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The present study was designed to evaluate clinical and antimicrobial effects of a single episode of subgingival tetracycline or chlorhexidine (CHX) irrigation in the absence of scaling and root planing.
Thirty patients diagnosed with chronic periodontitis were recruited for this study, each providing four non-adjacent untreated periodontal pockets...
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Introduction: Phase I therapy is the first step in the treatment of periodontal diseases. However, Scaling and root planing (SRP) alone was found to be of limited efficacy especially in certain unapproachable areas, hence use of an adjunct to SRP has been advocated. In past, chlorhexidine has been used as an adjunct to SRP successfully and is consi...
Introduction
Periodontal diseases are caused by pathogenic bacteria locally colonized in the dental biofilm creating infection; the main etiological factor is represented by dental plaque and in particular by anaerobic Gram-negative bacilli. For that reason, the first phase of periodontal treatment is always represented by the initial preparation w...
The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores.
One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal para...
Abstract
Background:
Periodontitis causes the destruction of soft and hard tissues. Stem cells have immense potential in regenerative cellular therapy. This clinical trial aimed to evaluate clinically and radiographically the effectiveness of the local application of Edelweiss stem cells as a nonsurgical treatment for stage III periodontitis.
Mat...
Aim: The aim of the study is to measure the change in depth of periodontal pockets after performing local drug delivery (LDD) with GREEN TEA GEL and comparing it with chlorhexidine gel (HEXIDINE GEL). Materials and Methods: A total of 20 chronic periodontitis patients participated based on the inclusion and exclusion criteria. Complete scaling and...
Citations
... Professional periodontal treatment may not always accomplish satisfactory debridement [9]. To overcome the drawbacks of conventional therapy, several antimicrobial agents have been used systemically or locally [10]. The null hypothesis was that antiplaque efficacy is same between essential oils, chlorhexidine gluconate and sterile saline groups. ...
Background: According to Egyptian pictograms and medical records, non-surgical periodontal treatment (NSPT) has been practised for a very long time. Several clinical studies have depicted relevant clinical results when subgingival irrigation was carried out as an adjuvant therapy to SRP. This study aims to compare essential oils as subgingival irrigant agents with chlorhexidine gluconate (CHX) and sterile saline over a period of 21 days. Setting and Design: This is a comparative study of three groups (chlorhexidine group, essential oil group, sterile saline group). Each group had ten patients having chronic periodontitis who were randomly assigned and treated with subgingival irrigants. For, the essential oil group, the irrigant was indigenously prepared at chairside. Material and Methods: Following the initial examination and selection of patients, clinical parameters were noted and collection of plaque samples was done. These samples were then sent for microbiological assay at baseline. SRP was done along with subgingival irrigation at baseline, 7 th and 14 th day. Clinical parameters were monitored again and plaque samples were sent for microbiological test on the 21 st day. Results: There was no significant difference noted between the groups in any of the clinical parameters. However, regarding microbiological parameter, better results were demonstrated in CHX group and essential oil group compared to sterile saline group that was statistically significant. CHX and essential oil group demonstrated no statistical difference. Conclusion: The result of this study suggests that essential oils can be used as a subgingival irrigant in the treatment of chronic periodontitis.
... Local antimicrobial solutions and gels provide an alternative for eliminating pathogenic microorganisms in areas where dental scaling and root planing cannot reach [5]. Among the chemical agents, chlorhexidine (CHX) has been frequently used because of its proven antimicrobial effect, availability, low cost, safety, efficacy, and low toxicity [6,7]. CHX reduces biofilm formation, alters adsorption and bacterial adhesion to the tooth surface, and disrupts the bacterial wall by cell lysis [8,9]. ...
Objective
Mouthwash is effective in maintaining oral hygiene in patients; however, there is concern that it may adversely affect human oral mucosa. We evaluated a pH-neutral electrolyzed super-oxidized solution (ESS, tradename OxOral®) combined with dental scaling in periodontitis patients. This longitudinal study was conducted with 34 patients divided into three groups. The control group treated with scaling plus saline, the second with scaling plus ESS mouthwash, and another with scaling plus ESS mouthwash and gel. The plaque index (PI), gingival index (GI), and probing depth (PD) were determined before and after periodontal treatment.
Results
The final PI and GI decreased compared with the initial measurements in the three treatment groups (p < 0.05). Scaling plus ESS mouthwash and gel significantly reduced the final PI, GI, and DP compared to the control group (p < 0.05).
Conclusion
Our study shows the antiseptic properties of ESS with mouthwash and gel. Further studies are needed to verify the results.
... This study is in accord with Stabholz et al. 9 and Krishna et al. 10 who assessed the use of a single period of tetracycline (10 mg/ mL) irrigation with no SRP at the investigational sites. As per their study, the extent of antimicrobial activity achieved is comparative to the tetracycline HCl concentration used for irrigation. ...
