A randomized controlled trial comparing surgical and non‐surgical periodontal therapy: a 3‐year clinical and cost‐effectiveness analysis

Miremadi, Seyed Reza; Bruyn, Hugo De; Steyaert, Harold; Princen, Katrijn; Cosyn, Jan

doi:10.1111/jcpe.12434

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…These findings can be compared to Müller and coworkers, who showed during a similar study design that after 3 months 428 out of 457 sites with PD > 4 mm were in need of retreatment and after 6 months 395 sites were treated again . This is in accordance with the observation that non‐surgical periodontal treatment has a greater need of retreatment compared to surgical interventions …”

Section: Discussionsupporting

confidence: 87%

“…12 This is in accordance with the observation that non-surgical periodontal treatment has a greater need of retreatment compared to surgical interventions. 32,33 The BOP also fell by more than 50% compared to BL in both groups with the test group showing significantly higher reductions at 3 months compared to the control group while the control group showed significantly higher reductions at 6 months. This result is thus not absolutely distinct.…”

Section: Discussionmentioning

confidence: 89%

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Trehalose powder for subgingival air‐polishing during periodontal maintenance therapy: A randomized controlled trial

Kruse

Akakpo

Maamar

et al. 2018

Journal of Periodontology

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Background Air‐polishing appears to be a promising procedure for subgingival biofilm removal in periodontal treatment. The aim of this study was to compare trehalose powder for subgingival air‐polishing with sonic debridement in residual periodontal pockets during maintenance therapy. Methods In this blinded, randomized, controlled clinical trial conducted over 6 months with a split‐mouth design, single‐rooted teeth in 44 participants with residual pocket depths of 5 mm and bleeding or >5 mm with and without bleeding were included in this study. Subgingival debridement was carried out using either trehalose powder with an air‐polishing device (test) or a sonic device (control). The reduction in the probing depths after 3 and 6 months was defined as the primary endpoint. A visual analog scale was used to evaluate the discomfort of both procedures. Results Both procedures showed statistically significant intragroup reductions in probing depths (test baseline [BL] 5.52 ± 0.93, 6 months 3.66 ± 0.81, control BL 5.55 ± 0.9, 6 months 3.68 ± 0.86, P < 0.001), clinical attachment level (test BL 6.93 ± 1.5, 6 months 5.3 ± 1.52, control BL 7.27 ± 1.8, 6 months 5.84 ± 1.71, P < 0.001), and bleeding on probing (test BL 86%, 6 months 41%, control BL 89%, 6 months 34%, P < 0.001) after 6 months with no significant intergroup differences (P > 0.05, respectively). The visual analog scale showed a significantly lower incidence of discomfort for air‐polishing compared with sonic scaling (test 2.33 ± 2.14, control 4.91 ± 2.65, P < 0.001). Conclusions Subgingival air‐polishing with trehalose powder showed comparable clinical outcomes to sonic scaling. Sonic scaling evoked more discomfort compared with air‐polishing.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 89%

Trehalose powder for subgingival air‐polishing during periodontal maintenance therapy: A randomized controlled trial

Kruse

Akakpo

Maamar

et al. 2018

Journal of Periodontology

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“…Similar to these findings, we found that respective AG values were 0.77 mm and 2.31 mm. On the other hand, in the study of Miremadi et al( 34 ), the mean CALs of shallow sites before and after NPT were 4.0±0.8 mm and 3.9±0.8 mm and the AG was statistically significant.…”

Section: Discussionmentioning

confidence: 71%

Relationships Between Initial Probing Depth and Changes in the Clinical Parameters Following Non-Surgical Periodontal Treatment in Chronic Periodontitis

Meseli

Kuru

2017

J Istanbul Univ Fac Dent

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Purpose:The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients.Subjects and Methods:A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth.Results:Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG.Conclusion:NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.

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“…Periodontal surgery results in greater probing depth reduction and clinical attachment gain in initially deep pockets (Heitz-Mayfield & Lang, 2013). As a result, surgery may reduce retreatment during follow-up (Miremadi et al, 2015). It increases morbidity and treatment costs (Miremadi et al, 2014;Miremadi et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…As a result, surgery may reduce retreatment during follow-up (Miremadi et al, 2015). It increases morbidity and treatment costs (Miremadi et al, 2014;Miremadi et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

A questionnaire‐based crossover study on the association of microbiological testing with prescription of systemic antibiotics following initial periodontal therapy

Vrijghem

Cosyn

Fransen

et al. 2021

J Clinic Periodontology

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Aim: (1) To assess prescription of systemic antibiotics following initial periodontal therapy with and without the availability of microbiological information; (2) To identify factors associated with prescription of systemic antibiotics following initial periodontal therapy.Materials and methods: Twenty-four clinicians were invited to complete a questionnaire on 20 patient records with respect to periodontal treatment planning, once with microbiological information available and once without. Randomization determined when the microbiological information was provided, and a 3-month washout period was respected between scoring sessions. Regression analysis was performed to identify factors associated with prescription of systemic antibiotics.Results: Twenty-one clinicians completed both scoring sessions. Clinicians prescribed systemic antibiotics in on average 56% (95% Confidence Interval (CI) [0.51; 0.61]) of the cases having microbiological information, and in 52% (95% CI [0.47; 0.57]) of the same cases not having that information (p = 0.094). The odds for prescribing systemic antibiotics were 3.34 (95% CI [2.06; 5.42]) times higher when the clinician had at least 3 years of experience, 2.55 (95% CI [1.40; 4.66]) times higher for patients diagnosed with periodontitis stage IV when compared to stage III, 1.08 (95% CI [1.04; 1.11]) times higher for younger patients, 2.78 times (95% CI [1.37; 5.56]) times higher for non-smokers and 2.22 (95% CI [1.27; 3.85]) times higher when less than three teeth would require extraction. No significant associations with the prescription of systemic antibiotics were found for detection of A.actinomycetemcomitans (p = 0.287), grade of periodontitis (p = 0.499) and gender of the patient (p = 0.067). Conclusions:Based on a limited number of cases and clinicians, several patient and clinician related factors were associated with prescription of systemic antibiotics following initial periodontal therapy. However, microbiological testing was not. K E Y W O R D S aggregatibacter actinomycetemcomitans, diagnostic factors, initial antibiotic treatment, microbiological test, periodontitis How to cite this article: Vrijghem C, Cosyn J, Fransen J, Christiaens V. A questionnaire-based crossover study on the association of microbiological testing with prescription of systemic antibiotics following initial periodontal therapy.

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A randomized controlled trial comparing surgical and non‐surgical periodontal therapy: a 3‐year clinical and cost‐effectiveness analysis

Abstract: Surgery was ultimately associated with a significantly lower need for re-treatment during supportive care, however, at significantly higher costs over the 3 years.

Cited by 8 publications

References 18 publications

Trehalose powder for subgingival air‐polishing during periodontal maintenance therapy: A randomized controlled trial

Trehalose powder for subgingival air‐polishing during periodontal maintenance therapy: A randomized controlled trial

Relationships Between Initial Probing Depth and Changes in the Clinical Parameters Following Non-Surgical Periodontal Treatment in Chronic Periodontitis

A questionnaire‐based crossover study on the association of microbiological testing with prescription of systemic antibiotics following initial periodontal therapy

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