Non-Surgical Chemotherapeutic Treatment Strategies for the Management of Periodontal Diseases

Krayer, Joe W.; Leite, Renata S.; Kirkwood, Keith L.

doi:10.1016/j.cden.2009.08.010

Cited by 80 publications

(71 citation statements)

References 76 publications

(65 reference statements)

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“…Its progression is associated to subgingival bacterial colonization 2 , whose toxins are absorbed and fixed to the cement surface 3 , acting as a barrier to the attachment of periodontal tissues [2][3][4][5][6] , consequently promoting irritation, collagen fiber degradation 3 , progressive alveolar bone, cement and periodontal ligament destruction 7 . Root surface conditioning of a tooth affected by periodontal disease aims to remove dental calculus, bacterial biofims and their toxins 2,[8][9] , which consequently contributes to a reduced inflammatory process, periodontal tissue repair [10][11][12] including formation of new supporting tissues [12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces

Lima

Peruzzo

Passador-Santos

et al. 2016

RGO, Rev. Gaúch. Odontol.

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In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces ABSTRACT ObjectiveThe objective of the present study was to evaluate, in vitro, fibroblastic proliferation on chemically conditioned root surfaces. Methods Forty single-rooted human teeth, were cut into fragments and divided into four groups (n=20): GI (control) -scaling and root planing (SRP); GII -SRP + conditioning with 10% citric acid; GIII -SRP + conditioning with 24% EDTA gel and GIV -SRP + conditioning with 50 mg/ml of tetracycline hydrochloride. The fibroblasts were placed on these surfaces and cell proliferation evaluated using Trypan Blue stain. Smayer layer formation was analyzed using Scanning Electron Microscopy. Results The results revealed that the chemical conditioners used were incapable of effectively removing the smear layer. However, when compared to the other groups, GIII showed the best results regarding removal of the smear layer (p<0.05). GI demonstrated the greatest cell proliferation at all studied time intervals compared to the chemically treated groups (p<0.05). ConclusionThe results of the present study reveal that all demineralizing agents evaluated presented lower cell proliferation levels when compared to the control group. In addition none of the chemical conditioners used removed the smear layer completely. Indexing terms: Chemical treatment. Periodontal debridment. Periodontal disease. RESUMO ObjetivoAvaliar in vitro a proliferação de fibroblastos em superfícies radiculares, previamente condicionadas quimicamente. MétodosPara este estudo, 40 dentes unirradiculares humanos hígidos, extraídos por acometimento periodontal irreversível, foram seccionados em fragmentos radiculares e divididos em 04 grupos (20 espécimes/grupo) de acordo com a aplicação do condicionamento ácido: GI (controle) -apenas submetidos à raspagem e alisamento radicular (RAR); GII -RAR + condicionamento com ácido cítrico a 10%; GIII-RAR + condicionamento com gel de EDTA a 24%, ph 7,0; e GIV-RAR + condicionamento com 50mg/ml de cloridrato de tetraciclina. Adicionalmente, as células foram plaqueadas sobre estas superfícies e foi avaliada a proliferação celular por meio do corante vital azul de Trypan. Para a análise da morfologia ultraestrutural foi utilizado Microscopia Eletrônica de Varredura (MEV). ResultadosOs resultados demonstraram que em relação à proliferação celular, os condicionadores químicos utilizados não foram capazes de remover efetivamente a smear layer. Entretanto, no grupo tratado com EDTA (GIII) foi observado uma maior remoção (P<0,05) na quantidade de smear layer quando comparado aos demais grupos. No grupo controle (GI) pode-se observar uma maior proliferação celular em todos os tempos (24h, 48h, 72h) quando comparado aos demais grupos que sofreram tratamento químico (P<0,05). ConclusãoConsiderando os agentes desmineralizantes avaliados, a maior remoção de smear layer e proliferação celular foram alcançados com o gel de EDTA a 24%, quando comparado ao grupo condicionado com cl...

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Section: Introductionmentioning

confidence: 99%

In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces

Lima

Peruzzo

Passador-Santos

et al. 2016

RGO, Rev. Gaúch. Odontol.

