Periodontal healing after non-surgical therapy with a modified sonic scaler: a controlled clinical trial

Aim: The aim of this study was to compare the clinical and microbiological healing outcomes following non-surgical periodontal therapy using a modified sonic scaler system versus scaling and root planing (S/RP) with hand instruments. Material and Methods: The study comprised 20 chronic periodontitis patients. Using a split-mouth design, both treatment modalities were randomly applied to one quadrant of the upper and lower jaws. Clinical and microbiological parameters were assessed at baseline, 4 weeks, and 6 months after treatment. Furthermore, post-operative hypersensitivity was investigated. The Wilcoxon signed-rank test (alpha=0.05) was used for statistical analysis. Results: With both therapy methods, periodontal conditions showed statistically significant clinical and microbiological improvements after 4 weeks and 6 months. Hypersensitive teeth were found only 4 weeks after S/RP. Besides a significantly better bleeding on probing reduction in deep S/RP sites and less time required for root instrumentation by the sonic scaler, no other clinical and microbiological parameters revealed significant differences between sites treated with the sonic scaler or S/RP. Conclusion: The sonic scaler system and S/RP seem to provide similarly favourable periodontal healing results, although in deep pockets S/RP appeared to achieve a better resolution of inflammation

Adjunctive Use of a Subgingival Controlled‐Release Chlorhexidine Chip Reduces Probing Depth and Improves Attachment Level Compared With Scaling and Root Planing Alone

The present studies evaluated the efficacy of a controlled‐release biodegradable Chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct to scaling and root planing on reducing probing depth (PD) and improving clinical attachment level (CAL) in adult periodontitis. Two double‐blind, randomized, placebo‐controlled multicenter clinical trials (5 centers each) were conducted; pooled data are reported from all 10 centers (447 patients). At baseline, following 1 hour of scaling and root planing (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip placement was repeated at 3 and/or 6 months if PD remained ≥ 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in placebo chip subjects received either placebo chip plus SRP or SRP alone. Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favoring the Chlorhexidine chip compared with both control treatments were observed with respect to PD (Chlorhexidine chip plus SRP, 0.95 ± 0.05 mm; SRP alone, 0.65 ± 0.05 mm, P \u3c 0.001; placebo chip plus SRP, 0.69 ± 0.05 mm, P \u3c 0.001) and CAL (Chlorhexidine chip plus SRP, 0.75 ± 0.06 mm; SRP alone, 0.58 ± 0.06 mm, P \u3c 0.05; placebo chip plus SRP, 0.55 ± 0.06 mm, P \u3c 0.05). The proportion of patients who evidenced a PD reduction from baseline of 2 mm or more at 9 months was significantly greater in the Chlorhexidine chip group (19%) compared with SRP controls (8%) (P \u3c 0.05). Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, discomfort, or sensitivity was the only adverse effect that was higher in the Chlorhexidine group as compared to placebo (P= 0.042). These data demonstrate that the adjunctive use of the Chlorhexidine chip results in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi‐center randomized control trials suggest that the Chlorhexidine chip is a safe and effective adjunctive chemotherapy for the treatment of adult periodontitis

Role of the Eikenella corrodens pilA Locus in Pilus Function and Phase Variation

The human pathogen Eikenella corrodens expresses type IV pili and exhibits a phase variation involving the irreversible transition from piliated to nonpiliated variants. On solid medium, piliated variants form small (S-phase), corroding colonies whereas nonpiliated variants form large (L-phase), noncorroding colonies. We are studying pilus structure and function in the clinical isolate E. corrodens VA1. Earlier work defined the pilA locus which includes pilA1, pilA2, pilB, and hagA. Both pilA1 and pilA2 predict a type IV pilin, whereas pilB predicts a putative pilus assembly protein. The role of hagA has not been clearly established. That work also confirmed that pilA1 encodes the major pilus protein in this strain and showed that the phase variation involves a posttranslational event in pilus formation. In this study, the function of the individual genes comprising the pilA locus was examined using a recently developed protocol for targeted interposon mutagenesis of S-phase variant VA1-S1. Different pilA mutants were compared to S-phase and L-phase variants for several distinct aspects of phase variation and type IV pilus biosynthesis and function. S-phase cells were characterized by surface pili, competence for natural transformation, and twitching motility, whereas L-phase cells lacked these features. Inactivation of pilA1 yielded a mutant that was phenotypically indistinguishable from L-phase variants, showing that native biosynthesis of the type IV pilus in strain VA1 is dependent on expression of pilA1 and proper export and assembly of PilA1. Inactivation of pilA2 yielded a mutant that was phenotypically indistinguishable from S-phase variants, indicating that pilA2 is not essential for biosynthesis of functionally normal pili. A mutant inactivated for pilB was deficient for twitching motility, suggesting a role for PilB in this pilus-related phenomenon. Inactivation of hagA, which may encode a tellurite resistance protein, had no effect on pilus structure or function

Healing of intrabony defects following treatment with an oily calcium hydroxide suspension (Osteoinductal). A controlled clinical study.

Contains fulltext : 50104.pdf (publisher's version ) (Closed access)The purpose of the present clinical study was to evaluate the healing of deep intrabony defects following the application of an oily calcium hydroxide suspension (OCHS). Thirty patients suffering from chronic periodontitis, each of whom displayed one intrabony defect, were randomly treated with access flap surgery (AFS) and the application of OCHS (test) or with AFS alone (control). The following clinical parameters were recorded at baseline and at 6 months after therapy: plaque index, gingival index, bleeding on probing, probing depth (PD), gingival recession, and clinical attachment level (CAL). No differences in any of the investigated parameters were observed at baseline between the two groups. At 6 months after therapy, the test group showed a reduction in mean PD from 7.7+/-1.5 to 2.9+/-0.9 mm (P<0.001) and a change in mean CAL from 9.6+/-2.1 to 5.5+/-2.5 mm (P<0.001). In the control group, the mean PD was reduced from 6.9+/-0.9 to 3.7+/-0.9 mm (P<0.001) and the mean CAL changed from 8.5+/-2.5 to 6.4+/-2.7 mm (P<0.001). OCHS resulted in statistically significant higher PD reductions (P<0.01) and CAL gains (P<0.05) than AFS alone. Within the limits of the present study, it can be concluded that: (1) at 6 months after surgery both therapies resulted in statistically significant PD reductions and CAL gains and (2) treatment with OCHS resulted in statistically significant higher CAL gains than treatment with AFS alone