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    Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study. Grusovin Maria Gabriella,Bossini Simone,Calza Stefano,Cappa Veronica,Garzetti Gianluca,Scotti Eleonara,Gherlone Enrico Felice,Mensi Magda Clinical oral investigations OBJECTIVE:The aim of this 12-month mono-centre double-blind randomized placebo-controlled clinical study was to evaluate the efficacy of Lactobacillus reuteri-containing lozenges during the supportive therapy of generalized periodontitis stage III and IV, grade C (GPIII-IVC) patients. MATERIAL AND METHODS:Twenty treated GPIII-IVC patients were randomly divided into 2 groups. The test group received two 3-month-long administrations of L. reuteri (2 lozenges/day after brushing) with a 3-month washout period, while the control one received a placebo. Outcome measures were tooth survival, complications and adverse events, change in probing pockets depth (PPD), change in probing attachment level (PAL), presence of bleeding on probing (BOP) and patient's evaluation of treatment. Measurements were collected at 3, 6, 9 and 12 months. RESULTS:At 1 year, no dropout, tooth loss, complications or adverse event were recorded. Mean PPD and mean PAL and percentages of sites with BOP were statistically improved (p < 0.05) compared with baseline in both groups, while more PPD reduction at all time points (p < 0.05) and more PAL gain at 6 months and more BOP reduction at 6 and 9 months were found in the probiotic group (p < 0.05). CONCLUSIONS:Within the limitation of the study, the use of L. reuteri probiotics lozenges improved some clinical outcomes in treated GPIII-IVC patients during maintenance therapy. Studies with a larger number of patients are needed to confirm these data. CLINICAL RELEVANCE:The use of L. reuteri probiotic lozenges could be considered as an adjunct in the maintenance therapy of GPIII-IVC patients. 10.1007/s00784-019-03065-x
    Effects of smoking on non-surgical periodontal therapy in patients with periodontitis Stage III or IV, and Grade C. Kanmaz Burcu,Lappin David F,Nile Christopher J,Buduneli Nurcan Journal of periodontology BACKGROUND:To evaluate possible effects of smoking on clinical, biochemical, and microbiological outcomes of non-surgical periodontal treatment in patients with periodontitis Stage III or IV and Grade C. METHODS:Conventional quadrant-wise non-surgical periodontal treatment was performed and whole-mouth periodontal measurements were recorded at baseline, 1, 3, and 6 months after completion of treatment. Saliva, gingival crevicular fluid, subgingival plaque, and blood samples were obtained at the same time points. Inflammatory cytokine levels, presence, and quantities of 11 different bacterial species were determined. Smoking status was validated by cotinine assay. RESULTS:Fourteen smoker and 13 non-smoker patients completed the study protocol and revealed similar clinical findings except for the higher plaque scores in the non-smokers at 6 months (P <0.01). Significant differences were found between the study groups in biofluid cytokine levels at 1 and 3 months (P <0.01). Gram-negative bacteria were more abundant in the smokers at baseline and so were Gram-positive bacteria in the non-smokers (P <0.01). Gram-negative bacteria repopulated in the smokers faster than in the non-smokers (P <0.01). CONCLUSIONS:The present findings suggest that smoker patients with periodontitis Stage III and IV, Grade C respond well to the non-surgical periodontal treatment during the 6-month follow-up. However, smokers exhibit faster repopulation of Gram-negative bacteria. 10.1002/JPER.19-0141
    Evaluation of Periodontal Status after Orthodontic Treatment: A Pilot Study on Patients with Stage IV/Grade C periodontitis. Jiao Jian,Xin Tian Yi,Shi Jie,Meng Huan Xin The Chinese journal of dental research : the official journal of the Scientific Section of the Chinese Stomatological Association (CSA) OBJECTIVE:To evaluate whether the periodontal status was affected in patients with stage IV/grade C periodontitis after orthodontic treatment. METHODS:Twenty-four patients with stage IV/grade C periodontitis who received combined periodontal and orthodontic treatment were included in this study. Probing depth (PD), bleeding on probing (BOP) and percentage of relative bone height (RBH%) were measured and calculated. Parameter changes before and after orthodontic treatment, and their differences between teeth adjacent to extraction sites (TAES) and teeth nonadjacent to extraction sites (TNES) were compared. Three-level analysis was performed to test the influential factors of PD and RBH% reduction after orthodontic treatment. RESULTS:No change of PD, BOP% and RBH% was detected after orthodontic treatment. No difference of PD, BOP% and RBH% was detected between TAES and TNES. BOP negative, excessive horizontal overlap, excessive vertical overlap, crowding, PD at T0 (the last periodontal visit before orthodontic treatment) and RBH% at T0 were positively associated with PD reduction after orthodontic treatment. Being female, excessive horizontal overlap, excessive vertical overlap, crowding, PD at T0 and RBH% at T0 were positively associated with a RBH% reduction. Space was negatively associated with a RBH% reduction. CONCLUSION:Periodontal stability can be obtained for patients with stage IV/grade C periodontitis after orthodontic treatment. Orthodontic treatment with extraction was safe for patients with severe periodontitis, however, attention should be given to TAES. 10.3290/j.cjdr.a43734
    Azithromycin and Full-Mouth Scaling For the Treatment of Generalized Stage III and IV Periodontitis: A 6-Month Randomized Comparative Clinical Trial. Oliveira Alcione M S D,Costa Fernando O,Nogueira Letícia Mara R,Cortelli Sheila C,Oliveira Peterson A D,Aquino Davi R,Miranda Taís B,Cortelli José R Brazilian dental journal The effectiveness of azithromycin combined with full-mouth scaling procedures was compared to quadrant-wise scaling combined with the same dosage of azithromycin when treating periodontitis patients over a 6-month period. In this randomized clinical trial study, thirty-four individuals diagnosed with generalized stage III and IV periodontitis underwent baseline, 3-month, and 6-month post-treatment examinations. The study population was randomly assigned to either full-mouth scaling (FMS) or quadrant-wise scaling and root planning (QSRP) in addition to their taking of systemic azithromycin (500 mg/day) for three consecutive days. Periodontal probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) were monitored along with the quantification of total bacterial load and red complex bacterial species (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) in subgingival samples by real time polymerase chain reaction. The volume of gingival crevicular fluid (GCF) was also monitored over time. The primary outcomes included improvements of PD and CAL. Data was statistically analyzed through a repeated-measures analysis of variance (ANOVA) test, multiple least significant difference (LSD) comparisons, Kruskal-Wallis, Friedman, and paired Student t-tests (p<0.05). FMS and QSRP provided similar PD, CAL, GI, PI, and GCF improvements. After treatment, the FMS group displayed lower mean values of total bacterial load and red complex bacterial species in comparison to the QSRP group. FMS and QSRP in conjunction with systemic azithromycin appeared to be an effective and reliable short-term therapeutic approach for the treatment of generalized stage III and IV periodontitis. However, FMD demonstrated superiority in regard to the 6-month antibacterial effects when compared to QSRP. 10.1590/0103-6440201902111