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“…Research by Dym and Zeidan cautions against empiric antibiotic therapy due to the prevalence of microbe resistance against commonly used antibiotics, while Krayer, Leite and Kirkwood suggest that initiating treatment prior to receiving the results of cultures and sensitivities is appropriate. [5,8] Our patient was treated with two different antibiotics prior to presentation and arrival at the appropriate diagnosis, which is perhaps why the blood and wound cultures remained negative after several days; this phenomenon is relatively common in other reported cases. [7] While awaiting the results of the cultures, treatment with ampicillin and sulbactam was initiated after reviewing the medication's documented efficacy in cases of jaw osteomyelitis.…”

Section: Discussionmentioning

confidence: 86%

Brodie abscess of the jaw: An unusual presentation of a rare complication of subacute osteomyelitis

DʼSouza

John

et al. 2017

CRIM

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Background: A Brodie abscess is a rare subtype of subacute osteomyelitis which can be acquired from local trauma or hematogenous spread secondary to transient bacteremia. However, to date there have been no reports of the presence of a Brodie abscess in the mandible. Case representation: Here we report a case of a 51-year-old female who presented to the emergency department with a 4-day history of left sided facial pain and trismus after recent dental manipulation. A computed tomography (CT) scan showed the presence of osteomyelitis with a Brodie abscess in the mandibular condyle. Empiric treatment was initiated with ampicillinsulbactam. After seven days of treatment, the antibiotics were switched to ceftriaxone and metronidazole on discharge. Five days later the patient returned to the hospital with the same symptoms that she initially presented with, indicating a failure of treatment. Follow-up CT scan showed the persistence of the Brodie abscess. Subsequently, IV ertapenem was initiated for a duration of eight weeks and the patient was instructed to obtain an oral surgery evaluation as an outpatient. Conclusions: This case highlights a unique presentation of a Brodie abscess, which has been previously exclusively found in long bones, and raises awareness of such a complication in patients whose facial erythema, pain, and swelling may not improve with first line therapy for a simple dental infection. Additionally, we highlight that the unique location of the mandibular condyle poses a treatment challenge and surgical replacement of the jaw appears to be the lone curative modality.

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“…Most evidence seems to exist for the beneficial effect of adjunctive systemic antibiotics and particularly for the combination of amoxicillin and metronidazole to non-surgical periodontal therapy [8,9,[69][70][71][72]. It has to be underlined that the systemic administration of antibiotics is only recommended in combination with mechanical debridement of the root surfaces i.e.…”

Section: Discussionmentioning

confidence: 99%

Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

M¹

2014

Dentistry

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Aim: To screen whether or not classical non-surgical periodontal therapy improved over the last four decades and how adjunctive local or systemic measures influenced its clinical outcome. Methodology:Starting from the year 1970, the entire annual sets of publications of every 5th year of the "Journal of Clinical Periodontology" and the "Journal of Periodontology" were hand searched for articles dealing with nonsurgical periodontal therapy, i.e. scaling and root planing either alone (SRP) or in combination with adjunctive local (SRPloc) or systemic (SRPsyst) treatment. Mean pocket reduction was computed for each of the three treatment modalities. Where applicable, a meta-analysis and a meta-regression as well as linear regression were performed.Results: A total of 52 articles were found. Twenty-six thereof were randomized clinical trials. The meta-analysis revealed a standardized mean difference of pocket reduction of 0.77 mm (95% CI=0.283; 1.255) and 0.90 mm (95% CI 0.210; 1.593 for SRPloc-SRP and SRPsyst-SRP, respectively (P<0.0001). Meta regression showed significantly more mean pocket reduction for SRPloc (p=0.011) and SRPsyst (p=0.001) than for SRP. In addition, a negative correlation between time to re-evaluation and mean pocket reduction could be found (p=0.015). None of the treatment modalities improved over the past 40 years. Conclusion:Adjunctive local or systemic measures seem to improve the classic non-surgical periodontitis therapy, i.e. scaling and root planing. None of the three analyzed treatment modalities improved over the past 40 years.

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Non-Surgical Chemotherapeutic Treatment Strategies for the Management of Periodontal Diseases

Cited by 80 publications

References 76 publications

In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces

In vitro evaluation of gingival fibroblasts proliferation and smear layer formation in pre-conditioned root surfaces

Brodie abscess of the jaw: An unusual presentation of a rare complication of subacute osteomyelitis

Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

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