Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among shamma users and non-users: A randomized controlled trial.
alveolar bone loss
gingival bleeding
periodontal disease
questionnaire
smokeless tobacco
Journal
Journal of periodontology
ISSN: 1943-3670
Titre abrégé: J Periodontol
Pays: United States
ID NLM: 8000345
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
13
08
2019
revised:
18
12
2019
accepted:
23
12
2019
pubmed:
28
1
2020
medline:
20
2
2021
entrez:
28
1
2020
Statut:
ppublish
Résumé
Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non-users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form). The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma-chewers that underwent SRP + PT; 3) group 3: Non-chewers that underwent SRP alone; and 4) group 4: Non-chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3- and 6-month follow-ups. Level of significance was set at P < 0.05. In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3-month follow-up. There was no significant difference in periodontal parameters at 3- and 6-month follow-ups in patients that underwent SRP with and without adjunct PT. Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.
Sections du résumé
BACKGROUND
Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non-users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form).
METHODS
The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma-chewers that underwent SRP + PT; 3) group 3: Non-chewers that underwent SRP alone; and 4) group 4: Non-chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3- and 6-month follow-ups. Level of significance was set at P < 0.05.
RESULTS
In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3-month follow-up. There was no significant difference in periodontal parameters at 3- and 6-month follow-ups in patients that underwent SRP with and without adjunct PT.
CONCLUSIONS
Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.
Identifiants
pubmed: 31985066
doi: 10.1002/JPER.19-0464
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1177-1185Informations de copyright
© 2020 American Academy of Periodontology.
Références
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.
Qadri T, Javed F, Poddani P, Tuner J, Gustafsson A. Long-term effects of a single application of a water-cooled pulsed Nd:yAG laser in supplement to scaling and root planing in patients with periodontal inflammation. Lasers Med Sci. 2011;26:763-766.
Vivekananda MR, Vandana KL, Bhat KG. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: A preliminary randomized clinical trial. J Oral Microbiol. 2010;2.
Galofre M, Palao D, Vicario M, Nart J, Violant D. Clinical and microbiological evaluation of the effect of Lactobacillus reuteri in the treatment of mucositis and peri-implantitis: A triple-blind randomized clinical trial. J Periodontal Res. 2018;53:378-390.
Ikram S, Hassan N, Baig S, Borges KJJ, Raffat MA, Akram Z. Effect of local probiotic (Lactobacillus reuteri) vs systemic antibiotic therapy as an adjunct to non-surgical periodontal treatment in chronic periodontitis. J Investig Clin Dent. 2019;10:e12393.
Bunaes DF, Lie SA, Enersen M, Aastrom AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following non-surgical and surgical periodontal therapy. J Clin Periodontol. 2015;42:933-942.
Preshaw PM, Holliday R, Law H, Heasman PA. Outcomes of non-surgical periodontal treatment by dental hygienists in training: impact of site- and patient-level factors. Int J Dent Hyg. 2013;11:273-279.
Javed F, Al-Rasheed A, Almas K, Romanos GE, Al-Hezaimi K. Effect of cigarette smoking on the clinical outcomes of periodontal surgical procedures. Am J Med Sci. 2012;343:78-84.
Sherwin MA, Gastwirth CM. Detrimental effects of cigarette smoking on lower extremity wound healing. J Foot Surg. 1990;29:84-87.
Mosely LH, Finseth F. Cigarette smoking: impairment of digital blood flow and wound healing in the hand. Hand. 1977;9:97-101.
Katuri KK, Alluri JK, Chintagunta C, et al. Assessment of periodontal health status in smokers and smokeless tobacco users: a cross-sectional study. J Clin Diagn Res. 2016;10:Zc143-zc146.
Daood U, Abduljabbar T, Al-Hamoudi N, Akram Z. Clinical and radiographic periodontal parameters and release of collagen degradation biomarkers in naswar dippers. J Periodontal Res. 2018;53:123-130.
Akram Z, Abduljabbar T, Hosain M, et al. Comparison of periodontal inflammatory parameters among habitual gutka-chewers and naswar-dippers: A split-mouth retrospective clinical study. Acta Odontol Scand. 2018;76:141-147.
Alsanosy RM. Smokeless tobacco (shammah) in Saudi Arabia: a review of its pattern of use, prevalence, and potential role in oral cancer. Asian Pac J Cancer Prev. 2014;15:6477-6483.
Samman MA, Bowen ID, Taiba K, Antonius J, Hannan MA. Mint prevents shamma-induced carcinogenesis in hamster cheek pouch. Carcinogenesis. 1998;19:1795-1801.
Brima EI. Determination of metal levels in shamma (smokeless tobacco) with inductively coupled plasma mass spectrometry (ICP-MS) in Najran. Asian Pac J Cancer Prev. 2016;17:4761-4767.
Salem G, Juhl R, Schiodt T. Oral malignant and premalignant changes in ‘Shammah’-users from the Gizan region. Acta Odontol Scand. 1984;42:41-45.
Al-Tayar B, Tin-Oo MM, Sinor MZ, Alakhali MS. Prevalence and association of smokeless tobacco use with the development of periodontal pocket among adult males in Dawan Valley, Yemen: A cross-sectional study. Tob Induc Dis. 2015;13:35.
Scheifele C, Nassar A, Reichart PA. Prevalence of oral cancer and potentially malignant lesions among shammah users in Yemen. Oral Oncol. 2007;43:42-50.
