| aar | Authors | Title | Source | Topics | abstract | pubmedtext | fulltext |
|---|---|---|---|---|---|---|---|
| 2004 | [No authors listed | Effectiveness of antimicrobial adjuncts to scaling and root-planing therapy for periodontitis | Evid Rep Technol Assess (Summ) 2004; (88): 1-4 | periodontics | |||
| 2003 | Al-Hamdan K, Eber R, Sarment D, Kowalski C, Wang HL | Guided tissue regeneration-based root coverage: meta-analysis. | J Periodontol 2003; 74(10): 1520-33 | periodontics | BACKGROUND: The goal of guided tissue regeneration-based root coverage (GTRC) is to repair gingival recession via new attachment formation. Numerous clinical trials have been conducted utilizing the concept of GTR to promote root coverage. Most GTRC studies have had relatively small sample sizes and have not utilized power calculations to determine appropriate sample size; therefore, it is difficult to draw strong conclusions from them. Hence, the purpose of this study is to combine data from currently available GTRC studies and to use meta-analysis to determine whether GTRC provides significantly improved clinical outcomes compared to conventional periodontal plastic surgical approaches for the treatment of marginal tissue recession. METHODS: Studies were identified that used GTR approaches to treat gingival recession from January 1990 to October 2001. Information from each study was entered into a database. Data were analyzed according to the following criteria: GTRC versus conventional mucogingival surgery (CMGS); membrane type; root conditioning; pretreatment recession depth; adjunctive use of bone replacement graft (BRG); and source of funding. Studies were ranked independently, and mean data from each were weighted accordingly. Meta-analysis was performed using the weighted means for each group. Paired t tests were used to determine statistical significance between each pair of groups. RESULTS: Forty papers were included for analysis. GTRC resulted in an average of 74% recession depth reduction, 41% complete root coverage, 3 mm AL gain, and 1 mm KG gain. Both GTRC and CMGS produced significant (P < 0.05) improvement compared to baseline measurements. Compared to GTRC, CMGS resulted in significantly (P < 0.05) increased KG (2.1 mm vs. 1.1 mm), root coverage (81% vs. 74%), and percentage of defects with complete root coverage (55% vs. 41 %). Use of absorbable membranes, root conditioning, shallow pretreatment recession (< 4 mm), and corporate sponsorship all resulted in significantly (P < 0.05) improved percentages of sites with complete root coverage but had no effect on other parameters. CONCLUSIONS: Based on this meta-analysis, guided tissue regeneration-based root coverage can be used successfully to repair gingival recession defects. Conventional mucogingival surgery, however, resulted in statistically better root coverage, width of keratinized gingiva, and complete root coverage. | Medline | |
| 2003 | Hallmon WW, Rees TD | Local anti-infective therapy: mechanical and physical approaches. A systematic review | Ann Periodontol 2003; 8(1): 99-114 | periodontics | |||
| 2003 | Hanes PJ, Purvis JP | Local anti-infective therapy: pharmacological agents. A systematic review | Ann Periodontol 2003; 8(1): 79-98 | periodontics | |||
| 2003 | Scannapieco FA, Bush RB, Paju S | Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review | Ann Periodontol 2003; 8(1): 54-69 | periodontics | |||
| 2003 | Fiorellini JP, Nevins ML | Localized ridge augmentation/preservation. A systematic review | Ann Periodontol 2003; 8(1): 321-7 | periodontics | |||
| 2003 | Oates TW, Robinson M, Gunsolley JC | Surgical therapies for the treatment of gingival recession. A systematic review | Ann Periodontol 2003; 8(1): 303-20 | periodontics | |||
| 2003 | Giannobile WV, Somerman MJ | Growth and amelogenin-like factors in periodontal wound healing. A systematic review | Ann Periodontol 2003; 8(1): 193-204 | periodontics | |||
| 2003 | Esposito M, Coulthard P, Worthington HV | Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects | Cochrane Database Syst Rev 2003; (2): CD003875 | periodontics | BACKGROUND: Periodontitis is a chronic infective disease of the gums caused by bacteria present in dental plaque. This condition induces the breakdown of the tooth supporting apparatus until teeth are lost. Surgery may be indicated to arrest disease progression and regenerate lost tissues. Several surgical techniques have been developed to regenerate periodontal tissues including guided tissue regeneration (GTR), bone grafting (BG) and the use of enamel matrix derivative (EMD). EMD is an extract of enamel matrix and contains amelogenins of various molecular weights. There is evidence to show that amelogenins are involved not only in enamel formation, but also in the formation of the periodontal attachment during tooth formation. OBJECTIVES: To test the efficacy of EMD in comparison with open flap debridement, GTR and various BG procedures for the treatment of intrabony defects. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Several journals were handsearched. No language restrictions were applied. Authors of randomised controlled trials (RCTs) identified, personal contacts and the manufacturer were contacted to identify unpublished trials. Most recent search: January 2003. SELECTION CRITERIA: RCTs on patients affected by periodontitis having intrabony defects treated with EMD compared with open flap debridement, GTR and various BG procedures with at least one year follow up. The outcome measures considered were: tooth loss, changes in probing attachment levels (PAL), pocket depths (PPD), gingival recessions (REC), marginal bone levels on intraoral radiographs and postoperative infections. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence interval (CI). Heterogeneity was investigated including both clinical and methodological factors. MAIN RESULTS: No difference in tooth loss was observed. A meta-analysis including eight trials showed that Emdogain treated sites displayed statistically significant PAL improvements (mean difference 1.3 mm, 95%CI: 0.8 to 1.8) and PPD reduction (1 mm, 95%CI: 0.5 to 1.4) when compared to flap surgery. Comparing Emdogain with GTR (six trials), GTR showed a statistically significant reduction of PPD (0.6 mm) and increase of REC (0.5 mm). No difference in postoperative infections was observed. REVIEWER'S CONCLUSIONS: Emdogain is able to significantly improve PAL levels (1.3mm) and PPD reduction (1mm) when compared to flap surgery, however these results may not have a great clinical impact, since it has not been shown that more periodontally compromised teeth could be saved. There was no evidence of clinically important differences between GTR and Emdogain. | Medline | |
