i) FDIS+MTZ; (ii) FDIS+placebo; (iii) SRP+MTZ; or (iv) SRP+placebo. Following active treatment, patients received biannual maintenance. In total, 161 patients (87.5%) completed the 5‐year follow‐up examination, at which the radiographic bone level (RBL), clinical attachment level, probing pocket depth, presence of plaque, and bleeding were recorded again. At the 5‐year follow up examination, minor radiological bone loss was observed in the intervention groups FDIS+placebo, SRP+MTZ, and SRP+placebo; by contrast, the FDIS+MTZ group did not show any change in RBL. Full‐mouth disinfection did not generally perform better than conventional SRP performed over a period of 2 to 4 weeks.
Aim
To investigate the potential benefit of enamel matrix derivative (EMD) as adjunct to re‐instrumentation of residual pockets persisting after steps 1 and 2 of periodontal therapy.
Material and ...Methods
44 adult patients participated in a multicentre feasibility randomized clinical trial with split‐mouth design. They had presented at re‐evaluation after initial non‐surgical periodontal therapy (steps 1 and 2 of periodontal therapy) for generalized periodontitis with at least 2 teeth with residual probing pocket depths (PPD) ≥5 and ≤8 mm, with bleeding on probing (BOP). Two teeth with similar PPD were randomized to receive re‐instrumentation either with (test) or without (control) adjunctive flapless administration of EMD. Differences in the changes of PPD and BOP from baseline to 6 and 12 months were analysed, and the frequencies of pocket closure (PPD ≤4 mm and no BOP) compared.
Results
For the primary outcome “change of mean PPD after 6 months,” a significant additional benefit of 0.79 ± 1.3 mm (p < .0001) could be observed for the test group. At 12 months, this difference could be maintained (0.85 ± 1.1 mm; p < .0001). The frequency of pocket closure in the test group was 69% at 6 and 80% at 12 months and significantly higher than in the control group with 34% and 42%, respectively (p < .01).
Conclusions
The results of the present feasibility study indicate a benefit of adjunctive EMD during non‐surgical retreatment (step 3 of periodontal therapy) of residual deep pockets.
The general objective of the study is to determine and analyze the perception of the brand of this club for its customers. The specific objectives are focused on: identifying and characterizing the ...sports organization's customers and building personas that allow the creation of personalized content; select dimensions of the service provided and assess consumers' perception; identify the value given by customers to the addition of new services. The results of the study offer a different perspective from previous studies, from the point of view of parents, who show greater interest in their students practicing a sport and are simultaneously looking out for their health and well-being, than precisely because they aspire to for them a career in football. Therefore, clubs should pay attention to this trend and try to respond to them. These principles apply both in Portugal and internationally, where opportunities, in financial terms and in terms of raw talent, present themselves as important growth prospects for the sports projects of Portuguese football clubs. To this end, the importance of developing and disseminating a differentiating brand, centered on customer needs, with quality and visible results is highlighted, allowing for an increase in the club's reputation and the opening of more football schools.
Background and Objective
Full‐mouth scaling and root planing (FM‐SRP) increases the systemic levels of inflammatory mediators via early inflammation but may be inhibited using an antimicrobial agent. ...This prospective intervention study evaluates the biological response and clinical effects of FM‐SRP with and without systemically administered azithromycin (AZM).
Materials and Methods
A multicenter parallel randomized controlled and open‐label trial. A central randomization center used computer‐generated tables to allocate treatments. Sixty‐three patients with moderate to severe generalized periodontitis (New American Academy of Periodontology Classification: Stage3 or 4, Grade B) were randomly assigned to receive FM‐SRP with AZM (test group, n = 32) or FM‐SRP without AZM (control group, n = 31). Clinical parameters and body temperature were measured, and subgingival plaque, peripheral blood, and gingival crevicular fluid were collected before and after treatment. Periodontopathic bacteria and IgG titers were measured by gingival crevicular fluid and peripheral blood. High‐sensitivity assays were used to analyze systemic and local inflammatory markers, such as endotoxin, high‐sensitive CRP (hs‐CRP), and six inflammatory cytokines. Follow‐up 6 weeks.
