OBJECTIVE: To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts. METHODS: In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model. RESULTS: At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×10⁹/L vs. (7.14±1.99)×10⁹/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P < 0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P < 0.05; (7.06±0.78)% vs. (7.64±1.16)%, P < 0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P < 0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×10⁹/L vs. (6.01±1.26)×10⁹/L, P < 0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×10⁹/L vs. (7.14±1.99)×10⁹/L, P < 0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P < 0.05). CONCLUSION Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.
Chronic Periodontitis/therapy* ; Diabetes Mellitus, Type 2/complications* ; Glycated Hemoglobin A/analysis* ; Humans ; Leukocytes/chemistry* ; Periodontal Index

OBJECTIVE: A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. METHODS: We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. RESULTS: Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. CONCLUSIONS Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.
C-Reactive Protein ; Chronic Periodontitis ; Humans ; Interleukin-6 ; Renal Insufficiency, Chronic/therapy* ; Tumor Necrosis Factor-alpha

OBJECTIVE: To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. METHODS: Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. RESULTS: Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. CONCLUSIONS CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.
Anti-Bacterial Agents ; therapeutic use ; Chronic Periodontitis ; drug therapy ; Clarithromycin ; Dental Scaling ; Humans ; Periodontal Index ; Root Planing ; Treatment Outcome

OBJECTIVE: To evaluate the clinical efficacy of ultrasound subgingival scaling combined with manual root planing for treatment of chronic periodontitis in elderly patients. METHODS: Forty elderly patients with chronic periodontitis were randomly divided into test group for treatment with ultrasound and Gracey subgingival curette for subgingival scaling combined with manual root planing and control group treated with ultrasound subgingival curette scaling (=20). We compared plaque index (PLI), bleeding index (BI), probing depth (PD), and attachment loss (AL) between the two groups before and at 6 weeks and 12 weeks after the treatment. RESULTS: After periodontal treatment, PLI, BI, PD and AL all decreased significantly in both groups compared with the levels before the treatment ( < 0.05). The patients in the test group showed significantly more obvious decrease of PD and AL than those in the control group ( < 0.05), but the reduction of PLI and BI was comparable between the two groups (>0.05). CONCLUSIONS Ultrasound subgingival scaling combined with manual root planing produces better therapeutic effect than ultrasonic subgingival scaling alone for treatment of chronic periodontitis in elderly patients.
Aged ; Chronic Periodontitis ; therapy ; Dental Scaling ; Humans ; Root Planing ; Treatment Outcome ; Ultrasonography

OBJECTIVE: To evaluate the survival rate and peri-implant clinical parameters of Locking-Taper implants in patients having lost their teeth due to non-periodontitis (NP) reasons, chronic periodontitis (CP) and aggressive periodontitis (AgP). METHODS: In the study, 145 subjects were installed with 315 Bicon Locking-Taper implants and followed up for 1-5 years. The subjects and implants were classified into three groups, tooth loss by NP, CP and AgP. NP included 44 subjects with 100 implants, CP 70 subjects with 132 implants and AgP 31 subjects with 83 implants. Periodontal parameters before subgingival scaling and root planning (T0), at the end of active periodontal therapy (T1) and at the time of last recall (T2) were recorded. Right after the installation of final restoration and at the time of last recall (T2), peri-implant probing parameters were recorded. RESULTS: After active periodontal therapy, mean probing depth (PD) in CP and AgP were reduced from 4.05 mm, 5.20 mm at T0 to 3.07 mm, 2.96 mm at T1 (P<0.001, P<0.001), (PD≥6 mm)% were reduced from 33.2%, 58.5% at T0 to 14.4%, 10.5% at T1 (P<0.001, P<0.001). The periodontal parameters remained stable at T2 compared with T1 (P>0.05). Cumulative survival rates of implants in NP, CP and AgP were 100%, 97.6% and 100% for 1-5 years' follow-ups with no statistical significance found. At T2, mean implant PD was 2.78 mm, 2.96 mm and 2.97 mm in NP, CP and AgP, with NP significantly lower than the other two groups (P=0.006, P=0.01). The percentage of implant sites with PD≥6 mm was 3.7% in CP and 4.8% in AgP, both significantly higher than NP (P=0.003, P<0.001). 8.4% implant sites showed at least 2 mm deeper than those at prosthesis installation were found in CP group, significantly higher than NP (4.3%, P=0.003). CONCLUSION Periodontal conditions of patients having lost their teeth for chronic and aggressive periodontitis were significantly improved after active periodontal therapy and remained stable during 1-5 years. Short-term survival rates of Locking-Taper implants in patients treated for CP and AgP was no less than those who lost their teeth for non-periodontitis reasons. More sites with increasing peri-implant probing depth were found in CP and AgP patients, compared with NP.
Aggressive Periodontitis/therapy* ; Chronic Periodontitis ; Dental Implants ; Dental Scaling ; Humans ; Periodontal Index ; Tooth Loss ; Treatment Outcome

