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Anton Sculean - One of the best experts on this subject based on the ideXlab platform.
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Healing of periodontal suprabony defects following treatment with open flap debridement with or without an enamel matrix derivative: A randomized controlled clinical study
Clinical Oral Investigations, 2020Co-Authors: Vincenzo Iorio-siciliano, Andrea Blasi, Stefan-ioan Stratul, Luca Ramaglia, Vela Octavia, Giovanni E. Salvi, Anton SculeanAbstract:Objectives To compare the healing of suprabony defects following treatment with either open flap debridement (OFD) and application of an enamel matrix derivative (EMD) with OFD alone. Methods Eighty patients with suprabony periodontal defects were randomly assigned to treatment with OFD + EMD (test) or OFD alone (control). The primary outcome variable was the difference in clinical attachment level (CAL) gain. At baseline and after 12 months, full-Mouth Plaque scores (FMPS), full-Mouth bleeding scores (FMBS), probing depths (PD), gingival recessions (GR), and CAL were recorded. Results Sixty-five patients were available for the 12-month follow-up examination. At 12 months, the mean FMPS was 21.9 ± 3.0% in the OFD + EMD and 21.1 ± 2.4% in the OFD group, respectively ( p = 0.30), while mean FMBS measured 20.4 ± 3.4% in the OFD + EMD group and 19.9 ± 2.9% in the OFD group ( p = 0.48). Mean CAL gain at sites treated with OFD + EMD was statistically significantly different ( p = 0.0001) compared with sites treated with OFD alone (3.4 ± 0.6 mm vs 1.8 ± 0.6 mm). A statistically significant difference ( p = 0.0001) was found between mean PD change in the OFD + EMD (3.9 ± 0.6 mm) and OFD alone (3.2 ± 0.6 mm) treated groups and also in terms of mean GR change between treatment with OFD + EMD (0.5 ± 0.7 mm) and OFD alone (1.4 ± 1.0 mm) ( p = 0.001). Conclusion Within their limits, the present results indicate that in suprabony periodontal defects, the application of EMD in conjunction with OFD may additionally improve the clinical outcomes compared with OFD alone. Clinical relevance In periodontal suprabony defects, the application of EMD in conjunction with OFD may additionally enhance the clinical outcomes in terms of CAL gain and PD reduction.
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clinical and microbiological effects of multiple applications of antibacterial photodynamic therapy in periodontal maintenance patients a randomized controlled clinical study
Photodiagnosis and Photodynamic Therapy, 2019Co-Authors: Kinga Grzechleśniak, Boris Gaspirc, Anton SculeanAbstract:Abstract Background At present, very limited data are available on the clinical and microbiological outcomes obtained following repeated application of aPDT following one single mechanical debridement. Objective To evaluate clinically and microbiologically the outcomes following one single session of subgingival mechanical debridement (scaling and root planing; e.g. SRP) followed by 1x immediate application of aPDT and 2 x subsequent use of aPDT without SRP. Materials and methods Forty patients diagnosed with generalized chronic periodontitis that were enrolled in periodontal maintenance (supportive periodontal therapy) program, were randomly assigned to one of the two treatments: 1. SRP by means of ultrasonic and hand instruments followed by one single session of SRP followed by 1x immediate application of aPDT and 2 x subsequent applications of aPDT without SRP (test) or 2. SRP alone (control). The following clinical parameters were recorded at baseline, at 3 and 6 months: Full-Mouth Plaque Scores (FMPS), Full-Mouth Bleeding Scores (BOP), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and Gingival Recession (RC). Additionally, microbiological samples were evaluated at baseline and six months after treatment. The primary outcome variable was BOP. Results Both treatments improved statistically significantly (p Conclusions In periodontal patients enrolled in a maintenance program one single session of SRP followed by 3x application of aPDT, enhanced the clinical and microbiological outcomes compared to SRP alone.