| 2003 | Pavia M, Nobile CG, Angelillo IF | Meta-analysis of local tetracycline in treating chronic periodontitis. | J Periodontol 2003; 74(6): 916-32 | Antibiotics Periodontics | BACKGROUND: Meta-analysis was used to assess the clinical efficacy of local delivery of tetracycline alone or as an adjunct to conventional mechanical therapy in patients with chronic periodontitis. METHODS: Studies were identified in MEDLINE and others sources. Meta-analyses were performed on the basis of probing depth (PD) at baseline, type of antimicrobial used, and experimental and control regimens (i.e., tetracycline plus scaling and root planing [SRP] versus SRP, tetracycline versus SRP, and tetracycline versus placebo, or no treatment). The effect of local tetracycline was evaluated for follow-up times of 4, 8, 12, 16, 24, and 36 weeks. Sensitivity analysis was performed according to antimicrobial delivery mode (irrigation, fibers, strips). A random effects model was used. RESULTS: The literature search identified 29 studies that met our inclusion criteria and were entered Into the meta-analysis. A significant mean reduction in PD for the combined tetracycline and SRP was observed regardless of initial probing depth and independently to the duration of follow-up. Tetracycline alone did not perform better than SRP, whereas they performed significantly better than placebo. Differences in improvement of attachment level (AL) were substantially similar to those encountered for PD. CONCLUSIONS: Our results documented that local. delivery of tetracycline improves the clinical outcomes of traditional treatment and should be considered particularly as an adjunct to SRP. Considerations regarding the adverse effects of widespread use of tetracycline should be taken into account when choosing a therapeutic strategy of chronic periodontitis. | Medline | |
| 2003 | Cohen RE; Research, Science and Therapy Committee, American Academy of Periodontology | Position paper: periodontal maintenance | J Periodontol 2003; 74(9): 1395-401 | periodontics | |||
| 2003 | Murphy KG, Gunsolley JC | Guided tissue regeneration for the treatment of periodontal intrabony and furcation defects. A systematic review | Ann Periodontol 2003; 8(1): 266-302 | periodontics | |||
| 2003 | Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL, Gunsolley JC | The efficacy of bone replacement grafts in the treatment of periodontal osseous defects. A systematic review | Ann Periodontol 2003; 8(1): 227-65 | periodontics | |||
| 2003 | Haffajee AD, Socransky SS, Gunsolley JC | Systemic anti-infective periodontal therapy. A systematic review | Ann Periodontol 2003; 8(1): 115-81 | periodontics | |||
| 2002 | Cobb CM | Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing | J Clin Periodontol 2002; 29 Suppl 2: 6-16 | periodontics | |||
| 2002 | Greenstein G, Hart TC | A critical assessment of interleukin-1 (IL-1) genotyping when used in a genetic susceptibility test for severe chronic periodontitis | J Periodontol 2002; 73(2): 231-47 | periodontics | |||
| 2002 | Quirynen M, Teughels W, De Soete M, van Steenberghe D | Topical antiseptics and antibiotics in the initial therapy of chronic adult periodontitis: microbiological aspects | Periodontol 2000 2002; 28: 72-90 | Antibiotics Periodontics | - | Medline | |
| 2002 | Research, Science, and Therapy Committee of the American Academy of Periodontology | Modulation of the Host Response in Periodontal Therapy (2002) | J Periodontol 2002; 73: 460-470 | Periodontics | This paper was prepared by the Research, Science, and Therapy Committee of the American Academy of Periodontology to provide the dental profession an overview of current and potential methods to modulate the host response in the treatment of periodontal diseases. Specifically, it discusses components of periodontal disease pathogenesis (i.e., immune and inflammatory responses, excessive production of matrix metalloproteinases and arachidonic acid metabolites, and regulation of bone metabolism) and their modulation. | Medline | J Periodontol |
| 2002 | Bjelland S, Bray P, Gupta N, Hirscht R | Dentists, diabetes and periodontitis. | Aust Dent J 2002; 47(3): 202-7 | Medicine Periodontics | |||
| 2002 | Montenegro R, Needleman I, Moles D, Tonetti M | Quality of RCTs in periodontology--a systematic review. | J Dent Res 2002; 81(12): 866-70 | Evidence Periodontology | |||
| 2002 | Hung HC, Douglass CW | Meta-analysis of the effect of scaling and root planing, surgical treatment and antibiotic therapies on periodontal probing depth and attachment loss. |
J Clin Periodontol 2002; 29(11): 975-86 | Antibiotics Periodontics | |||
| 2002 | King GN, Cochran DL | Factors that modulate the effects of bone morphogenetic protein-induced periodontal regeneration: a critical review | J Periodontol 2002; 73(8): 925-36 | Periodontics | |||
| 2002 | Greenstein G, Hart TC | Clinical utility of a genetic susceptibility test for severe chronic periodontitis: a critical evaluation | J Am Dent Assoc 2002; 133(4): 452-9 | Periodontics | |||
| 2002 | Slots J, Ting M | Systemic antibiotics in the treatment of periodontal disease. | Periodontol 2000 2002; 28(1): 106-176 | Antibiotics Periodontics | - | Medline | |
| 2002 | Needleman I, Tucker R, Giedrys-Leeper E, Worthington H | A systematic review of guided tissue regeneration for periodontal infrabony defects. |
J Periodontal Res 2002; 37(5): 380-8 | periodontics | |||
| 2001 | Needleman IG, Giedrys-Leeper E, Tucker RJ | Guided tissue regeneration for periodontal infra-bony defects. | Cochrane Database Syst Rev 2001; (2): CD001724 | Periodontics | BACKGROUND: Conventional treatment of destructive periodontal (gum) disease arrests the disease but does not regain the bone support or connective tissue lost in the disease process. Guided tissue regeneration (GTR) is a surgical procedure that aims to regenerate the periodontal tissues when the disease is advanced and could overcome some of the limitations of conventional therapy. OBJECTIVES: To assess the efficacy of GTR in the treatment of periodontal infra-bony defects measured against the current standard of surgical periodontal treatment, open flap debridement. SEARCH STRATEGY: We conducted an electronic search of the Cochrane Oral Health Group specialised trials register and MEDLINE up to October 2000. Hand searching included Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and bibliographies of all relevant papers and review articles up to October 2000. In addition, we contacted experts/groups/companies involved in surgical research to find other trials or unpublished material or to clarify ambiguous or missing data and posted requests for data on two periodontal electronic discussion groups. SELECTION CRITERIA: Randomised, controlled trials of at least 12 months duration comparing guided tissue regeneration (with or without graft materials) with open flap debridement for the treatment of periodontal infra-bony defects. Furcation involvements and studies specifically treating early onset diseases were excluded. DATA COLLECTION AND ANALYSIS: Screening of possible studies was conducted independently by two reviewers (RT & IN) and data abstraction by three reviewers (RT, IN & EGL). The methodological quality of studies was assessed in duplicate (RT & IN) using both individual components and a quality scale (Jadad 1998) and agreement determined by Kappa scores. Methodological quality was used in sensitivity analyses to test the robustness of the conclusions. The Cochrane Oral Health Group statistical guidelines were followed (HW) and the results expressed as weighted mean differences (WMD and 95% CI) for continuous outcomes and relative risk (RR and 95% CI) for dichotomous outcomes calculated using random effects models where significant heterogeneity was detected (P < 0.1). The final analysis was conducted using STATA 6 in order to combine both parallel group studies and intra-individual (split-mouth) studies. The primary outcome measure was gain in clinical attachment. Any heterogeneity was investigated. MAIN RESULTS: We initially included 23 trial reports. Twelve were subsequently excluded. Of these, seven presented six-months data only, three were not fully randomised controlled trials, one used a non-comparable radiographic technique. Eleven studies were finally included in the review, ten testing GTR alone and two testing GTR+bone substitutes (one study had both test treatment arms). For attachment level change, the weighted mean difference between