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Objective: This study sought to investigate whether the immediate systemic inflammatory response following full‐mouth debridement differs following use of hand compared with ultrasonic instruments. Methods: Thirty‐nine periodontitis patients were randomized to treatment with full‐mouth debridement using either hand or ultrasonic instrumentation completed within 24 hr. Serum and periodontal clinical parameters were collected at baseline, day 1, day 7 and day 90 post‐treatment. Differences in systemic inflammatory markers were assessed using general linear models at each timepoint, corrected for age, gender, smoking status, body mass index and baseline levels of each marker. Results: Across all patients, serum C‐reactive protein increased at day 1, with no differences between hand and ultrasonic groups (p(adjusted) =.22). There was no difference between groups in interleukin‐6 (p(adjusted) =.29) or tumour necrosis factor α (p(adjusted) =.53) at day 1. Inflammatory markers returned to baseline levels by day 7. Treatment resulted in equal and marked improvements in clinical parameters in both groups; however, total treatment time was on average shorter for ultrasonic instruments (p(adjusted) =.002). Conclusions: Ultrasonic instrumentation resulted in shorter treatment time with comparable clinical outcomes. Levels of serum C‐reactive protein at day 1 were similar following debridement with hand or ultrasonic instruments. [ABSTRACT FROM AUTHOR]

Aim: To assess the reporting and handling of incomplete outcome data in randomized clinical trials (RCTs) published in implant dentistry. Materials and methods: We included RCTs on interventions related to the treatment with dental implants and presented any form of missing data. PubMed, SCOPUS and Cochrane databases were searched for studies published between May 2015 and May 2018. Reporting and handling of missing data at the study level were evaluated using a series of relevant questions. Descriptive data were reported, and univariable analyses were performed to evaluate the association of study variables with quality of reporting and data handling. Results: One‐hundred and thirty‐seven RCT reports were included from the 7,116 initially retrieved publications. The reporting of incomplete outcome data varied greatly among the trials and for the different questions. The range of adequately reported questions was between 3.64% (question: comparison of baseline characteristics of all randomised participants) and 100% (question: explicit reporting of missing data). The complete case analysis was the most used (45.3%) approach for incomplete outcome data handling. Conclusions: Randomized studies in implant dentistry have room for improvement in both the reporting and the handling of incomplete outcome data. [ABSTRACT FROM AUTHOR]

Aim To assess whether outcome of immediate implant placement and immediate provisionalization after 1 year was non-inferior to immediate implant placement and delayed provisionalization regarding Marginal Bone Level (MBL). Materials and Methods Forty patients with a failing tooth in the aesthetic zone were randomly assigned for immediate implant placement with immediate ( n = 20) or delayed ( n = 20) provisionalization. Follow-up was at 1 month and after 1 year. The study was powered to detect a difference in MBL of <0.9 mm. Apart from MBL, soft tissue peri-implant parameters, aesthetic indexes and patient satisfaction were assessed. Results After 1 year, MBL changes were −0.75 ± 0.69 mesially and −0.68 ± 0.65 distally mm for the immediate group and −0.70 ± 0.64 and −0.68 ± 0.64 mm for the delayed group respectively ( NS). Regarding differences in means, non-inferiority was observed after 1 year (mesially: Group A versus B: difference in mean 0.08 mm (95% CI −0.38 to 0.53, p = 0.71 distally: Group A versus B: difference in mean 0.09 mm (95% CI −0.37 to 0.56 mm, p = 0.66).No significant differences in the other outcome variables were observed. Conclusions This study showed that immediate placement and immediate provisionalization was non-inferior to immediate placement with delayed provisionalization. In addition, although not powered for these outcome variables, no clinically relevant differences in other outcomes were observed (: ISRCTN57251089). [ABSTRACT FROM AUTHOR]

Aim To evaluate the potential of antimicrobial photodynamic therapy ( aPDT) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and Methods In a single-centred randomized and controlled clinical trial, 90 patients (51 females and 39 males) with untreated chronic periodontitis were randomly assigned to receive SRP with aPDT (test group) or SRP alone (control group). Clinical parameters and halitosis were recorded for 6 months after treatment by a periodontist who was blinded to the procedure. Results Inter-group and intra-group statistical analyses were performed. Significant difference between the two groups with respect to each variable was assessed using non-parametric Rank Order ancova. Probing pocket depth and clinical attachment levels showed statistically significant reduction in the test group on evaluation at 3 months and 6 months as compared to the control group ( p < 0.05). A statistically significant improvement in gingival index and gingival bleeding index was seen for the test group after 2 weeks and 1 month of aPDT ( p < 0.01), whereas the improvement in gingival index and gingival bleeding index at 3 months and in plaque index at 2 weeks after aPDT was less ( p < 0.05). Also, a significant difference was detected for the test group at 1 month in terms of halitosis ( p < 0.05), which did not persist for long. Conclusions Antimicrobial photodynamic therapy acts as a beneficial adjunct to SRP in non-surgical treatment and management of chronic periodontitis in short-term. Further studies are required to assess the long-term effectiveness of aPDT. [ABSTRACT FROM AUTHOR]

