Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT06209554 |
| Other study ID # |
treatment of periodontitis |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
January 13, 2023 |
| Est. completion date |
March 17, 2023 |
Study information
| Verified date |
January 2024 |
| Source |
Mansoura University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
The present study aims to evaluate the efficacy of subgingival air polishing by erythritol
and diode laser in the treatment of periodontitis (clinically and microbiologically).
Description:
Periodontitis, a chronic condition, leads to inflammation of the periodontium, resulting in
the degradation of the periodontal ligament and adjacent alveolar bone, potentially leading
to tooth loss The oral cavity, hosting nearly 700 distinct bacteria, is the primary origin of
periodontitis, where bacterial pathogens trigger an inflammatory response, causing connective
tissue deterioration. Gram-negative bacteria, including Aggregatibacter
actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella
forsythia, contribute to periodontitis.
Dental plaque illustrates bacterial growth in the form of a biofilm Porphyromonas gingivalis,
a Gram-negative anaerobic bacterium, is found in 85.75% of subgingival plaques associated
with chronic periodontitis. The presence of Aggregatibacter actinomycetemcomitans at the
individual level is notably associated with disease risk due to its genetic variation and
virulence factors.
Exclusive reliance on mechanical therapy (SRP) may fall short in eliminating pathogenic
bacterial species due to their presence within periodontal tissues or in regions inaccessible
by periodontal instruments during close debridement. These challenges pose constraints on the
enduring stability of outcomes in nonsurgical techniques, forming the rationale for
supplementary therapies involving antibiotics, antiseptics, nonchemical modalities, laser,
and photodynamic therapy.
Laser therapy, particularly the diode laser at 940 nm, in conjunction with SRP, enhances and
facilitates the healing process in treated sites. The diode laser, preferred for its
cost-effectiveness, portability, and user-friendly nature, simultaneously addresses the
removal of diseased soft tissues, targets microorganisms, and induces an antibacterial effect
within periodontal pockets.
Its favorable tissue penetration capabilities and absorption in pigmented tissues make it
particularly adept at targeting pigmented bacteria and granulation tissue.
The emergence of low-abrasive and resorbable powders, used with subgingival delivery tools,
sparks renewed interest in air-polishing devices (APDs) for periodontal treatment. Research
indicates that APDs contribute to a reduction in post-operative patient discomfort and
sensitivity, enhance patient acceptance, and result in minimal alterations to surrounding
soft and hard tissues. Air-flow therapy may be particularly beneficial for challenging cases
such as teeth with furcation involvement and sites with restricted access, traditionally
posing difficulties for thorough debridement using conventional instrumentation.
Initially designed to eliminate biofilm and stains, APDs using abrasive powders were found
detrimental to exposed root surfaces, gingiva, and certain restorative materials.
Subsequently, there was a shift towards the adoption of resorbable powders with low
abrasiveness, including glycine and erythritol, to mitigate adverse effects.
The recently introduced erythritol powder, a water-soluble, non-toxic sugar alcohol, and
artificial sweetener, is extensively employed in the food industry. Erythritol powder
air-polishing (EPAP) used as a monotherapy exhibits outcomes in supportive periodontal
therapy comparable to those achieved through conventional power-driven and manual
debridement.
There is a suggestion that erythritol powder may possess a prolonged antimicrobial effect on
the subgingival biofilm, with studies indicating its capability to decrease the numbers of P.
gingivalis and Aggregatibacter actinomycetemcomitans during supportive periodontal treatment.