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photodynamic therapy as adjunct to non surgical periodontal treatment in patients on periodontal maintenance a randomized controlled clinical trial
Lasers in Medical Science, 2009Co-Authors: Panos Chondros, Dimitris Nikolidakis, Nicos Christodoulides, Ralf Rossler, Norbert Gutknecht, Anton SculeanAbstract:Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following parameters were evaluated at baseline and at 3 months and 6 months after therapy: full Mouth Plaque score (FMPS), full Mouth bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC), and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At 3 months after therapy, the microbiological analysis showed a statistically significant reduction of F.n. and E.n. in the test group. At 6 months, statistically significantly higher numbers of E.c. and C.s. were detected in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PPD reduction and CAL gain, but it resulted in significantly higher reduction of bleeding scores than following scaling and root planing alone.
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periodontal treatment with an er yag laser compared to ultrasonicinstrumentation a pilot study
Journal of Periodontology, 2004Co-Authors: Anton Sculean, Frank Schwarz, Mohammad Berakdar, G E Romanos, Nicole B Arweiler, Jurgen C BeckerAbstract:Background: The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of ultrasonic scaling for non-surgical periodontal treatment. Methods: Twenty patients with moderate to advanced periodontal disease were randomly treated in a split-Mouth design with a single episode of subgingival debridement using either an Er:YAG laser device (160 mJ/pulse, 10 Hz) combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP diode laser radiation (ERL), or an ultrasonic instrument (UI). Clinical assessments of full-Mouth Plaque score (FMPS), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made at baseline and at 3 and 6 months following therapy. Results: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the ERL group from 40% at baseline to 17% after 6 months (P <0.0001) and in the UI group from 46% at baseline ...
Maurizio S Tonetti - One of the best experts on this subject based on the ideXlab platform.
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long term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery i recurrence of pockets bleeding on probing and tooth loss
Journal of Clinical Periodontology, 2007Co-Authors: Gianfranco Carnevale, Francesco Cairo, Maurizio S TonettiAbstract:Background: Periodontal surgery is indicated in the treatment of persistent pockets following cause-related therapy. The aim of this study was to evaluate the long-term effect of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. Methods: Three-hundred and four consecutive patients were identified and retrospectively examined while presenting for a supportive periodontal care (SPC) appointment (T2). All had received non-surgical periodontal treatment and osseous resective surgery as needed, to obtain no sites with probing depth (PD) > 3 mm before being enrolled in the SPC programme. The mean SPC duration for the patients was 7.8 ± 3.2 years while the mean interval of SPC was 3.4 ± 0.8 months. Results: During SPC, a total of 67 teeth had been removed (0.9%). At T2, mean full-Mouth Plaque scores (FMPS) was 13 ± 11.3% and full-Mouth bleeding scores (FMBS) was 2 ± 3%. In 98.5% of the sites, PD was minimal ( 3 mm). The majority of pockets at T2 showed PDs of 4-5 mm (83.4% of pockets). At the same time, the total number of pockets ≥ 6 mm was 68 and limited to 41 patients (13.8% of sample). Initial periodontal diagnosis of severe periodontitis, smoking habits, FMBS, number of teeth at completion of active periodontal therapy (Tl), number of surgically treated teeth, number of teeth with furcation involvement and number of multi-rooted teeth were associated with the number of pockets at T2. A total of 598 sites (2.1%) displayed bleeding on probing (BOP) at T2. The odds ratio of sites 4 mm or deeper to be BOP positive was 32.9 compared with sites of < 3 mm depth. Gender, FMBS, FMPS, furcation involvements and overall number of pockets were associated with the number of bleeding pockets at T2. Conclusion: Shallow PDs achieved by treatment of the persistent pockets by fibre retention osseous resective surgery can be maintained over time. These patients displayed minimal gingival inflammation and tooth loss during SPC.