GTR alone and open flap debridement was 1.11 mm (95% CI: 0.63 to 1.59), chi-square for heterogeneity 31.4 (df = 9), p<0.001) and for GTR+bone substitutes was 1.25 mm (95% CI: 0.89 to 1.61, chi-square for heterogeneity 0.01 (df = 1), p=0.91). GTR showed a significant benefit when comparing the numbers of sites failing to gain 2 mm attachment, with relative risk 0.58 (95% CI: 0.38, 0.88, chi-square for heterogeneity 5.72 (df = 3), p=0.13). The number needed to treat (NNT) for GTR to achieve one extra site gaining 2 mm or more attachment over open flap debridement was 8 (95% CI: 4, 33), based on an incidence of 32% of sites in the control group failing to gain 2 mm or more of attachment. For baseline incidences in the range of the control groups of 10% and 55% the NNTs are 24 and 3. Probing depth reduction demonstrated a small but statistically significant benefit for GTR, weighted mean difference 0.80 mm (95% CI: 0.14,1.46, chi-square for heterogeneity 10.0 (df = 4), p=0.04) or GTR+bone substitutes, weighted mean difference 1.24 mm (95% CI: 0.89, 1.59, chi-square for heterogeneity 0.03 (df = 1), p=0.85). No significant difference was noted for gingival recession between GTR and open flap debridement. Regarding hard tissue probing at surgical re-entry, a statistically significant greater gain was found for GTR compared with open flap debridement. This amounted to a weighted mean difference of 1.39 mm (95% CI: 1.08, 1.71, chi-square for heterogeneity 0.85 (df = 2), p=0.65). For GTR+bone substitutes the difference was greater, with mean difference 3.37 mm (95% CI: 3.14, 3.61). Heterogeneity between studies was highly statistically significant for all principal comparisons and could not be explained satisfactorily by sensitivity analyses. The quality of study reporting was poor with seven out of 11 studies graded as poor using the Jadad score | Medline | |
| 2001 | Ozkavaf A, Aras H, Huri CB, Yamalik N, Kilinc A, Kilinc K, Caglayan F | Analysis of factors that may affect the enzymatic profile of gingival crevicular fluid: sampling technique, sequential sampling and mode of data presentation | J Oral Sci 2001; 43(1): 41-8 | periodontics | |||
| 2001 | Taylor GW | Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. | Ann Periodontol 2001; 6(1): 99-112 | Medicine Periodontics | This review evaluates evidence for a bidirectional relationship between diabetes and periodontal diseases. A comprehensive Medline search of the post-1960 English language literature was employed to identify primary research reports of relationships between diabetes and periodontal diseases. Reports included in the review on the adverse effects of diabetes on periodontal health (DM-->PD) were restricted to those comparing periodontal health in subjects with and without diabetes. Review of adverse affects of periodontal infection on glycemic control included reports of periodontal treatment studies and follow-up observational studies in which changes in glycemic control could be assessed. Observational studies reporting DM-->PD provided consistent evidence of greater prevalence, severity, extent, or progression of at least one manifestation of periodontal diseases in the large majority of reports (supportive evidence in 44/48 total reviewed; 37/41 cross-sectional and 7/7 cohort). Additionally, there were no studies reviewed with superior design features to refute this association. Treatment studies provided direct evidence to support periodontal infection having an adverse, yet modifiable, effect on glycemic control. However, not all investigations reported an improvement in glycemic control after periodontal treatment. Additional evidence to support the effect of severe periodontitis on increased risk for poorer glycemic control comes from 2 follow-up observational studies. The evidence reviewed supports viewing the relationship between diabetes and periodontal diseases as bidirectional. Further rigorous, systematic study is warranted to establish that treating periodontal infections can be influential in contributing to glycemic control management and possibly to the reduction of the burden of complications of diabetes mellitus. | Medline | |
| 2001 | Anonym | Tissue banking of bone allografts used in periodontal regeneration | J Periodontol 2001; 72(6): 834-8 | Periodontics | |||
| 2001 | Petridis H, Hempton TJ | Periodontal considerations in removable partial denture treatment: a review of the literature. | Int J Prosthodont 2001; 14(2): 164-72 | periodontology prosthodontics | PURPOSE: A critical review of the literature on the periodontal considerations in removable partial denture (RPD) treatment is presented. MATERIALS AND METHODS: A MEDLINE search was conducted for studies pertaining to the effects of RPDs on the periodontal tissues during the various phases of prosthetic treatment. The review included both in vivo and in vitro studies. RESULTS: The use of RPDs leads to detrimental qualitative and quantitative changes in plaque. There seems to be a lack of information regarding the effects of RPDs on the status of periodontally compromised abutments. A number of studies, mainly in vitro, have failed to agree on the ideal RPD design. Clinical trials have shown that if basic principles of RPD design are followed (rigid major connectors, simple design, proper base adaptation), periodontal health of the remaining dentition can be maintained. CONCLUSION: Removable partial dentures do not cause any adverse periodontal reactions, provided that preprosthetic periodontal health has been established and maintained with meticulous oral hygiene. Frequent hygiene recalls and prosthetic maintenance are essential tools to achieve a good long-term prognosis. More prospective clinical trials are needed on the effect of RPDs on the condition of periodontally involved abutment teeth. | Medline | |
| 2001 | Garcia RI, Nunn ME, Vokonas PS | Epidemiologic associations between periodontal disease and chronic obstructive pulmonary disease. | Ann Periodontol 2001; 6(1): 71-7 | Medicine Periodontics | The nature of the relationship of periodontal disease to a number of systemic health outcomes, including chronic obstructive pulmonary disease (COPD), remains unclear. Various causal mechanisms have been proposed to explain the observed epidemiologic associations between periodontal diseases and respiratory diseases. We have reviewed the epidemiologic and clinical evidence for this association. The methodologic approach we have taken is based on a structured systematic review of the indexed biomedical literature on these subjects. The primary focus of this review was on the analysis of periodontal health status measures and their association with COPD, which includes chronic bronchitis and emphysema. We found that a paucity of published results exist on this specific relationship and those which do exist typically represent secondary analyses of existing data sets. Nevertheless, the epidemiologic evidence identified in this systematic review indicates that worse periodontal health status is associated with an increased risk of COPD, with odds ratios ranging from 1.45 to 4.50 (significant at the 95% confidence interval). However, it is possible that residual confounding by tobacco smoking may account in part for the observations. A causal association between periodontal health status and risk of COPD, although biologically plausible, remains speculative. Randomized controlled trials will be required in order to address the question of causality and to better understand the biological basis of these epidemiologic associations. | Medline | |