Adult ; China ; Chronic Periodontitis ; therapy ; Delivery of Health Care ; legislation & jurisprudence ; Dental Scaling ; Dentists ; legislation & jurisprudence ; Humans ; Liability, Legal ; Male ; Students, Medical ; legislation & jurisprudence

OBJECTIVETo evaluate the effect of subgingival scaling/root planning (SRP) and occlusal adjustment on clinical and occlusal parameters in teeth with chronic periodontitis and secondary occlusal trauma.

METHODSEighteen patients with chronic periodontitis and occlusal trauma were included and randomly divided into group A and group B. On day 0, group A was treated by full-mouth subgingival scaling and root planning, and group B was treated by occlusal adjustment in occlusal trauma site. On day 28, group A was treated by occlusal adjustment in occlusal trauma site, and group B was treated by full-mouth subgingival scaling and root planning. Probing depth (PD), attachment loss (AL), bleeding index (BI) were evaluated on 0, 28 and 56 d, and the occlusal time (OT) and the percentage of occlusal force were evaluated on 0, 28 and 56 d in occlusal trauma site. The data was statistically analyzed.

RESULTSIn baseline, the PD[(4.42 ± 1.41) mm vs (4.36 ± 1.38) mm], AL [(2.75 ± 1.32) mm vs (2.63 ± 1.37) mm] and BI [(2.20 ± 0.81) vs (2.24 ± 0.89)] of the full-mouth showed no significant difference between the two groups (P > 0.05). There was no significant difference in PD [(5.21 ± 1.21) mm vs (5.08 ± 1.12) mm], AL [(4.94 ± 1.47) mm vs (4.89 ± 1.32) mm], BI [(2.61 ± 0.92) vs 2.50 ± 0.79)], OT [(1.29 ± 0.39) s vs (1.34 ± 0.35) s] and the percentage of occlusal force [(6.8 ± 2.1)% vs (7.4 ± 1.7)%] in occlusal trauma site between the two groups(P > 0.05). After SRP therapy, the PD,AL,BI and OT were significantly decreased (P < 0.05).The clinical parameters exhibited no significant difference after only occlusal adjustment(P > 0.05).On 56 d, the reduction in clinical parameters was not significantly different between the two groups(P > 0.05),however the reduction of OT and the change of the percentage of occlusal force in group A [(0.85 ± 0.41) s, (2.2 ± 2.2)%] were more significant than those in group B [(0.70 ± 0.38) s; (1.5 ± 1.6)%] (P < 0.05). After occlusal adjustment, the increase of OT in group A [(0.21 ± 0.11) s] was lower than that in group B [(0.67 ± 0.37) s]through the 28-day observation period (P < 0.05).

CONCLUSIONSOcclusal adjustment alone is inadequate for control and management of periodontitis.SRP therapy can eliminate the inflammation and decrease the OT of tooth with occlusal trauma.The combination of SRP and occlusal adjustment may achieve more stable results.

