Chronic periodontitis: Efficacy of adjunctive antimicrobials

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review of the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. 21 RCTs were included with the findings showing that amoxicillin and metronidazole had the largest statistical benefit. Whether this benefit is a clinically important benefit is a wider question.

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Boric acid as an adjunct to non-surgical periodontal therapy?

gum disease, scale and polish

Non-surgical periodontal treatment is the mainstay of treatment for the management of periodontitis. A number of adjunctive treatments have been used to improve outcomes including, local and systematic antibiotics and photodynamic therapy.  It has been suggested that boric acid may be beneficial as boron compounds have antimicrobial, anti-inflammatory and immune regulatory effects and beneficial effects [read the full story…]

Top Dental Elf Blogs: Oct – Dec 2020

The Dental Elf

Blogs on Hyposalivation in the elderly, powered toothbrushes for patients undergoing orthodontic treatment and the impact of smoking on the outcomes of non-surgical periodontal treatment were our most popular blogs.

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Access flap procedures or subgingival debridement for periodontitis?

Periodontal disease
Periodontitis

This review comparing access flaps (AF) and subgingival debridement in achieving probing depth (PD) reduction in patients with periodontitis included 18 studies reported in 36 publications. While the results demonstrated a statistically significant improvement in PD reduction between AF and subgingival debridement this may not be clinically important.

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Smoking and its impact on non-surgical periodontal therapy

gum disease, scale and polish

This review of the impact of smoking on clinical outcomes of non-surgical periodontal treatment included 17 cohort studies of whihc 11 were prospective. The findings suggest statistically significant smaller improvements in the smoking that non-smoking group. However, any differences are modest and my not be clinically important.

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Photodynamic therapy as an adjunct to non-surgical periodontal treatment

iStock_000001604217XSmall dental laser

This review of the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical periodontal treatment included 17 RCTs. The studies were small and hetrogeneous including just 701 patients in total and of low quality providing very limited evidence.

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Chlorhexidine chip as adjunct to scaling and root planing in patients with chronic periodontitis

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This review of sub-gingival chlorhexidine chips as an adjunct to scaling and root planing in patients with chronic periodontitis included 15 RCTs involving 620 patients in total. Findings suggest an additional improvement with adjunctive use of chlorhexidine chips.

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Subgingival instrumentation for treating periodontitis

gum disease, scale and polish

This review evaluating the efficacy of subgingival instruments for the treatment of periodontitis included 19 RCTs. The findings show that mechanical subgingival instrumentation is efficacious in the nonsurgical treatment of periodontitis, irrespective of type of instrument or mode of delivery.

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Chronic periodontitis: pocket elimination after osseous resective surgery

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4 RCTs involving 96 patients were included in this review of osseous resective surgery (ORS) in the treatment of residual periodontal defects.
The findings suggest some benefit from ORS but they should be interpreted cautiously because of the limited number of small studies.

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Antiseptics as adjuncts to nonsurgical periodontal treatment

shutterstock_113989924  - periodontitis

This review of the effectiveness of adjunctive local antiseptics to conventional scaling and root planning (SRP) included 12 RCTs only 3 of whihc were considered to be at low risk of bias. While the findings suggest some benefit from the use of antiseptics with a sustained-release delivery the limited quality of the included studies means that the findings should be interpreted cautiously.

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