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

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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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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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Periodontitis: Systemic antimicrobials as an adjunct to non-surgical treatment

Periodontal disease
Periodontitis

This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.

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Routine scale and polish for periodontal health

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Two UK primary care-based trials were included in this Cochrane review update of routine scale and polish. They provide high certainty evidence of litte or no difference between 6- & 12-monthly scale and polish for adult regular attenders without severe periodontitis.

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Periodontal health: no additional benefit from 6 monthly Scale and Polish

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This large multicentre, cluster randomised controlled compared the clinical effectiveness and cost-effectiveness of theory-based, personalised oral hygiene advice or scale and polish’ with routine care in improving periodontal health in dentate adults attending general dental practice.

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Periodontal treatment and prevention in Down syndrome patients

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Only 9 small studies were identified for this review of the prevention and treatment of periodontal disease in patients with Down’s syndrome. More high quality studies are needed to help inform clinical practice

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Low quality evidence that periodontal treatment improves glycaemic control in diabetics

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This update of a 2010 Cochrane review found low quality evidence that periodontal treatment involving scaling and root planing does improve glycaemic control in people with diabetes, with a mean percentage reduction in HbA1c of 0.29% at 3-4 months, but there is insufficient evidence to demonstrate that this is maintained after 4 months.

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Guideline: Nonsurgical treatment of chronic periodontitis

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This new systematic review from the ADA includes 72 RCTs on nonsurgical treatment approaches for chronic periodontitis. The systematic review provides the basis for a new clinical practice guideline.

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Professional plaque removal more effective with oral hygiene instruction

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This is an update to a review first published 10 years ago. Only 3 new studies could be added. These provide some additional evidence that there is little value in providing professional plaque removal without oral hygiene instruction.

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