| 2001 | Tugnait A, Clerehugh V | Gingival recession-its significance and management | J Dent 2001; 29(6): 381-94 | periodontics | |||
| 2001 | Greenstein G, Lamster I | Efficacy of subantimicrobial dosing with doxycycline. Point/counterpoint. | J Am Dent Assoc 2001; 132(4): 457-66 | Antibiotics Periodontics | BACKGROUND: This article addresses the role of subantimicrobial dosing with doxycycline, or SDD, in the treatment of chronic periodontitis. The authors discuss and debate 10 issues with regard to SDD's utility as an adjunct to scaling and root planing. TYPES OF STUDIES REVIEWED: The authors reviewed reports of controlled clinical trials that assessed the efficacy of SDD. The main focus of this article is data from the U.S. Food and Drug Administration's phase 3 clinical trial that evaluated the efficacy of SDD in terms of alterations of probing depth, clinical attachment levels and disease progression. RESULTS: The authors compared data from test groups, which underwent root planing plus SDD, with data from control groups, which underwent root planing alone. The mean data suggest that SDD provides a defined but limited improvement of periodontal status when used in conjunction with scaling and root planing. Furthermore, several in vivo studies indicated that a nine-month course of SDD did not cause development of drug-resistant bacterial strains or alteration of the subgingival microbiota. CLINICAL IMPLICATIONS: Some patients may benefit from SDD. However, there are several issues that should be clarified before widespread use of SDD is recommended for patients with chronic periodontitis. The evidence indicates that suppression of the bacterial challenge, which reduces the host response, is the most efficient way to control periodontal diseases. | Medline | |
| 2001 | Machtei EE | The effect of membrane exposure on the outcome of regenerative procedures in humans: a meta-analysis. | J Periodontol 2001; 72(4): 512-6 | Periodontics | BACKGROUND: The significance of early membrane exposure on the regenerative outcome in guided tissue regeneration (GTR) and guided bone regeneration (GBR) procedures is somewhat controversial. Several clinical trials have shown better response when the membranes remained submerged (S) compared to those that have become exposed (E) during healing. Other studies have failed to show any such difference. Small sample size and/or large standard deviation of the changes might account for these discrepancies. The purpose of this meta-analysis is to critically combine the existing data in order to provide meaningful information based on a large database. METHODS: Studies of GTR in Class II furcation and intrabony defects (IBD), together with GBR around dental implants, where the membrane became exposed during the postoperative period, were combined to form 3 separate databases. A meta-analysis was employed to compare the 2 subgroups (E versus S) in each of the databases. First, weighted mean changes and weighted standard errors were calculated for each subgroup. Next, an individual study P value was calculated (1-tailed Student t test); finally, a combined Fisher's P statistic (with 5% significance level) was calculated from the individual P values. RESULTS: Five studies with a total of 101 sites were included in the furcation database; 43 of these sites became exposed. Mean horizontal attachment level (AL) gain for the S sites (3.72 +/- 0.15 mm) was slightly greater than that of the E sites (3.06 +/- 0.15 mm; P = 0.030257). For the intrabony group, there were 309 sites in 5 studies: of these, 142 sites became exposed. Mean gain in vertical AL was 4.22 +/- 0.15 mm and 4.69 +/- 0.13 mm for the E and S group, respectively (P = 0.011415). The GBR group included 60 sites in 2 studies: new bone formation in the 24 S sites (3.01 +/- 0.38 mm) was 6-fold greater compared with the 36 E sites (0.56 +/- 0.45 mm). These differences were also statistically significant (P = 0.001875). CONCLUSIONS: Membrane exposure during healing had a major negative effect on GBR around dental implants but only a minimal effect on GTR around natural teeth. | Medline | |
| 2000 | Greenstein G | Nonsurgical periodontal therapy in 2000: a literature review. | J Am Dent Assoc 2000; 131(11): 1580-92 | Periodontics | BACKGROUND: This article addresses the advantages and limitations of nonsurgical periodontal therapies to treat patients with mild-to-moderate chronic periodontitis. TYPES OF STUDIES REVIEWED: Controlled clinical trials were selected that assessed the efficacy of the following treatment methods: mechanical instrumentation, ultrasonic debridement, supragingival irrigation, subgingival irrigation, local drug delivery, administration of systemic antibiotics and host-response modulation. Evidently, data with regard to alterations of probing depth, clinical attachment levels and inflammatory status were evaluated. RESULTS: Comparison of the data from test and control groups revealed the following results. Manual and ultrasonic debridement can be used to treat most patients with mild-to-moderate chronic periodontitis. Patients who do not practice optimal plaque control can enhance their personal hygiene procedures by using supragingival irrigation. Subgingival irrigation usually does not provide any benefit beyond that achieved with root planing. Systemic and locally delivered antimicrobial agents appear to be most beneficial among patients who do not respond to conventional treatment. Host modulation may enhance root planing modestly. CLINICAL IMPLICATIONS: The data indicate that most patients with mild-to-moderate periodontitis can be treated with nonsurgical therapies. However, clinicians need to be aware of the limitations of each technique with regard to the magnitude of improvement that it can induce at specific sites. | Medline | |
| 2000 | Armitage GC | Periodontal infections and cardiovascular disease--how strong is the association? | Oral Dis 2000; 6(6): 335-50 | Medicine Periodontics | In the past decade there has been renewed interest in the old hypothesis that infections increase the risk of developing cardiovascular disease and stroke. There is now a convincing body of evidence that atherosclerosis has a major inflammatory component and is much more than the simple vascular accumulation of lipids. Infectious agents that have been linked to an increased risk of coronary heart disease (CHD) include Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpesviruses. The concept has emerged that each of these agents is an independent risk factor for CHD and that common chronic infections are important. In addition, periodontal infections have also been implicated as one of several factors contributing to the development of CHD. Evidence supporting a causative role of chronic infections in CHD is largely circumstantial. However, the evidence is sufficiently strong to warrant further examination of the possible link between chronic infections and CHD. In this review the lines of evidence for a causative role of C. pneumoniae in the development of CHD are summarized and contrasted with the lines of evidence suggesting a periodontal infection--CHD association. If common or widespread chronic infections are truly important risk factors for CHD, it is unlikely that a single infection will be shown to be causative. It is likely that the entire microbial burden of the patient from several simultaneous chronic infections is more important (e.g., H. pylori-caused gastric ulcers + C. pneumoniae-caused bronchitis + periodontitis). Increased cooperation between cardiologists and periodontists will be required to determine if, and what, combinations of common chronic infections are important in the pathogenesis of CHD and stroke. | Medline | |
