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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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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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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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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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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Halitosis: What are the best methods of prevention and control?

According to this review, Venlafaxine, Pregabalin, Escitalopram, and Duloxetine are viable alternatives to traditional drug treatment for generalised anxiety disorder.

44 RCTs were included in this Cochrane review assessing interventions for the prevention and control of halitosis. Only low to very-low cetrainty evidence was identified so conclusions regarding the superiority of any intervention could not be drawn.

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Periodontal treatment to prevent or manage cardiovascular disease

gum disease, scale and polish

Two small RCTs at high risk of bias were included in this Cochrane systematic review looking at the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis.

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