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clinical outcomes following treatment of human intrabony defects with gtr bone replacement material or access flap alone a multicenter randomized controlled clinical trial
Journal of Clinical Periodontology, 2004Co-Authors: Maurizio S Tonetti, Giulio Rasperini, Pierpaolo Cortellini, Niklaus P Lang, Jean Suvan, Patrick Adriaens, Dominik Dubravec, Alberto Fonzar, Ioannis Fourmousis, Roberto RossiAbstract:Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material. Materials and Methods: One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full-Mouth Plaque scores and full-Mouth bleeding scores (FMBS) were assessed. Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above-median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2–5.4) and by starting with deeper PPD (OR=1.7, 1.3–2.2) but were decreased by receiving treatment at the worst-performing clinical center (OR=0.9, 0.76–0.99). Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone.
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long term stability of clinical attachment following guided tissue regeneration and conventional therapy
Journal of Clinical Periodontology, 1996Co-Authors: Pierpaolo Cortellini, Giovan Paolo Pini Prato, Maurizio S TonettiAbstract:UNLABELLED 44 patients (34% smokers) presenting with severe periodontitis were treated with full Mouth root planing (RPL). In each patient, 1 intrabony defect was treated with guided tissue regeneration (GTR). After 1 year of monthly prophylaxis, full Mouth Plaque (FMPS) and bleeding (FMBS) scores were 8.3 +/- 4.1% and 5.6 +/- 3.8%. At 1 year, the GTR treated sites were matched, in each patient, with 1 RPL site, in terms of probing attachment level (PAL 6.8 +/- 2.4 mm GTR, and 6.5 +/- 2.3 mm RPL). At this point, 24 patients took part in a supportive periodontal care program. 20 patients did not participate, and received only sporadic care by general dentists. At 5 years, all patients were reexamined. FMPS was 10.5 +/- 6.8% and FMBS 7.7 +/- 6.4%. A significant PAL loss was observed in both sites (1.2 +/- 1.4 mm GTR, 1.3 +/- 1.3 mm RPL, p < 0.0001) between 1 and 5 years. Differences in PAL loss between GTR and RPL sites were not statistically significant. Only a minority of sites (34%), however, lost PAL, while 66% remained stable. 75% of the matched sites (GTR and RPL) within the same patients were concordant in terms of PAL stability. The 23 patients in which both sites remained stable, had good oral hygiene, complied with the recall system, and did not smoke. The 10 patients in which both sites lost PAL showed deteriorating oral hygiene, did not comply with the recall system, and smoked. PAL loss in the GTR and/or RPL sites was consistently observed in patients (losers) showing PAL loss in other teeth. Losers had, in general, negative subjects characteristics, and showed a higher prevalence of tooth loss. IN CONCLUSION (i) GTR and RPL sites showed comparable susceptibility to periodontal breakdown; (ii) stability of outcomes was consistently associated with good oral hygiene, compliance with a supportive periodontal care program, and no cigarette smoking.
Pierpaolo Cortellini - One of the best experts on this subject based on the ideXlab platform.
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clinical outcomes following treatment of human intrabony defects with gtr bone replacement material or access flap alone a multicenter randomized controlled clinical trial
Journal of Clinical Periodontology, 2004Co-Authors: Maurizio S Tonetti, Giulio Rasperini, Pierpaolo Cortellini, Niklaus P Lang, Jean Suvan, Patrick Adriaens, Dominik Dubravec, Alberto Fonzar, Ioannis Fourmousis, Roberto RossiAbstract:Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material. Materials and Methods: One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full-Mouth Plaque scores and full-Mouth bleeding scores (FMBS) were assessed. Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above-median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2–5.4) and by starting with deeper PPD (OR=1.7, 1.3–2.2) but were decreased by receiving treatment at the worst-performing clinical center (OR=0.9, 0.76–0.99). Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone.
