Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis

Abstract

The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.

The Influence of Periodontal Disease on Oral Health Quality of Life in Patients with Cardiovascular Disease: A Cross-Sectional Observational Single-Center Study

“…Of course, in severe cases of periodontal disease, there is need of recourse to surgical therapy, such as gingivectomy, flap debridement and excisional attachment procedures. Progress in oral health permitted the introduction of less invasive techniques, such as laser-assisted attachment procedures, with promising results [ 19 ].…”

Electronic cigarette use enriches periodontal pathogens

“…These risk factors can result in the accumulation of dental plaque, which is primarily composed of Gram-negative and anaerobic bacteria in gingival crevices (Lertpimonchai et al, 2017). Some well-known periodontal disease-associated bacterial species are Porphyromonas gingivalis, Tannerella forsythia, Campylobacter rectus, Prevotella intermedia, Treponema denticola, and Fusobacterium nucleatum (Boyer et al, 2020;Cirino et al, 2019;Sela, 2001;Signat et al, 2011). The bacteria release endotoxins and enzymatic byproducts, triggering host defense mechanisms and proinflammatory processes, which leads to apical and lateral deterioration of connective fibers in periodontal tissues (Lertpimonchai et al, 2017).…”

Influence of periodontal surgery on the subgingival microbiome—A systematic review and meta‐analysis

“…Follow‐up time points varied and ranged from 6 weeks to 12 months after surgical procedure. Microbiological follow‐up time points were reported as follows: 3 months in 75% (21 out of 28), 25,28,30,32,34,36–51 6 months in 57% (16 out of 28), 8,25,27,30,32–34,36,38,39,42,44–46,50,51 12 months in 29% (8 out of 28), 8,25,27,31,33,34,42,50 9 months in 11% (3 out of 28), 25,30,34 1.5 months 26 and 2 months 52 in 7% (2 out of 28) and 4 months 52 and 10 months 35 in 4% (1 out of 28) 35 of the studies.…”

“…In the majority of the studies, subgingival plaque samples were collected with a sterile periodontal curette (57%) 8,25,26,28,30,33,34,36,37,44–48,52,54 . The second most common sampling method used was sterile paper points (35%) 27,31,32,40–43,49–51 . One study collected subgingival plaque samples with a toothpick 39 and one study did not provide any information about the sampling methodology 38 .…”