Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis

Khattri, Shivi; Nagraj, Sumanth Kumbargere; Arora, Ankita; Eachempati, Prashanti; Kusum, Chandan Kumar; Bhat, Kishore; Johnson, Trevor; Lodi, Giovanni

doi:10.1002/14651858.cd012568.pub2

Cited by 54 publications

(76 citation statements)

References 159 publications

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“…The teeth revealed marginal increase in radiographic root width and length, an increased periapical bone density, and a narrowing in apical diameter [113]. Other studies compared the effect of PRF, PRP, and the blood clot technique in the revascularization of necrotic teeth with open apex, demonstrating continued root development and maintenance of functionality, following different follow-up periods, yet with some teeth not responding to vital testing [2,5,6,[114][115][116][117][118][119][120][121][122]. A further investigation induced bleeding in root canals and used PRF in mature necrotic teeth, showing a regain in pulp sensibility [123].…”

Section: Stem Cells Internationalmentioning

confidence: 99%

“…Stem/progenitor cells used in regenerative medicine are nonspecialized cells, demonstrating the ability of self-renewal and multilineage differentiation [3]. The potential of stem/progenitor cells, whether endogenous or exogenous, to adapt to various environmental niche could be exploited in regenerative endodontics and pulp-dentin tissue regeneration [4][5][6]. Therapeutic application of stem/progenitor cells is mainly dependent on the utilization of the transplanted cells, on suitable scaffolds and in combination with various growth factors to generate fully functional biological tissues [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cell-Based Transplantation versus Cell Homing Approaches for Pulp-Dentin Complex Regeneration

Ahmed

Abouauf

AbuBakr

et al. 2021

Stem Cells International

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Regenerative dentistry has paved the way for a new era for the replacement of damaged dental tissues. Whether the causative factor is dental caries, trauma, or chemical insult, the loss of the pulp vitality constitutes one of the major health problems worldwide. Two regenerative therapies were introduced for a fully functional pulp-dentin complex regeneration, namely, cell-based (cell transplantation) and cell homing (through revascularization or homing by injection of stem cells in situ or intravenously) therapies, with each demonstrating advantages as well as drawback, especially in clinical application. The present review is aimed at elaborating on these two techniques in the treatment of irreversibly inflamed or necrotic pulp, which is aimed at regenerating a fully functional pulp-dentin complex.

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Section: Stem Cells Internationalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cell-Based Transplantation versus Cell Homing Approaches for Pulp-Dentin Complex Regeneration

Ahmed

Abouauf

AbuBakr

et al. 2021

Stem Cells International

View full text Add to dashboard Cite

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“…There were 20 participants who had never experienced VR prior to the experiments. To them, everything about FIV was novel, therefore they could have experienced increased perceived reward and individual preference toward the VR [48], leading them to prefer the FIV for CHD diagnosis tasks. To test the hypothesis, a future study will include a survey on novelty and compare its result on the preference rating.…”

Section: Limitationsmentioning

confidence: 99%

A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development and Usability Testing

et al. 2020

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Background The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied. Objective The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD. Methods A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions. Results Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ22=9.0, P=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ22=14.1, P<.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (t=–1.01, P=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants. Conclusions The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.

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“…Periodontitis is an inflammatory destructive disorder of the tooth-supporting and -investing structures, associated with microbial dysbiosis [1]. Reversing periodontitis-associated dysbiosis is one of the primary strategies of periodontal therapy, comprising clinical strategies, implying the improvement of patients' self-performed oral hygiene [2], in combination with professional mechanical debridement [3,4] and in selective clinical conditions the application of adjunctive antimicrobial agents, systemically [5][6][7] or locally [8,9]. Compared to systemic antibiotic application, local delivery demonstrates lower incidence of side effects, improved compliance, with lesser chances for emergence of microbial resistance [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effect of locally delivered adjunctive antibiotics during surgical periodontal therapy: a systematic review and meta-analysis

et al. 2021

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Aim The present study aimed to systematically assess current evidence on effects of locally delivered antibiotics during periodontal surgery compared to periodontal surgery alone on clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, recession depth (RD) changes, gingival index (GI), bleeding on probing (BOP), and plaque index (PI). Methodology MEDLINE-PubMed, Cochrane-CENTRAL and Scopus databases were searched up to April 2021 for randomized clinical trials (RCT), evaluating effects of locally delivered antibiotics during periodontal surgery. CAL gain served as primary, while PPD reduction, RD changes, GI and PI as secondary outcomes. The Cochrane Risk of Bias Tool was used to assess possible bias. Data were extracted, and meta-analysis was performed where appropriate. Result Screening of 2314 papers resulted in nine eligible studies. No adverse events were reported. Data on outcome variables were pooled and analyzed using generic inverse variance model and presented as weighted mean difference (WMD) and 95% confidence interval (95% CI). Statistically significant improvements in favor of antibiotics’ delivery were observed in studies with follow-up of ≤6 months for CAL gain (WMD = 0.61 mm (95% CI [0.07, 1.14]; p = 0.03), PPD reduction (WMD = 0.41 mm (95% CI [0.02, 0.80]; p = 0.04)) and BOP (WMD = −28.47% (95% CI [−33.00, −23.94]); p < 0.001), while for GI improvements were notable for >6 to 12 months (WMD = −0.27 (95% CI [−0.49, −0.06]; p = 0.01)). Conclusion Within the current review’s limitations, locally delivered antibiotics during surgical periodontal therapy results in post-surgical improvements for CAL, PPD, and BOP (≤6 months) with a longer-lasting GI improvement. Further randomized controlled trials are needed with true periodontal end-points to assess the ideal antibiotic agent, dosage, and delivery methods. Clinical relevance Local delivery of antibiotics during periodontal surgery improved clinical parameters for up to 6-month follow-up, with beneficial longer effects on gingival inflammation. Within the current study’s limitation, the presented evidence could support the elective usage of locally delivered antibiotics during surgical periodontal therapy.

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Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis

Cited by 54 publications

References 159 publications

Cell-Based Transplantation versus Cell Homing Approaches for Pulp-Dentin Complex Regeneration

Cell-Based Transplantation versus Cell Homing Approaches for Pulp-Dentin Complex Regeneration

A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development and Usability Testing

Effect of locally delivered adjunctive antibiotics during surgical periodontal therapy: a systematic review and meta-analysis

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