| 2000 | Tonetti MS | Advances in periodontology | Prim Dent Care 2000; 7(4): 149-52 | periodontics | |||
| 2000 | Greenwell H, Bissada NF, Henderson RD, Dodge JR | The deceptive nature of root coverage results. | J Periodontol 2000; 71(8): 1327-37 | Periodontics | BACKGROUND: The purposes of this article are to: 1) propose a new method of reporting root coverage data; 2) compare existing root coverage techniques using the proposed data analysis method; and 3) discuss additional refinements to root coverage data analysis. Past studies have equated percent defect coverage with root coverage. This gives deceptive information about the magnitude of the residual recession defect. Defect coverage of 67% could actually amount to 92% root coverage. METHODS: The use of mean root lengths will permit the determination of true root coverage data. This should be reported in addition to defect coverage data. Also including frequency data will provide a better assessment of the predictability of the surgical techniques. RESULTS: A comparison table of root coverage studies demonstrates that the connective tissue graft is the most effective and predictable method that has been tested. CONCLUSIONS: Further refinements to data analysis may help researchers identify the determinants of predictable root coverage. | Medline | |
| 1999 | Breen HJ, Johnson NW, Rogers PA | Site-specific attachment level change detected by physical probing in untreated chronic adult periodontitis: review of studies 1982-1997. | J Periodontol 1999; 70(3): 312-28 | Periodontics | BACKGROUND: Site-specific attachment level change, detected from sequential physical probing measurements, is currently the most common method of determining the progression/regression or stability of disease status in subjects with chronic adult periodontitis. The sensitivity and accuracy of detection is dependent on the type of probe used, the recording method, the measurement error, and the method of data analysis. In recent years, there has been world-wide interest in developing instruments and methods to minimize measurement error. Published data report disturbingly wide variation in the prevalences and rates of site-specific attachment level change which are difficult to reconcile with biological likelihood. The present paper aims to summarize the salient points from the key studies and to compare the results. METHODS: The literature between 1982 and 1997 was reviewed for studies in which site-specific attachment level change was detected by physical probing methods in patients with chronic adult periodontitis. RESULTS: The review documents 23 studies by probe generation, compares methods and results and summarizes the results according to the thresholds and probe type used. The 23 studies used an array of probe types from the 3 probe generations. CONCLUSIONS: From this review, we conclude that: 1) There are surprisingly few papers which have addressed the question of site-specific attachment level change in untreated chronic adult periodontitis. 2) There are considerable differences in the probes used, in the thresholds achieved, in the number of measurements taken, in the number of subjects and sites studied, and in the duration of the studies. Valid comparisons between studies are, therefore, rarely possible. 3) Only 8 out of 23 papers from 1982 to 1997 have adequate data. Most papers report only losing sites and therefore ignore many of the measurements recorded. Only one paper describes losing sites, gaining sites, and sites showing exacerbation/remission patterns of change. 4) The range of changes described show such variation that it has to be concluded that we cannot reliably detect site-specific attachment level change by physical probing and thus, at the end of the 20th century, we have no clear idea of the natural history of this disease. | Medline | |
| 1999 | Knoll-Köhler E | Metronidazole dental gel as an alternative to scaling and root planing in the treatment of localized adult periodontitis. Is its effiacy proved? | Eur J Oral Sci 1999; 107: 415-21 | Antibiotics Periodontics | Eight randomized clinical trials, comparing the application of 25% metronidazole dental gel (Elzylol dental gel) once a week for two weeks with scaling and root planing in the "split-mouth" design for treating adult periodontitis, were evaluated and scored according to ANTCZAK et al. (1986) and BEGG et al. (1996). The aim of this investigation was to determine whether both treatment methods are of equal value. With a maximum of 1.0 in each case, the scores determined were (M +/- SD) 0.107 +/- 0.033 (range 0.072-0.168) for reporting the study protocol and 0.285 +/- 0.084 (range 0.120-0.400) for the data analysis, presentation and discussion. Though the study results show that both treatment modalities are of equal value, the quality of the trials does not allow a comparative therapy assessment at present. The state of the data is inadequate for applying local metronidazole dental gel as an alternative to mechanical instrumentation in adult periodontitis. | Medline | |
| 1998 | Anonym | Periodontology: Implant therapy, Non-surgical pocket therapy; Mucogingival therapy, Prevention, Periodontal regeneration around natural teeth | J Am Dent Assoc 1998; 129 Suppl: 15S-57S | disability implants mucosa periodontics periodontics | |||
| 1998 | Anonym | Supportive periodontal therapy (SPT) | J Periodontol 1998; 69(4): 502-6 | periodontics | |||
| 1998 | Laurell L, Gottlow J, Zybutz M, Persson R | Treatment of intrabony defects by different surgical procedures. A literature review. | J Periodontol 1998; 69(3): 303-13 | Periodontics | This article reviews studies presented during the last 20 years on the surgical treatment of intrabony defects. Treatments include open flap debridement alone (OFD); OFD plus demineralized freeze-dried bone allograft (DFDBA), freeze-dried bone allografts (FDBA), or autogenous bone; and guided tissue regeneration (GTR). The review includes only studies that presented baseline and final data on probing depths, intrabony defect depths as measured during surgery, clinical attachment level (CAL) gain, and/or bone fill. Some reports were case studies and some controlled studies comparing different treatments. In order to assess what can be accomplished in terms of pocket reduction, clinical attachment level gain, and bone fill with the various treatment modalities, data from studies of each treatment category were pooled for meta-analysis in which the data from and power of each study were weighted according to the number of defects treated. In addition, where there were data for each individual defect treated, these were used for simple regression analysis evaluating the influence of intrabony defect depth on treatment outcome in terms of CAL gain and bone fill. This was done in an effort to assess some predictability of the outcome of the various treatments. OFD alone resulted in limited pocket reduction, CAL gain averaged 1.5 mm and bone fill 1.1 mm. Bone fill, but not CAL gain, correlated significantly to the depth of the defect (R=0.3; P < 0.001), but the regression coefficient was only 0.25. OFD plus bone graft resulted in limited pocket reduction. CAL gain and bone fill averaged 2.1 mm. Bone fill showed a somewhat stronger correlation to defect depth than following OFD alone (R=0.43; P < 0.001) with a regression coefficient of 0.37. GTR resulted in significant pocket reduction, CAL gain of 4.2 mm, and bone fill averaging 3.2 mm. CAL gain and bone fill correlated significantly (P < 0.001) to defect depth (R=0.52 and 0.53 respectively) with the largest regression coefficients (0.54 and 0.58 respectively) among the three treatment modalities. By comparing outcomes following the various treatments it became obvious that to benefit from GTR procedures, the intrabony defect has to be at least 4 mm deep. | Medline | |