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coronally advanced flap procedure for root coverage treatment of root surface root planing versus polishing
Journal of Periodontology, 1999Co-Authors: Giovanpaolo Piniprato, Roberto Rotundo, Carlo Baldi, Umberto Pagliaro, Michele Nieri, Daniele Saletta, Pierpaolo CortelliniAbstract:This clinical study was designed to determine if mechanical instrumentation (root planing) of the exposed root is useful in treating gingival recession caused by traumatic toothbrushing following a coronally advanced flap (CAF). Ten patients with high levels of oral hygiene (full-Mouth Plaque score <20%), from 25 to 57 years of age, were selected for the study. Each patient showed 2 bilateral Class I or II maxillary recessions. A total of 20 recessions were treated. The difference in the recessions was ≤1 mm. In each patient, one recession was randomly assigned to the test group and the contralateral one to the control group. In the test group, the exposed root surface was polished at slow speed with a rubber cup and prophylaxis paste for 60 seconds. In the control group, the exposed root surface was planed with a sharp curet. In both test and control groups, a trapezoidal full- and partial-thickness flap was elevated, coronally displaced, and sutured to cover the treated root surface. Before treatment, t...
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long term stability of clinical attachment following guided tissue regeneration and conventional therapy
Journal of Clinical Periodontology, 1996Co-Authors: Pierpaolo Cortellini, Giovan Paolo Pini Prato, Maurizio S TonettiAbstract:UNLABELLED 44 patients (34% smokers) presenting with severe periodontitis were treated with full Mouth root planing (RPL). In each patient, 1 intrabony defect was treated with guided tissue regeneration (GTR). After 1 year of monthly prophylaxis, full Mouth Plaque (FMPS) and bleeding (FMBS) scores were 8.3 +/- 4.1% and 5.6 +/- 3.8%. At 1 year, the GTR treated sites were matched, in each patient, with 1 RPL site, in terms of probing attachment level (PAL 6.8 +/- 2.4 mm GTR, and 6.5 +/- 2.3 mm RPL). At this point, 24 patients took part in a supportive periodontal care program. 20 patients did not participate, and received only sporadic care by general dentists. At 5 years, all patients were reexamined. FMPS was 10.5 +/- 6.8% and FMBS 7.7 +/- 6.4%. A significant PAL loss was observed in both sites (1.2 +/- 1.4 mm GTR, 1.3 +/- 1.3 mm RPL, p < 0.0001) between 1 and 5 years. Differences in PAL loss between GTR and RPL sites were not statistically significant. Only a minority of sites (34%), however, lost PAL, while 66% remained stable. 75% of the matched sites (GTR and RPL) within the same patients were concordant in terms of PAL stability. The 23 patients in which both sites remained stable, had good oral hygiene, complied with the recall system, and did not smoke. The 10 patients in which both sites lost PAL showed deteriorating oral hygiene, did not comply with the recall system, and smoked. PAL loss in the GTR and/or RPL sites was consistently observed in patients (losers) showing PAL loss in other teeth. Losers had, in general, negative subjects characteristics, and showed a higher prevalence of tooth loss. IN CONCLUSION (i) GTR and RPL sites showed comparable susceptibility to periodontal breakdown; (ii) stability of outcomes was consistently associated with good oral hygiene, compliance with a supportive periodontal care program, and no cigarette smoking.
Paolo G Arduino - One of the best experts on this subject based on the ideXlab platform.
