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This study aimed to explore microbial aerosol distribution characteristics in the dental clinic during ultrasonic scaling and evaluate the effects of three different interventions on aerosol distribution and protective effects. For twenty minutes, ultrasonic scaling was carried out in a standardized operatory room. A blank control group and three intervention groups were created: high-volume evacuator (HVE), plasma purification (PP), and fenestrated ventilation (VT). The mass concentration of PM1.0, PM2.5, and PM10.0 aerosol particles was tracked in real time, and colony counts were calculated using air deposition. After ultrasonic scaling, there was a significant increase in aerosol dispersion of various particle sizes and distribution within a 1.5-m radius of the core area ( P  < 0.05). The number of colonies in each group varied over time at 0.5 and 1.0 m from the patient’s head, but there was no significant difference at 1.5 m ( P  > 0.05). The PP group demonstrated the greatest decrease in aerosol mass concentration difference. The VT group initially had the lowest aerosol mass concentration difference, but with a slight decrease. The aerosol mass concentration difference between the HVE groups grew with distance. Traditional ultrasonic scaling poses a risk of aerosol contamination during and after treatment. The operatory room’s air can be efficiently purified by plasma purification, which maintains lower levels of aerosol particle size than other groups. Microbial aerosols created by ultrasonic scaling can be quickly reduced by ventilation. At close range, the high-volume evacuator can lower the risk of infection while the benefit diminishes as the distance increases. Trial registration: This study was registered on the website of China Clinical Trial Registration Center (ChiCTR2400090751) (12/10/2024).

Aim To evaluate oxidation and antioxidant activity in the saliva of periodontitis patients following non-surgical periodontal therapy applied either as full mouth subgingival instrumentation (FM) or quadrantwise (Q). Methods Patients affected by periodontitis were randomly allocated to receive FM or Q and followed up at 1st and 3rd months. Saliva samples and periodontal variables were collected at baseline, 1st, and 3rd month. The primary outcomes were the total antioxidant status (TAS), total oxidant status (TOS). Secondary outcomes were clinical measurements, Tumour Necrosis Factor alpha (TNF alpha), and Oxidative Stress Index (OSI) parameters. Results Forty-five subjects were included in the study. Both FM and Q resulted reductions in all periodontal variables, TNF alpha and TOS values, with an improvement in TAS values compared to baseline. Significant differences were observed in the reductions of probing pocket depth (PPD) and clinical attachment level (CAL) between the FM group and the Q group as periodontal variables ( p  < 0.05). The change in TNF alpha (ng/L) and TAS (mmol Trolox Eq/L) from baseline to post treatment significantly improved in FM group compared to Q. Conclusion Both treatment protocols were efficient in the treatment of periodontitis but the FM therapy significantly reduced periodontal tissue inflammation, as evidenced by changes in both clinical and biochemical parameters in our study. However, it may be seen that FM therapy is more effective during short-term recovery, maybe the reason could be attributed to TAS and TNF alpha changes following FM therapy. Trial registration This study was registered at Thai Clinical Trials Registry. ( https://www.thaiclinicaltrials.org/show/TCTR20240416007 , TCTR ID: TCTR20240416007; date of registration: 16 April 2024)—retrospectively registered).

The aim of this study was to evaluate the efficacy and patient satisfaction of lidocaine aerosol for pain management during periodontal scaling and root planning in patients with chronic periodontitis or dental plaque-induced gingivitis. This study specifically concentrated on comparing the effectiveness of lidocaine aerosol as a topical anesthetic against a placebo, assessing its impact on pain perception during the procedure. Additionally, the relationship between periodontal treatment and the reduction of oxidative stress markers in these patients was assessed. Eighty-six patients with chronic periodontitis or dental plaque-induced gingivitis were included. Notably, 5.6% lidocaine and placebo aerosols were randomly applied to the labial (buccal) and lingual (palatal) sides, approximately 3 mm from the gingival surface, with three sprays on each side, prior to supragingival ultrasonic scaling in these patients. In this controlled, double-blind study, the effectiveness of a 5.6% lidocaine aerosol in reducing pain during supragingival ultrasonic scaling was evaluated. The study involved 50 patients who divided into two groups: one receiving the lidocaine aerosol and the other a placebo. Pain was assessed using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). The results revealed a statistically significant reduction in pain scores in the lidocaine group compared with the placebo group. Specifically, the mean VAS score in the lidocaine group was 2.1 ± 1.3, compared with 5.6 ± 1.7 in the placebo group ( P  < 0.01). Similarly, the NRS scores were significantly lower in the lidocaine group (2.3 ± 1.2) compared with the placebo group (5.9 ± 1.8, P  < 0.01). No adverse reactions were found in none of the groups. 5.6% lidocaine aerosol holds promise as an effective anesthetic option for reducing pain during supragingival ultrasonic scaling procedures in patients with chronic periodontitis or dental plaque-induced gingivitis. Chinese Clinical Trial Registry (No. ChiCTR2000029831, date: 2020-02-15).

