Chlorhexidine gel as an adjunct to non-surgical periodontal treatment

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This review of the efficacy of adjunctive subgingival administration of chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis included 17 RCTs only one of which was at low risk of bias for all domains. Findings suggest an improvement in pocket probing depth but not for clinical attachment.

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Periodontal surgery: Is a minimally invasive approach effective for infrabony defects?

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This review of minimally invasive periodontal surgery for the treatment of intra‐bony defects included 25 studies of which 10 were randomised controlled trials. There is limitied evidence comparing minimal and traditional approach but minimal invasive surgery may produce similar outcomes.

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Mesenchymal stem cells in periodontal regeneration?

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This review evaluating the potential efficacy of mesenchymal stem cells in periodontal regeneration included 15 small studies of very low quality. Additional high quality RCTs are neeeded to assess effectiveness before clinicial use.

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Hyaluronic acid as an adjunct to periodontal treatment

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This review looked at the adjunctive effects of hyaluronic acid (HA) on surgical or non-surgical periodontal treatment. Thirteen RCTs the majority at high risk of bias suggested that the topical application of HA may lead to additional clinical benefits.

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Tooth loss predictors in periodontal patients

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This review of predictors of tooth loss in patients with periodontitis undergoing treatment and receiving supportive care included 20 studies. Findings suggest older, non‐compliant patients, smokers, diabetics, those with IL‐1‐polymorphism, and teeth with bone loss, high probing pocket depths, mobility, as well as molars, especially with furcation involvement, are at higher risk of tooth loss.

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Periodontal infrabony defects: does autologous platelet concentrates (APC) improve surgical outcomes

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38 RCTs were included in this Cochrane review of the effects of autologous platelet concentrates (APC) used as an adjunct to periodontal surgery. Very low quality evidence was found for two approaches involving open flap debridement.

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Statins as an adjunct to periodontal treatment?

This well conducted Cochrane review found no evidence that statins

This review of the adjunctive effect of statins on mechanical periodontal therapy included 15 studies 12 of which were RCTs. The findings suggest a positive effect on probing pocket depth, clinical attachment level, and intrabony defects but the overall quality of evidence is considered to be low.

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Non-surgical periodontal therapy – which antibiotic regime?

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This review of amoxicillin & metronidazole as an adjunct to non-surgical periodontal treatment included 18 trials . A small benefit was seen with antibiotic use but no clinically meaningful difference between different doses or duration of amoxicillin-plus-metronidazole at 3 months post-treatment.

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Phytotherapy as an adjunct to nonsurgical periodontal treatment?

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7 small RCTs that majority of cross-over design were included in this review of phytotherapy as an adjunct to scaling and root planing for chronic periodontitis. While the findings suggest a benefit these should be viewed with caution until results from larger high quality studies are available.

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Intrabony periodontal defects – does combining bone substitutes and enamel matrix derivatives improve outcomes?

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This review of combining bone substitutes and enamel matrix derivatives for the management of intrabony periodontal defects only identified 5 small RCTs of limited quality. The addition of EMD to bony substitutes was not seen to be beneficial but the results should be interpreted cautiously due to limitations in the available evidence.

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