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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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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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

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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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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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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Smoking cessation and tooth loss

This review provides strong evidence for quitting smoking and reducing your risk of dementia.

This review assessing whether smoking cessation reduced the risk of tooth loss included 14 cross-sectional and 7 longitudinal studies suggestign that the risk of tooth loss in former smokers is comparable to that of never smokers

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Doxycycline as an adjunct to scaling and root planning in diabetics

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This review of the effectiveness of systemic doxycycline as an adjunct to scaling and root planning (SRP) with SRP alone in diabetic patients with periodontitis included 6 small RCTs suggesting no additional benefit from systemic docycycline.

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Periodontal treatment and glycaemic control in diabetes

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This review of the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycaemic control in patients with type 2 diabetes mellitus and chronic periodontitis included 14 RCTs suggesting some benefit in the short term.

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Intellectual disability and oral health

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This review of on the oral health of community dwelling adults with intellectual disabilities included 33 mainly cross-sectional studies showing a the continuing high prevalence of oral disease and treatment need

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