ObjectivesThe aim of the present randomized clinical trial (RCT) with a parallel arm design was to evaluate the clinical and microbiological efficacy of repeated ICG-aPDT as an adjunct to full-mouth subgingival debridement in the treatment of periodontitis.Materials and methodsTwenty-four periodontitis patients were treated with full-mouth ultrasonic subgingival debridement (FMUD). Initial sites with probing depth (PD) > 4 mm were randomly assigned to receive the test (ICG-aPDT with an 810 nm diode laser) or the control treatment (off-mode aPDT) one and four weeks after FMUD. Clinical parameters were registered after 3 and 6 months. The presence of the main periodontal pathogens in subgingival samples was assessed with real-time PCR.ResultsBoth treatment modalities resulted in significant clinical improvements at 3 and 6 months. The only significant differences in favour of the test group were found at 6 months for a higher PD reduction in initial deep pockets (PD ≥ 6 mm) and a higher percentage of closed pockets (PD ≤ 4 mm/no bleeding on probing). Limited microbiological changes were observed in both groups after treatment with no inter-group difference, except for a more significant reduction in Aggregatibacter actinomycetemcomitans and Parvimonas micra levels in the test group at 3 months.ConclusionThe combination of repeated ICG-aPDT and FMUD provided no benefits except for selective clinical and microbiological improvements compared to FMUD alone.Clinical relevanceBased on the obtained results, only limited adjunctive effects could be found for the combined use of ICG-aPDT and FMUD. Further, well-designed RCT with larger sample sizes are required to confirm these findings.Trial registrationClinicalTrials.gov NCT04671394.

The aim of the study is to compare the clinical efficacy of the application of \"Armenicum\" paste as an adjunct to SRP for the non-surgical treatment of patients with periodontitis. The current RCT prospective study was conducted on 157 patients with chronic periodontitis. The patients were blind randomly assigned into two groups: Group A (SRP + Armenicum\" paste) 81 patients (42 males and 39 females, 37 to 68 years) and Group B (SRP) 76 patients (39 males and 37 females, 37 to 68 years). Periodontal indices BOP, PPD, and DPI within each treatment group were measured before periodontal therapy, 3 and 6 months after the treatment. Group A underwent a periodontal treatment which included: supragingival and subgingival scaling, and additional use of local \"Armenicum\" paste. The Group B group only received supragingival and subgingival scaling. In our study, the mean BOP, DPI, and PPD showed a statistically significant difference from baseline to 3 months and 6 months (p ≤ 0.05) in both Group A and Group B. But, mean BOP and mean PPD reduction gain was found to be greater in Group-A than Group B at 3 months and 6 months. No statistical differences in clinical indices were recorded depending on gender and age. These results indicate that topical \"Armenicum\" paste provides an effective adjunctive treatment of chronic periodontitis. The results of the current study showed that the adjunctive use of \"Armenicum\" reduced signs of inflammation compared to standard SRP treatment alone. Periodontal therapy using Armenicum paste application can be considered as a promising method in the treatment of periodontitis.

ObjectivesThe purpose of this study is to investigate the clinical and microbiological effects of Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt as an adjunct to non-surgical periodontal treatment in periodontitis patients.Materials and methodsThis is a prospective randomized controlled clinical study registered with NCT05408364 under clinical trial registration. Thirty periodontitis patients were divided into 2 groups at random. As adjunctive to supra and subgingival instrumentation, the test group consumed Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt while the control group consumed natural yogurt, once daily for 28 days. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 28th day, and 3rd month. Microbiological analysis was performed using culture method by obtaining subgingival plaque samples from 2 periodontal sites with 4≤PD≤6 mm at the same time points.ResultsThe inter-group comparisons of PI, GI, and BOP as well as the changes between the measurement time points were statistically significant in favor of the test group. There were no significant differences in terms of PD and CAL changes between the study groups at all times (∆baseline–28 days, ∆baseline–3 months) (p>0.05). The number of patients presenting subgingival Bifidobacterium species was significantly greater in the test group than the control group at the 28th day (p<0.05).ConclusionsThe administration of probiotics has shown beneficial effects, albeit limited, on clinical and microbiological outcomes in the management of periodontitis patients.Clinical relevanceDaily consumption of probiotic yogurt may be supportive for supra and subgingival instrumentation.

