Akihiro Yashima

One-Stage Full-Mouth Versus Partial- Mouth Scaling and Root Planing During the Effective Half-Life of Systemically Administered Azithromycin

BACKGROUND One-stage full-mouth scaling and root planing (FM-SRP) in combination with systemically administered azithromycin was shown to be clinically and bacteriologically effective in the treatment of chronic periodontitis. However, FM-SRP requires 2 hours for completion. Azithromycin has a long half-life. Therefore, if SRP of the full mouth is performed within 7 days while an effective concentration of azithromycin remains in the gingiva, the effects may be the same as FM-SRP. The aim of this study was to compare the clinical and bacteriologic effects of FM-SRP and partial-mouth scaling and root planing (PM-SRP) in patients with chronic periodontitis, which was performed in three sessions within 7 days, during the effective half-life of systemically administrated azithromycin. METHODS Thirty adult subjects with chronic periodontitis were randomly divided into three groups (FM-SRP, PM-SRP, and control). A clinical examination was conducted to record the probing depth, clinical attachment level gain, bleeding on probing, gingival index, and volume of gingival crevicular fluid; bacterial samples were obtained before treatment and 1, 3, 6, 9, and 12 months thereafter. Quantitative and qualitative analyses were performed using the polymerase chain reaction-Invader method. RESULTS All clinical parameters showed better improvement in FM-SRP and PM-SRP groups compared to the control group, with no significant differences between the two test groups. Periodontal bacteria were well controlled in the two test groups, but they tended to increase gradually 3 months after treatment in the control group. CONCLUSION PM- and FM-SRP demonstrated comparable clinical and bacteriologic results.

The evaluation of bacterial flora in progress of peri-implant disease

BACKGROUND Cumulative interceptive supportive therapy (CIST) is currently used as a guideline for treating peri-implant diseases. The objectives of this study were to determine the detection rate and measure the number of periodontopathic bacteria in lesions of different CIST levels and thereby characterize peri-implant disease from a bacteriological viewpoint. METHODS This study included 105 patients who had both residual natural teeth and implants with peri-implant disease. A total of 105 implants were divided into levels A, B, C and D according to the CIST classification. Bacterial samples were collected from peri-implant pockets and four periodontopathic bacteria were measured by PCR and PCR-Invader assay. RESULTS The number of periodontopathic bacteria increased in line with CIST level, and the detection rate was also associated with CIST level. However, no difference was found in the bacterial detection rate of P. gingivalis and T. denticola between CIST-B and CIST-C. There was a higher detection rate of all periodontopathic bacteria for CIST-D. CONCLUSIONS The number of periodontopathic bacteria and detection rate increased as peri-implant disease advanced. However, there were no major differences in the detection rate between CIST-B and CIST-C. On the other hand, a higher detection rate of periodontopathic bacteria was seen for CIST-D.

Effect of the Keratinized Mucosa Width on the Health Status of Periimplant and Contralateral Periodontal Tissues: A Cross-sectional Study.

Introduction:The purpose of this study was to examine whether the width of keratinized mucosa (WKM) is associated with the health status of tissue surrounding dental implants and the contralateral teeth. Materials and Methods:Sixty patients who received implant-fixed unilateral prostheses in the premolar or molar region were recruited for the study. The following parameters were measured for each implant and contralateral tooth: WKM, gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), pus discharge, plaque accumulation (PA), gingival recession (GR), and difficulty of brushing. The effect of the WKM on the health status of the surrounding tissue was evaluated by comparing the different WKM groups (WKM < 2 mm vs WKM ≥ 2 mm). Results:Implants with a WKM <2 mm demonstrated significantly greater PPD, PA, and a higher rate of BOP compared with implants with a WKM ≥2 mm. There was significantly greater GR in contralateral teeth with a WKM <2 mm compared with a WKM ≥2 mm. In addition, implant sites had a higher rate of BOP compared with the contralateral teeth. Conclusions:Inadequate keratinized mucosa decreased cleansibility of implant sites and increased mucosal inflammation. There is a possibility that PA in implant sites caused more pronounced inflammatory response compared to contralateral tooth.

Full‐mouth scaling and root planing combined with azithromycin to treat peri‐implantitis

BACKGROUND Full-mouth scaling and root planing combined with azithromycin is clinically and bacteriologically effective for the treatment of chronic periodontitis. This study aimed to investigate the clinical and bacteriological effects of this combination treatment in patients with peri-implantitis. METHODS Twenty adult patients with both chronic periodontitis and peri-implantitis were randomly divided into two groups (10: test, 10: control). All patients underwent full-mouth scaling and root planing but the test group received azithromycin for 3 days before the procedure. The probing depth, bleeding on probing, and the gingival index were assessed clinically. Bacterial samples were obtained before treatment at 1 week and 1, 3, 6, 9 and 12 months after treatment. Quantitative and qualitative analyses were performed using the polymerase chain reaction Invader method. RESULTS All clinical parameters showed better improvement in both periodontitis and peri-implantitis in the test group. Periodontal bacteria were more effectively reduced in the test group, but gradually increased around implants 6 months after treatment and natural teeth 9 months after treatment. CONCLUSIONS Full-mouth scaling and root planing combined with azithromycin was temporarily useful for the treatment of peri-implantitis. Clinical improvements were maintained for about 9 months but periodontal bacteria increased again 6 months after treatment.