There is an association between chronic periodontitis and cardiovascular disease (CVD). However, it is not known whether periodontal therapy could prevent or manage CVD in patients with chronic ...periodontitis.
The objective of this systematic review was to investigate the effects of periodontal therapy in preventing the occurrence of, and management or recurrence of, CVD in patients with chronic periodontitis.
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 31 August 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 7), MEDLINE Ovid (1946 to 31 August 2017), Embase Ovid (1980 to 31 August 2017) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL EBSCO) (1937 to 31 August 2017) . The US National Institutes of Health Trials Registry (ClinicalTrials.gov), the World Health Organization International Clinical Trials Registry Platform and Open Grey were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.We also searched the Chinese BioMedical Literature Database (1978 to 27 August 2017), the China National Knowledge Infrastructure (1994 to 27 August 2017), the VIP database (1989 to 27 August 2017) and Sciencepaper Online (2003 to 27 August 2017).
Randomised controlled trials (RCTs) and quasi-RCTs were considered eligible. Studies were selected if they included patients with a diagnosis of chronic periodontitis and previous CVD (secondary prevention studies) or no CVD (primary prevention studies); patients in the intervention group received active periodontal therapy compared to maintenance therapy, no periodontal treatment or another kind of periodontal treatment in the control group.
Two review authors carried out the study identification, data extraction and risk of bias assessment independently and in duplicate. Any discrepancies between the two authors were resolved by discussion or with a third review author. A formal pilot-tested data extraction form was adopted for the data extraction, and the Cochrane tool for risk of bias assessment was used for the critical appraisal of the literature.
No studies were identified that assessed primary prevention of CVD in people with periodontitis. One study involving 303 participants with ≥ 50% blockage of one coronary artery or a coronary event within three years, but not the three months prior, was included. The study was at high risk of bias due to deviation from the protocol treatment allocation and lack of follow-up data. The trial compared scaling and root planing (SRP) with community care for a follow-up period of six to 25 months. No data on deaths (all-cause or CVD-related) were reported. There was insufficient evidence to determine the effect of SRP and community care in reducing the risk of CVD recurrence in patients with chronic periodontitis (risk ratio (RR) 0.72; 95% confidence interval (CI) 0.23 to 2.22; very low quality evidence). The effects of SRP compared with community care on high-sensitivity C-reactive protein (hs-CRP) (mean difference (MD) 0.62; -1.45 to 2.69), the number of patients with high hs-CRP (RR 0.77; 95% CI 0.32 to 1.85) and adverse events (RR 9.06; 95% CI 0.49 to 166.82) were also not statistically significant. The study did not assess modifiable cardiovascular risk factors, other blood test results, heart function parameters or revascularisation procedures.
We found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.
•Asymmetric 2D+T theory is applied for the motion prediction of heeled planing hulls.•Formulas are presented for the added mass of wedge sections in two directions.•Formulations of heave and sway ...force, as well as roll restoring and pitch moments are derived.•Predicted results are compared against available experimental data in six steps.•Sway force and yaw moment acting on the heeled warped planing boats are determined.
Current paper presents a mathematical model based on 2D-asymmetric wedge water entry to model heave and pitch motions of planing hulls at non-zero heel angles. Vertical and horizontal forces as well as heeling moment due to asymmetric water entry are computed using momentum theory in conjunction with added mass of impact velocity in vertical and horizontal directions. The proposed model is able to compute sway and yaw forces, roll moment, as well as heave and pitch motions in calm water and regular waves. Validity of the proposed model is verified by comparing the results against existing experimental data in both symmetric and asymmetric conditions. Ultimately, different parametric studies are conducted to examine the effects of non-zero heel angle on dynamic vertical motions. The resulting sway and yaw forces due to asymmetric motion are also derived and effects of heel angle on these side forces are investigated.
•New approach is proposed to solve hydrothermal generation scheduling.•Particle swarm optimization (PSO) is improved by adding dynamic learning ability.•New strategies are proposed for handling ...equality constraints.•Studying 3 non-convex cases with multi-chain cascade hydropower and thermal units.
The main objective of the short-term hydrothermal generation scheduling (SHGS) problem is to determine the optimal strategy for hydro and thermal generation in order to minimize the fuel cost of thermal plants while satisfying various operational and physical constraints. Usually, SHGS is assumed for a 1day or a 1week planing time horizon. It is viewed as a complex non-linear, non-convex and non-smooth optimization problem considering valve point loading (VPL) effect related to the thermal power plants, transmission loss and other constraints. In this paper, a modified dynamic neighborhood learning based particle swarm optimization (MDNLPSO) is proposed to solve the SHGS problem. In the proposed approach, the particles in swarm are grouped in a number of neighborhoods and every particle learns from any particle which exists in current neighborhood. The neighborhood memberships are changed with a refreshing operation which occurs at refreshing periods. It causes the information exchange to be made with all particles in the swarm. It is found that mentioned improvement increases both of the exploration and exploitation abilities in comparison with the conventional PSO. The presented approach is applied to three different multi-reservoir cascaded hydrothermal test systems. The results are compared with other recently proposed methods. Simulation results clearly show that the MDNLPSO method is capable of obtaining a better solution.
