Background: The aim of the study was to compare the effectiveness of photodynamic therapy (PDT) to steroid therapy in the treatment of oral lichen planus (OLP). Due to the lack of commercially available drug carriers, innovative proprietary solutions were used for both the photosensitiser and the steroid carrier—in the first case to shorten and in the second to extend the contact of the active substance with the mucosa. Methods: A prospective, randomised, single-blind, 12-week full contralateral split-mouth clinical trial of 30 patients with bilateral oral lichen planus was conducted. The prepared matrices were incorporated with active substances methylene blue 5% and 0,05% triamcinolone. The size of lesions, Thongprasom, ABISIS, and VAS scale were evaluated. Results: Relatively high rates of complete remission of lichen were demonstrated: immediately after treatment, 33.3% with PDT and 22.2% with triamcinolone (TA), and after 3 months, 54.2% with PDT and 62.9% with TA. After 3 months of treatment, a reduction in the area of evaluated lesions of 52.7% for PDT and 41.7% for TA was achieved. Conclusion: In situations of topical or general contraindications to oral corticosteroids, resistance to them, or the need for repeated treatment in a short period of time, PDT appears to be a very promising treatment option.

Background Two clinical parameters, the gingival thickness (GT) and the width of keratinized tissue (WKT), describe the gingival phenotype, which is defined as the 3-dimensional volume of the gingiva. The periodontal phenotype additionally includes the thickness of the labial plate of the alveolar crest (TLPAC). Material/Methods Thirty patients with healthy periodontium on the upper canines and incisors underwent measurements for crestal, supracrestal, free gingival thickness (FGT), the alveolar crest-gingival margin (AC-GM), alveolar crest-cementoenamel junction distance, and the TLPAC at 2, 4, and 8 mm apically from the edge of the alveolar crest using cone-beam computed tomography (CBCT) with computer-aided design and prosthetic-driven implant planning technology. For each tooth, the gingival and periodontal phenotype was evaluated on the basis of the gingival thickness, width of keratinized tissue (WKT), and TLPAC measurements. Each patient’s periodontal phenotype was evaluated according to the coronal width/length ratio of both the upper central incisors. Results The dentogingival units had varying average values for the 3 periodontal phenotypes (thin phenotype: FGT 0.65±0.06 mm, WKT 4.85±1.18 mm, AC-GM 3.17±0.64 mm, TLPAC2 0.66±0.28 mm; medium phenotype: FGT 0.87±0.07 mm, WKT 5.49±1.23 mm, AC-GM 3.36±0.65 mm, TLPAC2 0.76±0.37 mm; and thick phenotype: FGT 1.20 mm, WKT 6.00 mm, AC-GM 3.90 mm, TLPAC2 0.90 mm). Positive correlations were seen among WKT, FGT, AC-GM, and TLPAC2. Conclusions Positive correlations between the FGT and WKT, and the AC-GM distance confirm that measurements using CBCT with computer-aided design and prosthetic-driven implant planning technology can evaluate the gingival phenotype and TLPAC2 for the periodontal phenotype.

Traditional methods of non-surgical treatment of periodontitis, including mechanical scaling/root planing (SRP), do not guarantee remission of the disease. Local delivery of antimicrobial agents in periodontitis entails antimicrobial therapy placed directly in periodontal pockets. The advantage of this form of treatment is that the concentration of the drug after application significantly exceeds the minimum inhibitory concentration (MIC) and persists for up to several weeks. Therefore, many systems of locally applied devices, using a variety of antibiotics or antiseptics have been developed. There is continuous research aimed at introducing new forms of locally administered drugs, some of which have not proved to be effective, while others are promising. For almost 30 years such systems have been used for treatment as an adjuvant to SRP, and their efficacy has been evaluated. The aim of this article is to systematically review the contemporary literature regarding the currently available chemotherapeutics locally administered in the treatment of periodontitis.

The aim of this study was to develop and assess a polyvinyl alcohol-cellulose derivatives-based film with incorporated povidone-iodine (PVP-I) predicted for applications in the treatment of periodontitis. Films were fabricated by solvent-casting, and their physical characteristics, such as their surface and structure morphology, mechanical properties, and disintegrating time, were evaluated. For in vitro iodine release studies and evaluation, the antimicrobial activity was tested using a modified disc diffusion method against five microbial strains. For further use, we selected the film with polyvinyl alcohol-hydroxypropyl methylcellulose (PVA/HPMC_B) based on acceptable physicochemical properties. To assess the subacute toxicity of the film composition, the tissue regeneration process was tested in rats and compared to a conventional dressing commonly used in wound healing (Spongostan). Seven days after implantation, dorsal skin sections and blood samples (n = 10, in total n = 30) were examined. The wound area, epithelium, and dermis were evaluated microscopically, while the blood collected from the rats underwent biochemical analysis. The blood biochemistry results were comparable in all three groups. No significant histological differences between the Spongostan and the placebo film developed after subcutaneous implantation were observed. In contrast, the inflammation stage was reduced and the “scar” in the dermis was smaller when PVP-I and PVA/HPMC_B films were used. A smaller local inflammatory response inflicted less tissue damage, leading to the activation of subsequent regeneration phases and restoration of the area to its original state. The results obtained confirmed that PVP-I incorporated into PVA-hydroxypropyl methylcellulose film is a promising drug carrier, working faster and more effectively than the other two dressing materials evaluated. These developments provide a promising alternative in tissue regeneration and the wound healing process.

Combination of the classical subgingival instrumentation (scaling and root planing procedure, SRP) with an antibiotic administered to periodontal pockets in a suitable medium is a promising alternative protocol of nonsurgical periodontal treatment. It enables obtaining the long-term minimum drug concentration inhibiting the development of periopathogens. Objectives: Clinical and microbiological evaluation of periodontal pockets two months after single application of a gel containing piperacillin and tazobactam (Gelcide)® in relation to the nonsurgical treatment procedure (SRP). Materials and methods: Ten patients aged 24–56 years (mean 39.5) with chronic periodontitis, nonsmokers with acceptable oral hygiene and no classical exclusion criteria were qualified for treatment. In the maxilla area, SRP was performed and the assessed gel was inserted to two randomly selected adjacent periodontal pockets. Clinical evaluation included the assessment of bleeding on probing (BoP), pocket depth (PD), and clinical attachment loss (CAL) at six measurement points. A microbiological examination with the use of PET deluxe diagnostic kit in the drug-administered pockets and symmetrically in two pockets on the other side of the dental arch was performed. The examination was conducted before the treatment and two months later. Results: Two months after the treatment, a significant improvement in all analyzed clinical parameters was observed. However, the extent of this improvement did not differ significantly between the compared treatment methods. No statistically significant differences were found in the number of bacteria before and after the treatment, except for a significant decrease in the number of Micromonas micros (2957 vs. 589, p = 0.028) and a higher number of the green complex bacteria Capnocytophaga gingivalis (5439 vs. 2050, p = 0.041) after antibiotic had been used. Conclusion: No significant clinical and microbiological differences were found after additional administration of gel with piperacillin and tazobactam in relation to SRP in the preliminary study.