S.P. Paraskevas

The Effect of a Pulsed Nd:YAG Laser in Non-Surgical Periodontal Therapy

BACKGROUNDnLaser treatment may serve as an alternative or adjunctive treatment to conventional mechanical therapy in periodontics. The neodymium-doped:yttrium, aluminum, and garnet (Nd:YAG) laser has been used in periodontics. Systematic reviews aid in clinical decision-making. The aim of this study was to evaluate, in a systematic manner and after a comprehensive search of the literature, the (additional) therapeutic effects of using a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis.nnnMETHODSnThe focused question for this systematic review was, What is the efficacy of a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis, either as monotherapy or as an adjunct to non-surgical periodontal treatment? The efficacy of this technique was compared to conventional therapy (ultrasonics and/or hand instrumentation) in removing plaque, as well as in improving clinical parameters, such as periodontal inflammation and probing depth. Articles published before May 2008 in the databases of MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials were searched to identify appropriate studies. Clinical parameters of periodontal inflammation, namely, plaque, bleeding, gingivitis, probing depth, clinical attachment level, and gingival recession, were selected as outcome variables.nnnRESULTSnIndependent screening of the titles and abstracts of 285 PubMed and 38 Cochrane articles resulted in eight publications that met the eligibility criteria. Means +/- SDs were collected by data extraction; only descriptive analysis was possible.nnnCONCLUSIONSnThe majority of the studies analyzed showed no beneficial effect of a pulsed Nd:YAG laser compared to conventional therapy (ultrasonics and/or hand instrumentation) in the initial treatment of patients with periodontitis. The pulsed Nd:YAG laser was assessed as monotherapy and as an adjunct to non-surgical periodontal treatment; efficacy was determined by the extent of plaque removal and the reduction of periodontal inflammation. This literature review suggests that there is no evidence to support the superiority of the Nd:YAG laser over traditional modalities of periodontal therapy.

The efficacy of woodsticks on plaque and gingival inflammation : a systematic review

OBJECTIVEnTo review the literature on whether a hand-held triangular woodstick, as compared with no adjunct or other interdental cleaning device in addition to daily toothbrushing, can improve clinical parameters of gingival inflammation.nnnMATERIAL AND METHODSnMEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2008 to identify appropriate studies. Plaque and gingivitis were selected as outcome variables.nnnRESULTSnIndependent screening of the titles and abstracts of 181 MEDLINE and 65 CENTRAL papers yielded seven publications with eight clinical experiments that met the eligibility criteria. The improvement in gingival health, as observed in seven studies, represents a significant incremental benefit realized by the use of triangular woodsticks. None of the studies that scored plaque demonstrated any significant advantage to the use of woodsticks, as opposed to alternative methods, in gingivitis patients.nnnCONCLUSIONnEvidence from controlled trials, most of which were also randomized, shows that woodsticks do not have an additional effect on visible interdental plaque or gingival index, but do, however, provide an improvement in interdental gingival inflammation by reducing the bleeding tendency.

The effect of the Vector® scaler system on human teeth: a systematic review

AIMnTo review the available literature, considering the effect of instrumentation with the Vector ultrasonic scaler on human teeth in vitro and in vivo compared to conventional ultrasonic instruments and/or hand instrumentation. The assessed effects are calculus removal, time of instrumentation, root surface aspects, cell attachment, patients perception, bleeding upon probing, pocket depth, clinical attachment loss and microbiological effects.nnnMATERIALS AND METHODSnMEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched up through January 2008 to identify appropriate studies.nnnRESULTSnIndependent screening of the titles and abstracts of 270 MEDLINE-PubMed and 15 Cochrane papers resulted in 15 suitable publications. The studies differed in design and outcome, so this review summarizes the outcomes in a descriptive manner. Comparisons are presented against conventional ultrasonic system and scaling and root planing.nnnCONCLUSIONnThe Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets. The Vector ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other conventional ultrasonic system. The operator should however consider the extra time needed for instrumentation.

Mechanische en manuele plaquebeheersing

De oorzaak van de twee meest voorkomende mondziekten (i.e. caries en tandvleesontsteking) is plaque op de tanden (tandplaque). Deze plaque is een biofilm die met moeite van de tandoppervlakken verwijderd kan worden. Een biofilm is een complexe gemeenschap van bacterien met eigen regels, hierarchie en manier van communiceren. De producten van de biofilm kunnen een reeks reacties veroorzaken die tot afbraak van het parodontium kunnen leiden (Haffajee & Socransky, 1994). Mechanische verwijdering van de plaque door middel van een tandenborstel is de meest gebruikte methode van mondhygiene.