| 1998 | Seymour RA, Steele JG | Is there a link between periodontal disease and coronary heart disease? | Br Dent J 1998; 184(1): 33-8 | Medicine Periodontics | OBJECTIVE: To provide a critical review of the studies completed to date that have investigated a link between coronary heart disease and dental health. DESIGN: Retrospective analysis. SETTING: Mainly hospital-based patients or subjects involved in longitudinal health care studies. MAIN OUTCOME MEASURES: The incidence of coronary heart disease and its relationship to dental health and other recognised risk factors. RESULTS: Evidence suggests that dental health, in particular periodontal disease, may be a significant risk factor for coronary heart disease and further coronary events. Possible biological mechanisms that link the two diseases are appraised. CONCLUSIONS: There does appear to be increasing evidence that a relationship exists between dental health and coronary heart disease, especially in males aged 40-50 years. The presence of a hyperinflammatory monocyte phenotype may provide a common biological mechanism that links the two diseases. | Medline | |
| 1997 | Elter JR, Lawrence HP, Offenbacher S, Beck JD | Meta-analysis of the effect of systemic metronidazole as an adjunct to scaling and root planing for adult periodontitis. | J Periodontal Res 1997; 32(6): 487-96 | Antibiotics Periodontics | The purpose of this meta-analysis was to provide a quantitative overview of clinical trials assessing the use of systemic metronidazole (S-MET) as an adjunct to scaling and root planning (S&RP) in the treatment of adult periodontitis. Eight clinical trials were chosen based upon a priori selection criteria, and two outcomes, "reduction in probing pocket depth" (PD) and "gain in clinical attachment level" (CAL), were analyzed. Results for each outcome were stratified by initial PD 1-3 mm, 4-6 mm, or > or = 7 mm and length of follow-up 4-6 wk, 9-13 wk, or 14-26 wk. S-MET in conjunction with S&RP was superior to S&RP alone in reducing PD where initial PD was 4-6 mm and follow-up was 9-13 wk (0.43 mm; 99% CI 0.12, 0.73). No significant advantage was observed for S-MET for reducing PD where initial PD was less than 4 mm or follow-up was longer than 13 wk. S-MET in conjunction with S&RP was superior to S&RP alone in reducing CAL where initial PD was 4-6 mm and follow-up was 4-6 wk (0.29; 99% CI 0.01, 0.58) and where follow-up was 9-13 wk (weighted mean difference 0.32; 99% CI 0.03, 0.61). Significant heterogeneity of effect was not seen for PD or Cal at any level of initial PD or length of follow-up. No significant dose-response relationship was observed. This meta-analysis was limited due to diversity of data presentation and the small number of trials in each stratum. These results suggest that S-MET in conjunction with S&RP may offer a benefit over S&RP alone in the treatment of adult periodontitis patients in managing pockets of 4 mm or greater, but the additional benefit was not evident if initial PD was less than 4 mm or follow-up was beyond 13 wk. | Medline | |
| 1997 | Evans GH, Yukna RA, Cambre KM, Gardiner DL | Clinical regeneration with guided tissue barriers. | Curr Opin Periodontol 1997; 4: 75-81 | Periodontics | This review of the current periodontal literature evaluates clinical regeneration with guided tissue barriers in infrabony defects and furcations. A meta-analysis was conducted by calculating weighted means with confidence intervals for each treatment group. Clinical improvement in infrabony defects was best for polylactic acid/polyglactin (PLA/PGA) barriers, with a mean pocket reduction of 5.3 mm and a mean gain in clinical probing attachment level of 4.7 mm. For furcations, special attention was given to the frequency of either complete or partial (> or = 50%) furcation closure. Complete furcation closure was an infrequent result of guided tissue regeneration, occurring in only 7% to 19% of furcations treated with barriers. For the time period reported, the best clinical results in furcations and infrabony defects occurred with PLA/PGA-type barriers. However, there were no statistically significant differences among the various barriers in infrabony defects or furcations. | Medline | |
| 1997 | Tonetti MS, Cortellini P | Case selection and treatment considerations of guided tissue regeneration in deep intrabony defects. | Curr Opin Periodontol 1997; 4: 82-8 | Periodontics | Evidence reported in the period covered by this review, and here summarized with a meta-analysis, indicated that guided tissue regeneration (GTR) management of deep intrabony defects resulted in clinically significant and predictable gains in tooth support. Controlled randomized clinical trials demonstrated that GTR therapy was associated with significantly greater improvements in clinical attachment than access flap procedures alone. A series of recent investigations have also indicated that the magnitude and possibly the predictability of the expected outcomes are dependent upon a variety of patient, defect, and procedure-associated factors. Substantial evidence has been provided that clinical improvements obtained with GTR can be maintained over time. | Medline | |
| 1997 | Chapple IL | Periodontal disease diagnosis: current status and future developments | J Dent 1997; 25(1): 3-15 | periodontics | |||
| 1997 | Oates TW, Kalkwarf KL | Long-term prognosis following resectional and regenerative periodontal procedures | Curr Opin Periodontol 1997; 4: 69-74 | Periodontics | |||
| 1997 | Chung RM, Grbic JT, Lamster IB | Interleukin-8 and beta-glucuronidase in gingival crevicular fluid | J Clin Periodontol 1997; 24(3): 146-52 | periodontics | |||
| 1996 | Anonym | Consensus reports. Implant therapy; Periodontal implications: mucocutaneous disorders; Periodontal regeneration around natural teeth; Surgical pocket therapy; Mucogingival therapy;Periodontal diseases: epidemiology and diagnosis; prevention | Ann Periodontol 1996; 1: 1-946 | antibiotics evidence implant periodontics pharmacotherapy | |||
| 1996 | Bollen CM, Quirynen M | Microbiological response to mechanical treatment in combination with adjunctive therapy: a review of the literature | J Periodontol 1996; 67(11): 1143-58 | Antibiotics Periodontics | The recognition of the microbial origin and the specificity of periodontal infections has resulted in the development of several adjunctive therapies (antibiotics and/or antiseptics) to scaling and root planing in the treatment of chronic adult periodontitis. This article aims to review the "additional" effect of a subgingival irrigation with chlorhexidine, or a local or systemic application of tetracycline or metronidazole, performed in combination with a single course of scaling and root planing in patients with chronic adult periodontitis. All treatment modalities are compared with scaling and root planing, based on their impact on: the probing depth (PD); total number of colony forming units per ml (CFU/ml); the proportions and/or the detection-frequency of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia; and/or on the percentages of cocci, spirochetes, motile, and other micro-organisms on dark field microscopy examination. All treatment modalities, including scaling and root planing without additional chemical therapy, resulted in significant reductions in the probing depth and the proportions of periodontopathogens, at least during the first 8 weeks post-therapy. However in comparison to a single course of scaling and root planing, the supplementary effect of adjunctive therapies seems to be limited. In general, only the irrigation with chlorhexidine 2%, the local application of minocycline, and the systemic use of metronidazole (in case of large proportions of spirochetes) or doxycycline (in case of large proportions of A. actinomycetemcomitans) seem to result in a prolonged supplementary effect when compared to scaling and root planing. Therefore, the use of antibiotics on a routine basis, especially in a systemic way, in the treatment of chronic adult periodontitis, can no longer be advocated, considering the increasing danger for the development of microbial resistance. | Medline | |