Adult ; Aged ; Bite Force ; Chronic Periodontitis ; physiopathology ; therapy ; Dental Occlusion, Traumatic ; physiopathology ; therapy ; Dental Scaling ; Female ; Humans ; Male ; Middle Aged ; Occlusal Adjustment ; Periodontal Attachment Loss ; therapy ; Periodontal Index ; Root Planing

Chronic Periodontitis ; complications ; diagnosis ; diagnostic imaging ; therapy ; Dental Pulp Diseases ; complications ; diagnosis ; diagnostic imaging ; therapy ; Dental Scaling ; Female ; Humans ; Periodontal Debridement ; Periodontal Diseases ; complications ; diagnosis ; diagnostic imaging ; therapy ; Radiography ; Root Canal Therapy ; Root Planing ; Young Adult

OBJECTIVETo compare the special series of ultrasonic inserts with Gracey curettes in the effectiveness and efficiency for non-surgical periodontal treatment.

METHODSA total of 30 patients with moderate to advanced chronic periodontal disease were treated with both ultrasonic inserts (ultrasonic group) and Gracey curettes (Gracey group) according to a prospective, randomized, controlled, one-blind, "split-mouth" design. Twenty-six cases were available for the whole follow-up period. Plaque index (PLI), bleeding index(BI), probing depth (PD), attachment loss (AL) were evaluated before and 6 weeks after treatment. Treatment time was recorded. The severity of pain during treatment and teeth sensitivity after treatment were evaluated by the visual analogue scale (VAS). Differences in clinical parameters were analyzed with the Wilcoxon signed ranks test and Mann and Whitney U-test.

RESULTSNo significant differences in any of the clinical parameters were observed at baseline between the two groups. The mean value of PD, BI, PLI, AL decreased in both ultrasonic group and Gracey group. At moderately deep site (initial PD between 4 mm and 5 mm), PD [M(Q(25), Q(75))] changed in the ultrasonic group from 4.0 (4.0, 4.5) mm to 3.0 (3.0, 3.0) mm (P < 0.001) and in the Gracey group from 4.0 (4.0, 5.0) mm to 3.0(3.0, 3.0) mm (P < 0.001). At deep sites (initial PD ≥ 6 mm) PD [M(Q(25), Q(75))] changed in the ultrasonic group from 7.0(6.0, 7.0) mm to 5.0(4.0, 7.0) mm (P < 0.001) and in the Gracey group from 7.0 (6.0, 7.0) mm to 5.0(4.0, 6.0) mm(P < 0.001). In the furcation area, PD [M(Q(25), Q(75))] changed from 5.0(4.0, 7.0) mm to 3.0(3.0, 5.0) mm (P < 0.001) in both Gracey group and ultrasonic group. However, the average time of active instrumentation was (2.41 ± 0.61) min/tooth in the ultrasonic scaling and (2.71 ± 0.61) min/tooth in the Gracey curette (P < 0.001). VAS scores [M(Q(25), Q(75))] of pain during treatment was 5.0(3.0, 6.7) in the ultrasonic group and 5.9 (4.9, 8.0) in the Gracey group (P = 0.001). VAS scores [M(Q(25), Q(75))] of sensitivity after treatment was 4.0 (1.8, 6.0) in the ultrasonic group and 4.9 (2.0, 8.0) in the Gracey group (P = 0.043).

CONCLUSIONSTreatment with the special series of ultrasonic inserts was as effective as the Gracey curette during initial therapy period in all clinical parameters measured and has the advantage of being quicker.

Adult ; Blood Loss, Surgical ; Chronic Periodontitis ; therapy ; Dental Plaque Index ; Dental Scaling ; adverse effects ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain Measurement ; Periodontal Attachment Loss ; etiology ; Single-Blind Method ; Ultrasonic Therapy ; adverse effects ; instrumentation

Chronic Periodontitis ; diagnosis ; diagnostic imaging ; therapy ; Dental Scaling ; Follow-Up Studies ; Furcation Defects ; diagnosis ; diagnostic imaging ; therapy ; Gingival Hyperplasia ; diagnosis ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Periodontal Index ; Radiography, Panoramic ; Root Canal Therapy ; Tooth Loss ; diagnosis ; diagnostic imaging ; therapy ; Tooth, Artificial