... 2 In addition, various systemic and local chemical antimicrobial agents have been introduced for the treatment of peri-implantitis, which suppress periodontopathogens more effectively compared to mechanical techniques, and improve the results of conventional mechanical therapeutic techniques. [3][4][5][6][7] Some disadvantages of antimicrobial agents' use, (such as antibiotics) include an increase in the counts of bacteria resistant to these agents, the need for the use of different antibiotics due to the diversity of periodontopathogens, an increase in the number of immunosuppressed patients and the incidence of unfavorable reactions. Considering the complications above, it is necessary to expand research ...
Introduction: Side effects related to antibiotic therapy for peri-implantitis are rare in laser therapy (LT); therefore, the aim of this study was to evaluate the effectiveness of LT and photodynamic therapy (PDT) on patients with primary peri-implantitis. Methods: In this randomized clinical trial, 40 implants presenting primary peri-implantitis in 20 patients with a mean age of 52.6 years old were included using the simple sampling technique. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth while mechanical debridement with titanium curettes and air polishing with sodium bicarbonate powder was accomplished around the implants. The implants were randomly divided into two groups and treated with LT (control) and PDT (test). The clinical indices were measured at baseline, 6 weeks and 3 months after treatment. Real-time polymerase chain reaction (PCR) was used for analysis of microbial samples at baseline and 3-month follow-up. Data were analyzed with SPSS 20, using repeated-measures analysis of variance (ANOVA) and Friedman's and Mann-Whitney tests (a = 0.05). Results: Both groups showed statistically significant improvements in terms of bleeding on probing (P < 0.001), probing pocket depth (PPD) (P = 0.006) and modified plaque index (P < 0.001), with no significant differences between the 2 groups (P > 0.05). The number of Aggregatibacter actinomycetemcomitans (P = 0.022), Tannerella forsythia (P = 0.038) and Porphyromonas gingivalis (P = 0.05) in the test group and Porphyromonas gingivalis (P = 0.015) in the control group significantly decreased. Conclusion: The results suggested that LT and PDT have significant short-term benefits in the treatment of primary peri-implantitis.
... Krishna et al. [19] found similar improvements in CAL value after irrigation of periodontal pockets with both chlorhexidine and saline, which is in accordance with the results of MacAlpine et al. [17] and the results of our study. ...
Objective:
The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP).
Material and methods:
A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL).
Results:
The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall.
Conclusion:
Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
... The ideal sample size to ensure an adequate power for the study was calculated based on the results from a study by Stabholz et al., [5] Krishna et al., [6] and Hosaka et al. [7] Based on the calculation, it was decided that minimum 17 subjects per group were necessary for 80% power at 95% confidence interval (α = 0.05). ...
... Our study is not in agreement with Stabholz et al. [5] and Krishna et al. [6] who evaluated the results of a single episode of irrigation with tetracycline 10 mg/ml and 50 mg/ml in the absence of SRP in the experimental sites. According to their study, the amount of antimicrobial activity retained is proportional to the concentration of tetracycline HCl used for irrigation, so 10 mg/ml tetracycline was not sufficient to bring significant clinical results. ...
Background:
This study was performed to evaluate and compare the clinical and antimicrobial efficacy of subgingival irrigation with tetracycline and povidone-iodine as an adjunct to nonsurgical periodontal therapy.
Materials and methods:
Twenty subjects with chronic moderate periodontitis were recruited in this split-mouth study with probing pocket depth of >3 and ≤5 mm and clinical attachment loss of 3-4 mm in relation to 16, 36, and 46. In each subject, three selected periodontal pockets were assigned to receive one out of three irrigants (1) sterile water (control) in 16; (2) tetracycline at 10 mg/ml in 36; (3) 2% povidone-iodine in 46, and these sites were designated as Group A, Group B, and Group C, respectively. Plaque score, gingival score, pocket probing depth, and clinical attachment level were evaluated before treatment and at 1 and 3 months posttreatment. Multiplex polymerase chain reaction was used to detect Porphyromonas gingivalis and Tannerella forsythensis which have been implicated as the major risk factors for periodontal disease. Subgingival plaque collected before treatment and at 1 and 3 months posttreatment. Data were analysed using ANOVA and repeated measure ANOVA. Results were considered significant if P < 0.05.
Results:
Clinical and microbiological parameters were reduced posttreatment, the reduction being significantly higher in Group B compared to Group C.
Conclusion:
It can be concluded that chemical and mechanical therapies were of slight benefit in the treatment of chronic moderate periodontitis, and there was an adjunctive effect of significance when scaling and root planing was combined with a single subgingival irrigation with tetracycline or povidone-iodine in lower concentration.