Al-Askar M, Abduljabbar T, Vohra F, et al. Comparison of self-perceived oral symptoms and periodontal parameters among habitual shamma-chewers, gutka-chewers, and non-chewers. Quintessence Int. 2017;48:251-260.
Brima EI. Detection of cytological changes in oral mucosa among users of smokeless tobacco (shamma) in the KSA. Diagn Cytopathol. 2017;45:693-699.
Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45(suppl 20):S149-s161.
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89(suppl 1):S159-S172.
Alqahtani F, Alqahtani M, Shafqat SS, Akram Z, Al-Kheraif AA, Javed F. Efficacy of mechanical debridement with adjunctive probiotic therapy in the treatment of peri-implant mucositis in cigarette-smokers and never-smokers. Clin Implant Dent Relat Res. 2019;21(4).
Flichy-Fernández A, Ata-Ali J, Alegre-Domingo T, et al. The effect of orally administered probiotic Lactobacillus reuteri-containing tablets in peri-implant mucositis: A double-blind randomized controlled trial. J Periodontal Res. 2015;50:775-785.
Galofré M, Palao D, Vicario M, Nart J, Violant D. Clinical and microbiological evaluation of the effect of Lactobacillus reuteri in the treatment of mucositis and peri-implantitis: A triple-blind randomized clinical trial. J Periodontal Res. 2018;53:378-390.
Tekce M, Ince G, Gursoy H, et al. Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: A 1-year follow-up study. J Clin Periodontol. 2015;42:363-372.
Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25:229-235.
Javed F, Nasstrom K, Benchimol D, Altamash M, Klinge B, Engstrom PE. Comparison of periodontal and socioeconomic status between subjects with type 2 diabetes mellitus and non-diabetic controls. J Periodontol. 2007;78:2112-2119.
Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification. J Periodontol. 2018;89(suppl 1):S1-s8.
Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification. J Clin Periodontol. 2018;45(suppl 20):S1-S8.
Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O. Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: A systematic review and meta-analysis. J Clin Periodontol. 2016;43:520-530.
Lallier TE, Moylan JT, Maturin E. Greater sensitivity of oral fibroblasts to smoked versus smokeless tobacco. J Periodontol. 2017;88:1356-1365.
Payne JB, Johnson GK, Reinhardt RA, Schmid M. Histological alterations following short-term smokeless tobacco exposure in humans. J Periodontal Res. 1998;33:274-279.
Javed F, Chotai M, Mehmood A, Almas K. Oral mucosal disorders associated with habitual gutka usage: A review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:857-864.
Mavropoulos A, Aars H, Brodin P. The acute effects of smokeless tobacco (snuff) on gingival blood flow in man. J Periodontal Res. 2001;36:221-226.
Hallstrom H, Lindgren S, Yucel-Lindberg T, Dahlen G, Renvert S, Twetman S. Effect of probiotic lozenges on inflammatory reactions and oral biofilm during experimental gingivitis. Acta Odontol Scand. 2013;71:828-833.
Shah MP, Gujjari SK, Chandrasekhar VS. Evaluation of the effect of probiotic (inersan(R)) alone, combination of probiotic with doxycycline and doxycycline alone on aggressive periodontitis-a clinical and microbiological study. J Clin Diagn Res. 2013;7:595-600.
Pelekos G, Ho SN, Acharya A, Leung WK, McGrath C. A double-blind, paralleled-arm, placebo-controlled, randomized clinical trial of the effectiveness of probiotics as an adjunct in periodontal care. J Clin Periodontol. 2019;46(12):1217-1227.
Javed F, Al-Kheraif AA, Al Amri MD, et al. Periodontal parameters and whole salivary cytokine profiles among habitual gutka chewers and non-chewers. J Periodontol. 2015;86:689-695.
Javed F, Vohra F, Al-Kheraif AA, Malmstrom H, Romanos GE. Comparison of periodontal inflammatory conditions among habitual gutka chewers and betel quid chewers. Oral Dis. 2015;21:437-442.
Colombo AP, Boches SK, Cotton SL, et al. Comparisons of subgingival microbial profiles of refractory periodontitis, severe periodontitis, and periodontal health using the human oral microbe identification microarray. J Periodontol. 2009;80:1421-1432.
Vohra F, Akram Z, Bukhari IA, Sheikh SA, Riny A, Javed F. Comparison of periodontal inflammatory parameters and whole salivary cytokine profile among Saudi patients with different obesity levels. Int J Periodontics Restorative Dent. 2018;38:e119-e126.
Kellesarian SV, Malignaggi VR, Majoka HA, et al. Effect of laser-assisted scaling and root planing on the expression of pro-inflammatory cytokines in the gingival crevicular fluid of patients with chronic periodontitis: A systematic review. Photodiagnosis Photodyn Ther. 2017;18:63-77.
Javed F, Thafeed Alghamdi AS, Mikami T, et al. Effect of glycemic control on self-perceived oral health, periodontal parameters, and alveolar bone loss among patients with prediabetes. J Periodontol. 2014;85:234-241.
Javed F, Al Amri MD, Al-Kheraif AA, et al. Efficacy of non-surgical periodontal therapy with adjunct Nd:yAG laser therapy in the treatment of periodontal inflammation among patients with and without type 2 diabetes mellitus: A short-term pilot study. J Photochem Photobiol B. 2015;149:230-234.