Background This study aimed to compare the efficacy of three different techniques, namely virtual simulation technology (VS), traditional pathological typodont (TT), and quail egg (QE), in pre-clinical training of periodontal ultrasonic scaling. It also aimed to propose an integrated teaching approach for ultrasonic scaling teaching. Methods This single-blind randomized multi-arm trial enrolled 108 fourth-year students from Guanghua School of Stomatology at Sun Yat-sen University. The participants were randomly, evenly assigned to VS, TT, or QE group. First, the participants received theoretical review on ultrasonic scaling and demonstrative teaching. Then in the 90-minute operation training by group, students used traditional typodont equipped in head-simulators, raw quail eggs, or scaling module of the UniDental VS system respectively. Then all participants practiced on pathological models for 30 min. In the final operation examination, participants were instructed to remove the supra- and sub-gingival calculi pre-set on designated teeth by ultrasonic scalers within 30 min. Their performances were evaluated by residual calculus rate and a multi-perspective scoring scale. After the examination, questionnaires were provided to assess the teaching effects of each method and the fidelity of VS. Statistical analysis was carried out using one-way, two-way ANOVA, and multiple t-test. Results Students in VS group had significant higher total test scores than QE group (87.89 ± 6.81, 83.53 ± 8.14) and TT group (85.03 ± 6.81). VS group scored higher in several dimensional comparisons with the other two groups, especially in difficult situations. QE group had higher scores particularly in force application and supra-gingival scaling. TT group scored the highest in pivot stability practice and body position training. Students gave higher scores when assessing the fidelity of VS than experienced teachers. Conclusion The study highlights the importance of specialized pre-clinical training on ultrasonic scaling for dental students. The methods adopted in current study (VS, TT and QE) each offered unique advantages in education, which can be combined to create an integrative teaching procedure. This procedure aims to provide an effective, advisable and normative pre-clinical training procedure for ultrasonic scaling. By utilizing the strengths of each method, dental educators can deliver high-quality training and ensure that students are well-prepared for clinical practice.

ObjectivesTo determine if minimally invasive non-surgical therapy (MINST) outperforms classical non-surgical periodontal therapy for stage III periodontitis with primarily suprabony (horizontal) type defects.Materials and methodsIn a split-mouth randomised controlled trial, 20 patients’ dental quadrants were randomly assigned to MINST or classical non-surgical treatment. The primary outcome variable was the number of sites with probing pocket depth ≥ 5 mm and BOP. Treatment method, tooth type, smoking status, and gender were evaluated using a multivariate multilevel logistic regression model.ResultsAfter 6 months, the percentage of sites with PD ≥ 5 mm and BOP that healed (MINST = 75.5%; control group = 74.1%; p = 0.98), and the median number of persisting sites (MINST: 6.5, control group: 7.0; p = 0.925) were similar in both groups. In the test and control groups, respectively, median probing pocket depths (2.0 mm vs. 2.1 mm) and clinical attachment level (1.7 mm vs. 2.0 mm) changed significantly (p < 0.05) but similarly. Significantly less gingival recession occurred in the MINST group’s deep molar pockets compared to the control group (p = 0.037). Men (OR = 0.52, p = 0.014) and non-molars (OR = 3.84, p 0.001) had altered odds for healing of sites with PD ≥ 5 mm and BOP.ConclusionsMINST reduces gingival recession associated with molar teeth, although it performs similarly to traditional non-surgical therapy in treating stage III periodontitis with predominately horizontal-type defects.Clinical relevanceMINST performs similarly to non-surgical periodontal therapy in stage III periodontitis with predominantly suprabony defects.Trial registrationClinicaltrials.gov (NCT04036513) on June 29, 2019.

Background Periodontal diseases are regarded as the most common diseases of mankind. The prevalence rate of periodontal disease assumes a clear growth tendency, increasing by 57.3% from 1990 to 2010. Thereby, effective periodontal therapy is still a long-term task and a difficult problem. The goals of periodontal therapy are to eliminate the infectious and inflammatory processes of periodontal diseases. Root planing, in order to eliminate the “infected cementum,” has been an important step in the treatment of periodontitis since the 1970s. However, along with the understanding of the effects of endotoxin on the root surface, the necessity of manual root planing has been gradually queried. Ultrasonic instruments, which are more recent innovations, would not remove the cementum excessively, and are also more time-saving and labor-saving compared to using hand instruments. Hence, an increasing number of dentists prefer to do scaling with ultrasonic instruments only. However, the necessity of root planing remains emphasized in the international mainstream views of periodontal mechanical treatment. Therefore, this study is devoted to compare the clinical effect of ultrasonic subgingival debridement and ultrasonic subgingival scaling combined with manual root planing, which takes the implementation of root planing as the only variable and is more in line with the current clinical situation, thus hoping to provide some valuable reference to dentists. Methods/design Forty adult patients who fit the inclusion criteria are being recruited from the Peking University Hospital of Stomatology (Beijing, China). By means of randomization tables, one quadrant of the upper and lower teeth is the test group and the other is the control group. Test group: ultrasonic subgingival scaling combined with manual root planing. Control group: ultrasonic subgingival debridement. In a 24-week follow-up period, plaque index, probing depth, clinical attachment loss, bleeding index, furcation involvement, mobility, and patient-reported outcome (Visual Analog Scale for pain and sensitivity) will be observed and documented. Discussion This study evaluates the effectiveness of ultrasonic subgingival scaling combined with manual root planing and ultrasonic subgingival debridement alone in the nonsurgical treatment of periodontitis with a split-mouth design after 1, 3 and 6 months. The result of the trial should potentially contribute to an advanced treatment strategy for periodontitis with an ideal clinical outcome. Trial registration International Clinical Trials Registry Platform (ICTRP), ID: ChiCTR1800017122 . Registered on 12 July 2018.