Aim To evaluate the direct effects of periodontal therapy in Chronic Obstructive Pulmonary Disease ( COPD) patients with chronic periodontitis ( CP). Materials and Methods In a pilot randomized controlled trial, 60 COPD patients with CP were randomly assigned to receive scaling and root planing ( SRP) treatment, supragingival scaling treatment, or oral hygiene instructions only with no periodontal treatment. We evaluated their periodontal indexes, respiratory function, and COPD exacerbations at baseline, 6 months, 1, and 2 years. Results Compared with the control group, measurements of periodontal indexes were significantly improved in patients in two treatment groups at 6-month, 1-year, and 2-year follow-up (all p < 0.05). Overall, the means of forced expiratory volume in the first second/forced vital capacity ( FEV1/ FVC) and FEV1 were significantly higher in the two therapy groups compared with the control group during the follow-up ( p < 0.05). In addition, the frequencies of COPD exacerbation were significantly lower in the two therapy groups than in the control group at 2-year follow-up ( p < 0.05). Conclusions Our preliminary results from this pilot trial suggest that periodontal therapy in COPD patients with CP may improve lung function and decrease the frequency of COPD exacerbation. [ABSTRACT FROM AUTHOR]

Background Simplified periodontal therapy might be a pragmatic strategy for public health programmes targeting Indigenous Australian adults. The objective of this randomized controlled trial was to evaluate oral health effects of single-visit, non-surgical periodontal therapy compared to no treatment. Methods This parallel-group, randomized, open label clinical trial enrolled 273 Indigenous Australians aged ≥18 years with periodontitis. Intervention participants received full-mouth periodontal scaling and root planing during a single visit while the control group received no treatment. Endpoints were summary variables derived from clinical assessments of probing depth, clinical attachment loss, plaque, calculus and gingival bleeding before treatment and 3 months later. Results Endpoints could be calculated for 169 participants with follow-up data. Compared to the control group, there were statistically significant reductions in extent of shallow pockets: PD ≥4 mm (mean difference −2.86, [95% CI −5.01 to −0.71], p = 0.009) and gingival bleeding (mean difference −0.25, [95% CI −0.43 to −0.08], p = 0.005) but not deeper pockets PD ≥5 mm (mean difference −0.48, [95% CI −1.78 to 0.82], p = 0.468) or plaque scores. Conclusions Periodontal therapy produced improvements in shallow periodontal pockets and measures of gingival bleeding in these Indigenous Australians. [ABSTRACT FROM AUTHOR]

Aim This split-mouth double-masked randomized controlled clinical study evaluated the effectiveness of photoactivated disinfection ( PAD) using light-emitting diode ( LED) as an adjunct in the management of patients affected by moderate to severe chronic periodontitis. Materials and Methods Sixteen patients affected by moderate to severe chronic periodontitis were enrolled. After scaling and root planing (SRP), each quadrant was assigned to one of the following groups: LED group (625-635 nm, maximum power density: 2000 mW/cm2), photosensitizer group (tolouidine blue O, 0.1 mg/ml), PAD group (photosensitizer and LED) and control group (no adjunctive treatment). The adjunctive treatments were repeated after 7 and 14 days. The clinical parameters of bleeding on probing, probing pocket depth and clinical attachment level were measured at baseline and 1 and 3 months after SRP. Results At 1 and 3 months, all groups showed significant improvements with regard to all clinical parameters compared to baseline (all p: <0.001). There were no significant differences among groups in terms of changes of clinical parameters in any time interval (all p > 0.05). Conclusion The application of PAD using LED with the current setting did not have additional effects on clinical parameters in patients diagnosed with moderate to severe chronic periodontitis compared with SRP alone. [ABSTRACT FROM AUTHOR]

Objective To compare the treatment outcome of scaling and root planing ( SRP) in combination with systemic antibiotics, local antibiotic therapy and/or periodontal surgery. Material and Methods One hundred and eighty-seven patients were assigned to eight groups treated by SRP plus none, one, two or three adjunctive treatments and monitored for 24 months in a randomized controlled clinical trial using a 2 × 2 × 2 factorial design. Systemic amoxicillin + metronidazole ( SMA), local tetracycline delivery ( LTC) and periodontal surgery (SURG) were evaluated as adjuncts. Changes in clinical attachment level ( CAL) and probing pocket depth ( PPD) were statistically evaluated by ancova of main effects. Results Effects of adjunctive therapy to SRP were minimal at 3 months. Between 3 and 6 months PPD reduction occurred particularly in patients receiving periodontal surgery. After 6 months, both CAL gain and PPD reduction reached a plateau that was maintained at 24 months in all groups. The 24-month CAL gain was improved by SMA (0.50 mm) while PPD was reduced by SMA (0.51 mm) and SURG (0.36 mm). Smoking reduced CAL gain and PPD reduction. Conclusion Patients receiving adjunctive therapies generally exhibited improved CAL gain and/or PPD reduction when compared with the outcome of SRP alone. Only additive, not synergistic effects of the various adjunctive therapies were observed. [ABSTRACT FROM AUTHOR]