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conservative approach in patients with pemphigus gingival vulgaris a pilot study of five cases
International Journal of Dentistry, 2014Co-Authors: Alessio Gambino, Paolo G Arduino, Paola Carcieri, M Carbone, Lucio Carbone, Roberto BroccolettiAbstract:Objectives. The aim of this pilot study was to describe the clinical efficacy of a conservative oral hygiene protocol in patients affected by gingival pemphigus vulgaris (PV) applied in a case series. Methods. Subjects suffering from PV with gingival localisation and slightly responsive to conventional treatment with systemic corticosteroids and immunosuppressive drugs were selected among individuals treated in the Unit of Oral Medicine Section of the University of Turin. Five subjects received nonsurgical periodontal therapy, over a 7-day period, including oral hygiene instructions; patients were instructed about domiciliary oral hygiene maintenance and instructions were reinforced at each visit and personalised if necessary. Clinical outcome variables were recorded at baseline (before starting) and 16 weeks after intervention, including full Mouth Plaque score (FMPS), bleeding scores (FMBS), probing pocket depth (PPD), oral pemphigus clinical score (OPCS), and patient related outcomes (visual analogue score of pain). Results. Five patients were treated and, after finishing the proposed therapy protocol, a statistical significant reduction was observed for FMBS (P = 0.043) and OPCS (P = 0.038). Conclusions. Professional oral hygiene procedures with nonsurgical therapy are related to an improvement of gingival status and a decrease of gingival bleeding in patients affected by PV with specific gingival localization.
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professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization a pilot study in 12 patients
International Journal of Dental Hygiene, 2012Co-Authors: Paolo G Arduino, E Lopetuso, Paola Carcieri, Sarah Giacometti, M Carbone, Carlotta Tanteri, Roberto OccolettiAbstract:To cite this article: Int J Dent Hygiene 10, 2012; 138–141 DOI: 10.1111/j.1601-5037.2010.00527.x Arduino PG, Lopetuso E, Carcieri P, Giacometti S, Carbone M, Tanteri C, Broccoletti R. Professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization: a pilot study in 12 patients. Abstract: Objectives: The aim of this prospective case series was to assess the clinical efficiency of an oral hygiene protocol in patients affected by mucous membrane pemphigoid (MMP) with specific gingival localization, before starting any medical treatment. Methods: Patients received oral hygiene instruction followed by non-surgical periodontal therapy including oral hygiene instructions in a 3-week cohort study. Clinical outcome variables were recorded at baseline and 5 weeks after intervention and included, as periodontal parameters, full Mouth Plaque (FMPS) and bleeding (FMBS) scores and patient-related outcomes (visual analogue score of pain). Results: A total of 12 patients were recruited. The mean age at presentation was 59.5 ± 14.52 years. Five weeks after finishing the oral hygiene and periodontal therapy protocol, a statistical significant reduction was observed for FMPS (P = 0.001), FMBS (P = 0.022) and reported pain (P = 0.0028). Conclusions: Professional oral hygiene procedures and non-surgical periodontal therapy are connected with improvement of gingival status and decrease in gingival-related pain, in female patients affected by MMP with specific gingival localization.
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periodontal status in oral mucous membrane pemphigoid initial results of a case control study
Oral Diseases, 2011Co-Authors: Paolo G Arduino, Marco Carrozzo, Sergio Gandolfo, Paola Carcieri, M Carbone, Carlotta Tanteri, Francesco Daiuto, Nicolo Gardino, Roberto OccolettiAbstract:Oral Diseases (2010) 17, 90–94 Objective: To evaluate the periodontal status of mucous membrane pemphigoid (MMP) patients and compare it with that of healthy controls. Methods: A prospective study was undertaken to examine the impact of gingival MMP lesions on the human periodontium of 29 patients. Parameters evaluated included full Mouth Plaque score (FMPS), full Mouth bleeding upon probing scores, probing depths (PD), gingival recession, clinical attachment level (CAL), mobility score, furcation involvement, number of missing teeth and Machtei criteria. Results: All periodontal parameters recorded were increased in cases when compared to controls in univariate statistics. The mean differences between groups in PD (0.8 ± 0.2 mm, 95% CI 0.3–1.3), CAL (1.3 ± 0.4 mm, 95% CI 0.4–2.2), FMPS (41.0 ± 6.2%, 95% CI 28.7–53.4), FMBS (16.2 ± 6.6%, 95% CI 3.0–29.4) and tooth loss (2 ± 1 teeth, 95% CI 1–3) were all statistically significant (P < 0.01 for all). Substantial differences in domiciliary oral hygiene routines were observed (P < 0.0001). In multivariate models when FMPS was included as covariate the difference between groups in all clinical periodontal parameters was no longer statistically significant. Conclusions: Our results showed that periodontal status is worse in MMP patients if compared with healthy controls due to a substantial difference in oral hygiene. Oral health should be promoted in MMP.