| 1995 | Berkey CS, Antczak-Bouckoms A, Hoaglin DC, Mosteller F, Pihlstrom BL | Multiple-outcomes meta-analysis of treatments for periodontal disease. | J Dent Res 1995; 74(4): 1030-9 | Periodontics | The results of periodontal therapy vary by disease severity, outcome measure, and method of data analysis. Several clinical trials and a subsequent meta-analysis have demonstrated that, for teeth with severe disease, surgery decreases probing depth (PD) and increases attachment level (AL) more than non-surgical treatment. For other disease levels, the choice of therapy depends on the outcome measure. When clinical trials use two or more outcome measures (such as PD and AL), investigators ordinarily analyze each outcome separately. When the correlations are incorporated among the outcomes, a meta-analysis can use generalized-least-squares (GLS) regression to analyze multiple outcomes jointly. We applied the GLS multiple-outcomes model in a meta-analysis of 5 trials comparing surgical and non-surgical periodontal treatments, each assessing the outcomes PD and AL one year after treatment. The clinical conclusions are similar to those reported earlier, but our estimates of the relative benefits of surgical and non-surgical treatment should be more accurate, because the GLS method takes into account correlation between AL and PD. When correlations between the two outcomes rise, as they do with increasing severity of disease, the GLS estimates depart from those derived from separate analyses of PD and AL. | Medline | |
| 1995 | Sigurdsson TJ, Tatakis DN, Lee MB, Wikesjo UM | Periodontal regenerative potential of space-providing expanded polytetrafluoroethylene membranes and recombinant human bone morphogenetic proteins | J Periodontol 1995; 66(6): 511-21 | periodontics | |||
| 1995 | Machtei EE, Schallhorn RG | Successful regeneration of mandibular Class II furcation defects: an evidence-based treatment approach. | Int J Periodontics Restorative Dent 1995; 15(2): 146-67 | Periodontics | The purpose of the present evidence-based critical review was to define goals and outcomes for regenerative therapy of Class II furcation defects and rank the efficacy of current regenerative procedures based on the available literature. Meta-analysis was employed to quantitate the mean overall expected changes and compare various techniques. The evidence presented in the literature was used to determine factors affecting regeneration of Class II furcation defects. These factors were used to establish decision-making trees to enhance success and highlight potential shortcomings of the technique. Guided tissue regeneration, used alone or in combination with bone replacement grafts, had the highest overall ranking. Mean reduction in probing depths and gains in vertical and horizontal attachment levels were all statistically significant at 6 months. Similar results were obtained in the 12-month studies. Compared to flap debridement, guided tissue regeneration resulted in greater reduction in probing depths and greater gains in vertical and horizontal attachment levels. Guided tissue regeneration provided almost identical results whether used with or without root conditioning, suggesting that root conditioning does not offer an adjunctive effect. A combination of guided tissue regeneration and bone replacement grafts yielded better results than did guided tissue regeneration alone in reducing probing depths and increasing vertical attachment levels. The decision-making trees derived from analysis of these results may assist the clinician in improving success and predictability of guided tissue regeneration procedures in Class II furcation defects. | Medline | |
| 1995 | Watts TL | Periodontal inflammation and attachment loss: a critical problem for biological studies | Oral Dis 1995; 1(4): 254-8 | periodontics | |||
| 1995 | Spranger H | Investigation into the genesis of angular lesions at the cervical region of teeth | Quintessence Int 1995; 26(2): 149-54 | periodontics | |||
| 1995 | Cortellini P, Bowers GM | Periodontal regeneration of intrabony defects: an evidence-based treatment approach | Int J Periodontics Restorative Dent 1995; 15(2): 128-45 | periodontics | |||
| 1995 | Nguyen AM, el-Zaatari FA, Graham DY | Helicobacter pylori in the oral cavity. A critical review of the literature | Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79(6): 705-9 | periodontics | |||
| 1995 | Hujoel PP, DeRouen TA | A survey of endpoint characteristics in periodontal clinical trials published 1988-1992, and implications for future studies | J Clin Periodontol 1995; 22(5): 397-407 | Periodontics | Endpoints are conditions or events that are associated with individual study subjects and that are used to assess treatment efficacy. 2 types of endpoints can be distinguished: "true" endpoints (reflect unequivocal evidence of tangible benefit to the patient) and "surrogate" endpoints (usually a measure of disease process). The purpose of this study was to survey four aspects of endpoint usage in randomized controlled trials (RCT's) on the treatment of periodontitis: (1) the typical number of endpoints per RCT, (2) the proportion of RCTs using the same endpoint, (3) the proportion of RCTs using true endpoints, and (4) whether treatment choice influenced endpoint choice. 92 publications (1988-1992) reporting on 82 RCT's were identified. The typical number of endpoints per RCT was 6 (range: 1-28). The 3 most frequently used endpoints were mean probing depth (78% of the trials), mean probing attachment level (66%), and the plaque index (37%). In total, 153 distinct surrogate endpoints were defined. Most of these were used infrequently; over 80% of the 153 endpoints were used in fewer than 5 of the 82 trials. No trials used tooth loss as a true endpoint. In the design of an RCT, treatment choice influenced surrogate endpoint choice. Surrogate endpoints based on re-entry surgery were exclusively used for regenerative procedures and microbiological surrogate endpoints were mostly used for RCT's on anti-microbials. The conclusion is that the typical RCT used multiple surrogate endpoints, some of which were used infrequently by other trials. Such endpoint usage characteristics are suitable for exploratory RCTs (designed to identify active treatments or to elucidate treatment mechanisms). The question is raised as to whether periodontal research has reached the point of needing properly designed definitive studies, whose purpose it would be to provide unequivocal evidence of tangible benefits to the patient by the various treatments. If a need for definitive randomized controlled trials is perceived, then the use of (multiple) surrogate endpoints as primary outcomes should be questioned. Surrogate endpoint usage has led to both false positive and false negative conclusions in other chronic disease studies. Endpoint selection and validation in RCTs may be an important element in resolving controversies about periodontal treatments | Medline | |
