Clinical and Microbiological Effects of Weekly Supragingival Irrigation with Aerosolized 0.5% Hydrogen Peroxide and Formation of Cavitation Bubbles in Gingival Tissues after This Irrigation: A Six-Month Randomized Clinical Trial

Abstract

Introduction. The study investigated the effect of weekly supragingival irrigation with aerosolized 0.5% hydrogen peroxide (H2O2) solution as a maintenance periodontal therapy on clinical and microbiological parameters in patients with chronic periodontitis. The other purpose was to investigate whether cavitation bubbles can penetrate not only into periodontitis-damaged tissues but also into ex vivo porcine healthy periodontal tissues. Materials and Methods. The study included 35 systemically healthy patients with chronic periodontitis (CP). After nonsurgical periodontal debridement (NSPD), all patients were randomized into two groups: the Control group (NSDP alone, n=18) and the Test group (NSDP plus supragingival irrigation, n=17). Clinical (Approximal Plaque Index (API), Bleeding Index (BI), and Modified Gingival Index (MGI)) and microbiological (Polymerase Chain Reaction technology (using a micro-IDent® kit)) measurements were performed at the initial time point, 3 months, and 6 months after NSPD. The impact of supragingival irrigation on diseased gingival tissues of CP patients (n=5) and on ex vivo porcine healthy gingival tissue samples (n=3) was evaluated to estimate morphological changes in healthy and diseased gingival tissues. Results. Morphological data revealed that supragingival irrigation caused the formation of cavitation bubbles in diseased gingival tissue of CP patients and in healthy porcine gingival tissues. The decrease in API, BI, and MGI scores after 6 months in the Test group significantly (p≤0.01, p≤0.05, and p≤0.01, respectively) exceeded that in the Control group. Test group patients demonstrated a decrease in periodontal sites showing Pocket Probing Depth>4 mm and, after 6 months, a statistically significant decrease in the proportion of periopathogenic bacteria. Conclusion. The effectiveness of mechanical periodontal treatment combined with weekly supragingival irrigation with aerosolized 0.5% H2O2 solution on clinical and microbiological parameters of periodontal tissues of periodontitis patients is reliably higher than that of mechanical periodontal debridement alone. It has been found that cavitation bubbles as a result of irrigation with the aerosolized 0.5% hydrogen peroxide solution can form not only in periodontal tissues of periodontitis patients but also in ex vivo porcine healthy gingival tissues.

Effects of different immunosuppressive drugs on the periodontal status and changes in periodontal pathogenic bacterial flora in rheumatoid arthritis patients

“…The papilla bleeding index (using a periodontal probe) was determined as an index of gingival inflammation. Periodontal condition was assessed using periodontal probing depth, bleeding on probing, and classification of clinical attachment loss [none/mild periodontitis, moderate periodontitis (interproximal sites of 2 mm or more, with clinical attachment loss of 4 mm or more, not on the same tooth, or interproximal sites of 2 mm or more, with probing depth of 5 mm or more); severe periodontitis (interproximal sites of 2 mm or more, with clinical attachment loss of 6 mm or more on different teeth, or interproximal site of 1 mm or more, with the probing depth of 5 mm or more] [7,15]. The clinical examinations were carried out by dentists with minimum experience of 3 years, and they were naïve to the immunosuppressive therapies used.…”

Experimental Study of Laser-Induced Cavitation Bubbles near Wall: Plasma Shielding Observation

“…The water jet-induced cavitation bubble, recognized for its extensive impact range, high efficiency, and eco-friendliness, is extensively utilized in ship maintenance and chemical equipment cleaning [1][2][3][4][5][6]. In medicine, ultrasound-induced cavitation bubbles are used in cancer treatment, stone crushing, and gingival surgery owing to their small impact area and large impact force [7][8][9]. In recent years, with the development of laser technology, it has been found that a cavitation bubble will emerge between the laser and liquid medium.…”