Roberto Occoletti - One of the best experts on this subject based on the ideXlab platform.
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professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization a pilot study in 12 patients
International Journal of Dental Hygiene, 2012Co-Authors: Paolo G Arduino, E Lopetuso, Paola Carcieri, Sarah Giacometti, M Carbone, Carlotta Tanteri, Roberto OccolettiAbstract:To cite this article: Int J Dent Hygiene 10, 2012; 138–141 DOI: 10.1111/j.1601-5037.2010.00527.x Arduino PG, Lopetuso E, Carcieri P, Giacometti S, Carbone M, Tanteri C, Broccoletti R. Professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization: a pilot study in 12 patients. Abstract: Objectives: The aim of this prospective case series was to assess the clinical efficiency of an oral hygiene protocol in patients affected by mucous membrane pemphigoid (MMP) with specific gingival localization, before starting any medical treatment. Methods: Patients received oral hygiene instruction followed by non-surgical periodontal therapy including oral hygiene instructions in a 3-week cohort study. Clinical outcome variables were recorded at baseline and 5 weeks after intervention and included, as periodontal parameters, full Mouth Plaque (FMPS) and bleeding (FMBS) scores and patient-related outcomes (visual analogue score of pain). Results: A total of 12 patients were recruited. The mean age at presentation was 59.5 ± 14.52 years. Five weeks after finishing the oral hygiene and periodontal therapy protocol, a statistical significant reduction was observed for FMPS (P = 0.001), FMBS (P = 0.022) and reported pain (P = 0.0028). Conclusions: Professional oral hygiene procedures and non-surgical periodontal therapy are connected with improvement of gingival status and decrease in gingival-related pain, in female patients affected by MMP with specific gingival localization.
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periodontal status in oral mucous membrane pemphigoid initial results of a case control study
Oral Diseases, 2011Co-Authors: Paolo G Arduino, Marco Carrozzo, Sergio Gandolfo, Paola Carcieri, M Carbone, Carlotta Tanteri, Francesco Daiuto, Nicolo Gardino, Roberto OccolettiAbstract:Oral Diseases (2010) 17, 90–94 Objective: To evaluate the periodontal status of mucous membrane pemphigoid (MMP) patients and compare it with that of healthy controls. Methods: A prospective study was undertaken to examine the impact of gingival MMP lesions on the human periodontium of 29 patients. Parameters evaluated included full Mouth Plaque score (FMPS), full Mouth bleeding upon probing scores, probing depths (PD), gingival recession, clinical attachment level (CAL), mobility score, furcation involvement, number of missing teeth and Machtei criteria. Results: All periodontal parameters recorded were increased in cases when compared to controls in univariate statistics. The mean differences between groups in PD (0.8 ± 0.2 mm, 95% CI 0.3–1.3), CAL (1.3 ± 0.4 mm, 95% CI 0.4–2.2), FMPS (41.0 ± 6.2%, 95% CI 28.7–53.4), FMBS (16.2 ± 6.6%, 95% CI 3.0–29.4) and tooth loss (2 ± 1 teeth, 95% CI 1–3) were all statistically significant (P < 0.01 for all). Substantial differences in domiciliary oral hygiene routines were observed (P < 0.0001). In multivariate models when FMPS was included as covariate the difference between groups in all clinical periodontal parameters was no longer statistically significant. Conclusions: Our results showed that periodontal status is worse in MMP patients if compared with healthy controls due to a substantial difference in oral hygiene. Oral health should be promoted in MMP.