BACKGROUND: Scaling and root planing SRP being the mainstay of treatment of periodontitis encompasses unambiguous impediments. antiseptics represent an aid to nonsurgical periodontal therapy. ...OBJECTIVE: This randomized controlled, split mouth study design with an observation period of three months aims to clinically evaluate the efficacy of ozonised oil and chlorhexidine as an adjunct to SRP. METHODS: Twenty-five patients of both sexes with an age range of 30–65 years diagnosed with chronic periodontitis and having a periodontal probe depth (PD)≥5 mm and CAL≥3 mm on at least 1 site in each quadrant were included in this randomised split mouth design study. Patients were allocated in 2 experimental treatment groups as SRP + chlorhexidine gel (control sites) and with SRP + ozone oil (test sites). The plaque index (PI), gingival index (GI), and periodontal pocket depth (PPD), clinical attachment level (CAL) were recorded at baseline data and after 30 days post-baseline. RESULTS: The present study showed significant results in both the groups with regards to the improvement in the clinical parameters. When comparison was made between the two groups, it has been assessed that the use of the ozonized oil in addition to SRP did not show significant differences when compared to conventional SRP + chlorhexidine. CONCLUSION: For bye to SRP, ozonized oil can be considered as a viable alternative to chlorhexidine in the treatment of periodontitis, especially considering its low toxicity compared to chlorhexidine.
Background
In a previous pilot study, one‐time application of anti‐Porphyromonas gingivalis gingipain egg yolk immunoglobulin (IgY) into scaling and root planing (SRP)‐treated periodontal pockets ...showed profound improvement of clinical and bacteriological parameters in patients with chronic periodontitis. The present study aims to evaluate the efficacy of daily use of lozenges fortified with the antibody as an adjunct to non‐surgical therapy in patients with periodontitis.
Methods
Sixty‐four patients with periodontitis were divided randomly into a test and a placebo group. The groups were treated by SRP followed by a daily use of lozenges containing either specific IgY against P. gingivalis gingipains (test) or a sham‐immune IgY (placebo). Gingival bleeding index (GBI), probing pocket depth (PD) and quantitation of P. gingivalis in the gingival pockets were assessed at baseline and 8 weeks after the initiation of treatment and compared by using Wilcoxon signed rank test, Mann‐Whitney U‐test or t test.
Results
Both groups showed significant improvement of all parameters at 8 weeks post treatment (P < 0.001). There was a significant difference in reduction of GBI (P < 0.001) and P. gingivalis cell counts (P < 0.05) in the test group compared with the placebo group. The reduction of PD was greater in the test group compared with the placebo group although there was no statistically significant difference between the two groups.
Conclusions
The adjunctive use of lozenges containing IgY antibody against gingipains from P. gingivalis resulted in clinical and microbiological benefits in the treatment for chronic periodontitis. Additional investigations are needed to examine if the IgY brings benefits to case patients who do not receive SRP.
Objectives: To review the literature on non‐surgical treatment of peri‐implant mucositis and peri‐implantitis.
Material and Methods: A search of PubMed and The Cochrane Library of the Cochrane ...Collaboration (CENTRAL) as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included.
Results: Out of 437 studies retrieved a total of 24 studies were selected for the review. Thus the available evidence for non‐surgical treatment of peri‐implant mucositis and peri‐implantitis is scarce.
Conclusions: It was observed that mechanical non‐surgical therapy could be effective in the treatment of peri‐implant mucositis lesions. Furthermore, the adjunctive use of antimicrobial mouth rinses enhanced the outcome of mechanical therapy of such mucositis lesions. In peri‐implantitis lesions non‐surgical therapy was not found to be effective. Adjunctive chlorhexidine application had only limited effects on clinical and microbiological parameters. However, adjunctive local or systemic antibiotics were shown to reduce bleeding on probing and probing depths. Minor beneficial effects of laser therapy on peri‐implantitis have been shown; this approach needs to be further evaluated. There is a need for randomized‐controlled studies evaluating treatment models of non‐surgical therapy of peri‐implant mucositis and peri‐implantitis.
Background
Several potential benefits have been attributed to the platelet‐rich fibrin (PRF), including enhanced tissue healing properties. In this study, we hypothesized that the application of PRF ...as an adjunct to conventional scaling and root planing (ScRp) would enhance the outcomes of non‐surgical periodontal therapy.
Methods
The present study was a split‐mouth randomized controlled clinical trial design in 24 deep periodontal pockets in 12 patients with periodontitis. The pockets were randomly assigned as test or control. The test group received PRF as an adjunct to ScRp, whereas the control group received ScRp only. We measured periodontal clinical parameters at baseline, 3, and 6 months after the treatments. To study the initial healing in response to treatment, transforming growth factor‐β (TGF‐β) and collagen‐1 (Col‐1) in gingival crevicular fluid (GCF) were measured using enzyme‐linked immunosorbent assay at baseline, third, seventh, and 14th days.
Results
The test group showed a significantly greater pocket reduction, higher clinical attachment gain, and less gingival recession than the control group at 3 and 6 months. The test Col‐1 levels (1.27 ± 1.05, 1.35 ± 0.76, 0.97 ± 0.53 ng/site) and TGF‐β levels (11.93 ± 2.68, 12.54 ± 3.66, 17.19 ± 11.66 pg/site) were higher than the control Col‐1 levels (0.76 ± 0.20, 0.84 ± 0.24, 0.57 ± 0.19 ng/site) and TGF‐β levels (6.34 ± 1.67, 6.35 ± 3.44, 7.51 ± 2.85 pg/site) at all measurement days respectively.
Conclusions
Non‐surgical application of the PRF as an adjunct to conventional ScRp may effectively improve the periodontal clinical parameters via increasing expression of the GCF TGF‐β and Col‐1 levels.
To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and ...nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS-I. For the meta-analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%-66%), followed by scaling and root planing (SRP) (44%-36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%-28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%-26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency.
Objective
Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling ...and root planing (SRP) versus SRP alone for the treatment of CP.
Materials and methods
Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored.
Results
Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm,
p
< 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm,
p
< 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%,
p
< 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (
p
< 0.05); and the level of inflammatory mediators was significantly reduced (
p
< 0.003) compared to SRP alone.
Conclusions
SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone.
Clinical relevance
Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.
PDF