... The ideal sample size to ensure an adequate power for the study was calculated based on the results from a study by Stabholz et al., [5] Krishna et al., [6] and Hosaka et al. [7] Based on the calculation, it was decided that minimum 17 subjects per group were necessary for 80% power at 95% confidence interval (α = 0.05). ...
... Our study is not in agreement with Stabholz et al. [5] and Krishna et al. [6] who evaluated the results of a single episode of irrigation with tetracycline 10 mg/ml and 50 mg/ml in the absence of SRP in the experimental sites. According to their study, the amount of antimicrobial activity retained is proportional to the concentration of tetracycline HCl used for irrigation, so 10 mg/ml tetracycline was not sufficient to bring significant clinical results. ...
... For these cases of refractory subjects or non-responding sites, the adjunctive use of antibacterial agents, usually in the form of subgingival irrigants, has been proposed. In the treatment of PD, subgingival irrigation (SI) is used as a lavage to flush away the bacteria that are in contact with the periodontal tissues, in order to improve the outcome of SRP (Krishna et al., 2011). ...
... Among the different antibacterial agents, chlorhexidine digluconate is the most studied and used in periodontics because of its proven antimicrobial effects (Shiloah and Hovious, 1993), availability, low cost (Shahab et al., 2011), safety, efficacy, substantivity and low toxicity (Krishna et al., 2011). Studies have shown that subgingival irrigation with chlorhexidine is effective in reducing periodontal inflammation and in controlling subgingival plaque (Soh et al., 1982) and is effective in periodontitis, improving all clinical parameters evaluated (Asari et al., 1996). ...
The aim of this study was to evaluate the histometric effects of subgingival irrigation with different solutions as adjuvant for the treatment of periodontal disease in rats. Periodontal disease was induced by ligature in the first lower molars of 91 Wistar rats over the course of 28 days. After removal of the ligatures, the animals were subjected to scaling and root planing, followed by subgingival irrigation with different solutions (0.9% saline, 0.2% chlorhexidine, 0.1% and 0.5% sodium hypochlorite and 11% propolis extract). The animals were sacrificed 7 and 14 days after the treatment and tissue was processed for histometric analysis for evaluation of bone support and epithelial migration. The histometric analysis showed no statistically significant differences between the group treated with scaling and groups treated with subgingival irrigation (p > 0.05) regarding bone support and epithelial migration. Similarly, significant differences were not found among the different solutions used for subgingival irrigation. This study agrees with the position of the American Academy of Periodontology, which states that there is insufficient evidence to indicate the routine use of subgingival irrigation as adjuvant to periodontal treatment.
... Moreover, Stabolhz et al. [6] in a randomized, split mouth clinical The favorable results obtained in the abovementioned studies may be due to the high concentration of tetracycline HCl used (100mg/ml) and repeated administration (every other day for a two-week period) and the localized concentration of the drug at the site of disease activity. [27] The amount of drug delivered often creates sulcular medication concentrations exceeding the equivalent of 1mg/ml. This level is considered bactericidal for the majority of bacteria that exhibit resistance to systemically delivered concentrations. ...
... [5] Chlorhexidine, a bisbiguanide compound, has been shown to possess a broad-spectrum of topical anti-microbial activity. [6] It has been used by dental professionals for plaque control and for the treatment of gingival inflammation. [7] Chlorhexidine was primarily used in mouth-rinses and was recommended in the hygiene phase of treatment as an adjunct to tooth-brushing. ...
The present study was aimed to develop and optimize in situ gel for the treatment of periodontal disease.
Temperature-sensitive in situ gel containing 0.1% w/v Chlorhexidine hydrochloride was formulated by cold method using different polymers. Preliminary study was carried out to optimize different types and concentration of polymers such as Poloxamer 188, Poloxamer 407, Gellan gum, and Carbopol 934P. Central composite design was employed for optimization of the effect of independent variables such as Poloxamer 407 and Carbopol 934P on responses such as gelation temperature, spreadability, cumulative percentage release at 2 h, and time for 50% drug release (t50 %). Each formulations were evaluated for clarity, pH, gelation temperature, spreadability, drug content, in vitro drug release, t50 %, and cumulative percentage drug release at 2 h.
Results of evaluation parameters revealed that the drug release, gelation temperature was considerably decreased with increasing t50 % as the concentration of each polymer was increased. The desirability function was utilized to find out optimized formulation of the factorial design. Formulation F6 showed the highest overall desirability of 0.6283 and, therefore, this formulation was considered to be the optimized formulation. The % relative error was calculated, which showed that observed responses were in close agreement with the predicted values calculated from the generated regression equations.
The clarity, pH, drug content of all formulations was found to be satisfactory. Further, all the formulations showed sustained drug release for a period of 6 h, which satisfied to treat periodontal disease.
