Top Dental Elf Blogs: Oct – Dec 2021

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Amoxicillin and metronidazole as an adjunct to full-mouth scaling and root planing, malignant transformation on oral lichen planus and toothbrushing to prevent ventilator-associated pneumonia was out most popular blogs between October to December 2021.

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Tricalcium phosphates for infra-bony periodontal defects

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This review of the clinical efficacy of tricalcium phosphates (-containing) biomaterials in the treatment of periodontal infra-bony defects includes 16 RCTs. While the findings suggest improvements in pocket depth and clinical attachment level only 6 of the studies contributed to the meta-analyses and the number of events and studies are small so the findings should be viewed cautiously.

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Periodontitis: Adjunctive amoxicillin and metronidazole with full-mouth scaling and root planing

This review of whether amoxicillin and metronidazole used as an adjunct to full-mouth scaling and root planing improved clinical outcomes included 11 RCTs. While the findings indicate significant improvements in clinical attachment level and pocket probing depth they may not be clinically important.

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Periodontitis: Locally delivered anti-microbials as an adjunct to surgical periodontal treatment

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This review of the effectiveness of locally delivered adjunctive antibiotic treatment during periodontal surgery on clinical outcomes included 9 RCTs. While the findings suggested that adjunctive locally delivered antibiotics could improve some clinical sutcomes they evidence was limited and of very low certainty.

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

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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…]

Access flap procedures or subgingival debridement for periodontitis?

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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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Photodynamic therapy as an adjunct to non-surgical periodontal treatment

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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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Periodontitis: Locally delivered antimicrobials as an adjunct to non-surgical treatment

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This review of of locally delivered antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis included 50 RCTs. While the findings indicate statistically significant benefits for probing pocket depth and clinical attachment level (CAL) at 6-9 months and for CAL at 12-60 months their clinical importance can be questioned. In addition most of the studies(47) were considered to be at high risk of bias.

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Subgingival instrumentation for treating periodontitis

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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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Non-surgical periodontal treatment and oral health related quality of life

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This review of the evidence for the relationship between non-surgical periodontal therapy (NSPT) and patient-based outcomes included 13 mainly observational studies. While the findings suggest that NSPT improves oral health related quality of life but the quality of the evidence is limited.

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