Results
The total number of bacteria and the number of Porphyromonas gingivalis and Prevotella intermedia were significantly lower in the test group after FM‐SRP. IgG titers for P gingivalis significantly decreased after FM‐SRP with AZM, and the body temperature increased significantly after FM‐SRP without AZM. In the control group, serum hs‐CRP, IFN‐γ, IL‐12p70, and IL‐6 were significantly increased one day after treatment, but subsequently decreased below the original numerical value. In the test group, only hs‐CRP showed a significant increase.
Conclusions
FM‐SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM‐SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM‐SRP.
Aim
The aim of this study was to assess the effect of systemic antibiotic therapy on the treatment of aggressive periodontitis (AgP).
Methods
This study was conducted and reported in accordance with ...the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2014 for randomized clinical trials comparing the treatment of subjects with AgP with either scaling and root planing (SRP) alone or associated with systemic antibiotics. Bayesian network meta‐analysis was prepared using the Bayesian random‐effects hierarchical models and the outcomes reported at 6‐month post‐treatment.
Results
Out of 350 papers identified, 14 studies were eligible. Greater gain in clinical attachment (CA) (mean difference MD: 1.08 mm; p < 0.0001) and reduction in probing depth (PD) (MD: 1.05 mm; p < 0.00001) were observed for SRP + metronidazole (Mtz), and for SRP + Mtz + amoxicillin (Amx) (MD: 0.45 mm, MD: 0.53 mm, respectively; p < 0.00001) than SRP alone/placebo. Bayesian network meta‐analysis showed additional benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics.
Conclusions
SRP plus systemic antibiotics led to an additional clinical effect compared with SRP alone in the treatment of AgP. Of the antibiotic protocols available for inclusion into the Bayesian network meta‐analysis, Mtz and Mtz/Amx provided to the most beneficial outcomes.
A young female patient presents to the dental clinic for scaling and root planing with known gonococcal arthritis. The patient is undergoing treatment for the condition with antibiotics. She endorses ...bilateral temporomandibular joint pain. For treatment, the scaling and root planning procedure was completed by quadrant. The patient tolerated the procedure well in this fashion.
The modelling and simulation of planing craft manoeuvres requires coupled six degrees of freedom (6 DOF) motion equations. A coupled 6 DOF motion equation needs hundreds of manoeuvring hydrodynamic ...coefficients (MHCs) that are mostly determined using the planar motion mechanism (PMM) test. The number of test runs is too high, unless a kind of simplification is imposed to the motion equations. This study modifies 6 DOF motion equations to 4+2 DOF motion equations in which heave and pitch equations are replaced by dynamic draught and trim (so-called running attitude), respectively. The method is applicable for a manoeuvre that commences in the planing regime and ends in the same regime. On that basis, the PMM test is conducted and the model is restrained in the vertical plane at a certain running attitude, determined by a resistance test. The 4+2 DOF method, together with MHCs from the PMM test, are employed for the simulation of turning manoeuvres of a 25° prismatic planing hull. The results of the simulation indicate that the 4+2 DOF method reasonably predicts the path of the craft during the turning manoeuvre and cuts the number of PMM tests required at the same time. The PMM test results show that MHCs are highly related to forward speed and wetted surfaces. The turning manoeuvre simulation shows that the non-linear terms of MHCs cannot be ignored. The STD/L (Steady Turning Diameter divided by Length of the craft) for a planing craft is very large, compared to ships.
Highlights • Efficacy of photodynamic therapy (PDT) versus antibiotics in periodontitis was assessed. • Five randomized control trials (RCTs) were included. • Significant heterogeneity was found in ...the laser parameters. • None of the studies showed additional benefits of PDT at follow up. • More RCTs with standard laser parameters and longer follow ups are required.
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