| 1994 | Hujoel PP | A meta-analysis of normal ranges for root surface areas of the permanent dentition | J Clin Periodontol 1994; 21(4): 225-9 | periodontics | |||
| 1994 | Mendieta C, Williams RC | Periodontal regeneration with bioresorbable membranes | Curr Opin Periodontol 1994;: 157-67 | periodontics | |||
| 1993 | Antczak-Bouckoms A, Joshipura K, Burdick E, Tulloch JF | Meta-analysis of surgical versus non-surgical methods of treatment for periodontal disease. | J Clin Periodontol 1993; 20(4): 259-68 | Periodontics | A meta-analysis was performed on 5 randomized controlled trials comparing surgical with non-surgical treatment for periodontal disease. The specific procedures considered were the modified Widman flap compared with scaling and root planning or curettage with anesthesia. We chose the most consistently reported outcomes, pocket depth and attachment level, for analysis. At 1 year of follow-up, surgical treatment reduced pocket depth more than non-surgical for all initial levels of disease, but by 5 years, only the deepest initial pockets (> 7 mm) showed significant improvement over non-surgically treated teeth (0.51 mm reduction, p < 0.01). Attachment level showed significantly better early results for non-surgical treatment for less diseased teeth, but by 5 years, all significant differences had disappeared. We computed quality scores following a method described by Chalmers. The mean quality score for study data analysis and presentation was 0.37 +/- 0.009 and for the study protocol, the mean quality score was 0.19 +/- 0.002. We find that this meta-analysis supports findings relating response to therapy with initial level of disease severity. We also find that the choice of outcome measure influences the choice of therapy, with surgical therapy providing greater benefit for probing depth and non-surgical therapy providing greater benefit for attachment level. These results must be viewed, however, in light of the low quality scores of the evaluated studies and the potential for bias due to lack of binding, the small mean treatment differences, and the observer measurement variability. | Medline | |
| 1993 | Kaldahl WB, Kalkwarf KL, Patil KD | A review of longitudinal studies that compared periodontal therapies. | J Periodontol 1993; 64(4): 243-53 | Periodontics | There have been numerous longitudinal periodontal studies that have compared the effects of two or more therapies on various clinical parameters. These studies are reviewed and their results are compiled. Both surgical and non-surgical therapy produced improvement in periodontal health. Surgical therapy tended to create greater short-term probing depth reduction than non-surgical therapy; however, the advantage was lost in some studies over time. In shallow probing depths, surgery produced a greater loss of probing attachment than non-surgical therapy. In deeper probing sites, the short-term results comparing mean probing attachment change following non-surgical and surgical therapy were mixed. In most studies, no long-term differences in mean probing attachment level change were present between non-surgical and surgical therapy. There were no differences between surgical and non-surgical therapy in any of the gingival inflammatory indices. | Medline | |
| 1993 | Antczak-Bouckoms A | Meta-analysis of clinical trials in periodontal research. | Periodontol 2000 1993; 2: 140-9 | Periodontics | - | Medline | |
| 1992 | Hayes C, Antczak-Bouckoms A, Burdick E | Quality assessment and meta-analysis of systemic tetracycline use in chronic adult periodontitis. | J Clin Periodontol 1992; 19(3): 164-8 | Antibiotics Periodontics | The use of systemic tetracycline in the treatment of periodontal disease has been controversial. To investigate this controversy, we performed a quality assessment and attempted to perform a meta-analysis of 13 published studies. We evaluated the quality of the study protocol and data analysis and presentation for each study. We were unable to combine data from the majority of studies due to heterogeneity of the outcomes evaluated and limitations in data reported in the individual studies. Therefore, only 2 studies were included in the quantitative meta-analysis. On a scale of 0-1, the mean score for this group of studies was 0.27 (+/- 0.19) for study protocol and 0.31 (+/- 0.11) for data analysis and presentation. Mean reduction in probing depth for the group treated with tetracycline plus scaling was 2.45 mm; for the group which received only scaling, 2.02 mm; for the group that received only tetracycline, 1.98 mm; and for the control group, 0.65 mm. We conclude that analysis of data from the published literature does not demonstrate that the use of systemic tetracycline is more beneficial than conventional treatment in the management of adult periodontal disease. More information is needed in order to perform an extensive meta-analysis of this subject. | Medline | |
| 1992 | Hujoel PP, Baab DA, DeRouen TA | The power of tests to detect differences between periodontal treatments in published studies | J Clin Periodontol 1992; 19(10): 779-84 | periodontics | |||
| 1992 | Hujoel PP, Baab DA, DeRouen TA | The power of tests to detect differences between periodontal treatments in published studies. | J Clinical Periodontology 19(10): 779-84, 1992 | Periodontics | 10 studies comparing periodontal treatment modalities were re-examined to see if they had adequate power to detect true differences. Attachment level (AL) and pocket depth (PD) were the 2 variables assessed. A statistical test's power refers to its probability of detecting a significant sample difference in treatment means, given a predetermined value for alpha (level of significance), delta (a clinically meaningful underlying difference), and the sample size. Studies were included that stratified their data by initial pocket depths, reported sample size, and lasted at least 6 months. Power calculations were done for 173 treatment comparisons, using delta = 0.5 mm and alpha = 0.05. For shallow pockets (1-3 mm), most studies had a strong chance of detecting true differences (median power = 83%). For moderate pockets (4-6 mm), median power dropped to 38%. However, median power dropped to 14% for deep pockets (> 6 mm), with 75% of the tests having less than a 20% chance of detecting a 0.5 mm difference. Many of the modalities reported as "not significantly different" from each other have not had a fair trial, especially for deep pockets. In order to improve a study's power, 4 factors are discussed: the number of compared treatments, the expected noise or random error, the patient sample size, and the average number of sites per patient for each pocket depth category. | Medline | |
| 1991 | Kingman A, Loe H, Anerud A, Boysen H | Errors in measuring parameters associated with periodontal health and disease | J Periodontol 1991; 62(8): 477-86 | Periodontics | |||
| 1990 | Anonym | Competency objectives for dental public health | J Public Health Dent 1990; 50(5): 338-44 | Education caries-pub periodontics-pub | |||
| 1987 | Antczak-Bouckoms AA, Weinstein MC | Cost-effectiveness analysis of periodontal disease control | J Dent Res 1987; 66(11): 1630-5 | Periodontics | |||
| 1987 | Krejci RF, Kalkwarf KL, Krause-Hohenstein U | Electrosurgery--a biological approach | J Clin Periodontol 1987; 14(10): 557-63 | periodontics |