Microbiological outcomes from different periodontal maintenance interventions: a systematic review

Angst, Patrícia Daniela Melchiors; Stadler, Amanda Finger; Oppermann, Rui Vicente; Gomes, Sabrina Carvalho

doi:10.1590/1807-3107bor-2017vol310033

Cited by 4 publications

(5 citation statements)

References 43 publications

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“…Periodontitis is a chronic infection of the gums, in which bacteria such as Porphyromonas gingivalis occupy the dental pocket and cause inflammation leading to destruction of the periodontal ligament and loss of teeth [39]. The standard treatment is ‘scaling and root planning’ (SRP) which is basically a mechanical removal of bacterial plaque [40]. Periodontitis can be treated by injected a PS such as MB into the dental pocket and then introducing a narrow laser fiber to excite the dye with red light.…”

Section: Potential Clinical Applicationsmentioning

confidence: 99%

Potentiation of antimicrobial photodynamic inactivation by inorganic salts

Hamblin

2017

Expert Review of Anti-infective Therapy

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Introduction Antimicrobial photodynamic inactivation (aPDI) involves the use of non-toxic dyes excited with visible light to produce reactive oxygen species (ROS) that can destroy all classes of microorganisms including bacteria, fungi, parasites, and viruses. Selectivity of killing microbes over host mammalian cells allows this approach (antimicrobial photodynamic therapy, aPDT) to be used in vivo as an alternative therapeutic approach for localized infections especially those that are drug-resistant. Areas covered We have discovered that aPDI can be potentiated (up to 6 logs of extra killing) by the addition of simple inorganic salts. The most powerful and versatile salt is potassium iodide, but potassium bromide, sodium thiocyanate, sodium azide and sodium nitrite also show potentiation. The mechanism of potentiation with iodide is likely to be singlet oxygen addition to iodide to form iodine radicals, hydrogen peroxide and molecular iodine. Another mechanism involves two-electron oxidation of iodide/bromide to form hypohalites. A third mechanism involves a one-electron oxidation of azide anion to form azide radical. Expert commentary The addition of iodide has been shown to improve the performance of aPDT in several animal models of localized infection. KI is non-toxic and is an approved drug for antifungal therapy, so its transition to clinical use in aPDT should be straightforward.

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Section: Potential Clinical Applicationsmentioning

confidence: 99%

Potentiation of antimicrobial photodynamic inactivation by inorganic salts

Hamblin

2017

Expert Review of Anti-infective Therapy

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“…Another important issue to stress is that when NSPT is performed in two separate steps, the effect of PMPR will not only improve the supragingival environment but also, to some extent, the subgingival ecology. Reducing levels of supragingival biofilm and gingival inflammation enable a shift in subgingival microbiota, 28 even in deep pockets, 29 decreasing the severity of PPD, the proportion of BoP sites, and, ultimately, the complexity of the SRP 30–32 . Importantly, higher improvements on the effect of supragingival scaling are reached when achievable subgingival biofilm is removed together with supragingival dental calculus and biofilm, 18 when compared to an intervention restricted to the supragingival environment 17 .…”

Section: Discussionmentioning

confidence: 99%

Should supragingival scaling be performed separately prior to subgingival scaling and root planning in nonsurgical periodontal therapy? A systematic review of randomized trials

Oliveira,

de Oliveira,

Angst

et al. 2023

Int J Dental Hygiene

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ObjectiveTo systematically evaluate randomized controlled trials (RCTs), with at least 6 months of follow‐up, on whether professional mechanical plaque removal (PMPR) including supragingival scaling should be performed prior and separately from subgingival scaling and root planning (SRP) in nonsurgical periodontal therapy (NSPT), in terms of clinical and patient‐reported outcomes (PROs) (CRD42020219759).MethodsThe MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science electronic databases, as well as grey literature sources, were searched by two independent reviewers up to May 2023. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and GRADE for assessing the certainty of evidence. Random‐effects pairwise meta‐analyses compared the changes in probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BoP) of a stepwise NSPT approach (PMPR prior and separately from SRP) and conventional one‐step NSPT through mean differences (MDs) and associated confidence intervals (95% CI).ResultsTwo RCTs were included, including data of 77 participants with severe periodontitis. One RCT presents high risk of bias and the other has some concerns. No significant differences were found between the stepwise approach and performing both steps simultaneously for any clinical outcomes, with overall very low certainty on evidence. No adverse effects were detected and there was no data on PROs.ConclusionsThere is very‐low certainty evidence of no significant difference on PPD and BoP reductions and CAL gain between supragingival scaling performed prior and separately from SRP and conventional one‐step NSPT.

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“…[100][101][102][103][104] Clinical investigations have assessed the association of several types of statins with SRP in the treatment of periodontitis. 8,105,106 A recent systematic review with meta-analysis included 12 studies that applied 1.2% atorvastatin, simvastatin, or rosuvastatin gel subgingivally as an adjunct to non-surgical periodontal therapy. Considering intrabony defects, there was an overall mean difference of 2.25 mm in PPD reduction and 2.19 mm in CAL gain at 9 months between the use of statin gels and placebo.…”

Section: Statinsmentioning

confidence: 99%

“…Finally, the results of step 3 should be reevaluated for the accomplishment of the therapy endpoints and, if these endpoints are achieved, a strict maintenance program should be implemented. 6,7,8 Non-surgical periodontal therapy (NSPT) is the term used to generally describe subgingival mechanical instrumentation performed during the second step of treatment. Standard NSPT, mainly performed by means of scaling and root planing (SRP), is the gold-standard treatment for Stage I-III periodontitis.…”

Section: Introductionmentioning

confidence: 99%

New tendencies in non-surgical periodontal therapy

et al. 2021

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The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.

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Microbiological outcomes from different periodontal maintenance interventions: a systematic review

Cited by 4 publications

References 43 publications

Potentiation of antimicrobial photodynamic inactivation by inorganic salts

Potentiation of antimicrobial photodynamic inactivation by inorganic salts

Should supragingival scaling be performed separately prior to subgingival scaling and root planning in nonsurgical periodontal therapy? A systematic review of randomized trials

New tendencies in non-surgical periodontal therapy

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