Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, sometimes leading to failure. This literature review was conducted to investigate the diversity of other therapeutic approaches and their potential contributions to the successful management of the disease. This research scrutinized the alterations in microbial diversity and imbalances in crucial microbial species, which contribute significantly to the pathogenesis of periodontitis. Within the limitations of this study, we highlight the importance of understanding the treatment plan’s role in periodontitis disease, opening the way for further research and innovative treatment plans to mitigate the impact of periodontitis on oral health. This will aid both healthcare professionals and patients in preventing and effectively treating periodontitis, ultimately improving oral health outcomes and overall systemic health and well-being.

Exploring the Efficacy of Novel Therapeutic Strategies for Periodontitis: A Literature Review

Research in the field of periodontal disease continues to focus on disease-associated microorganisms, as the microbial plaque and the host immune responses are considered to be important causative factors, that are highly responsible for the progression of this disease. The purpose of this article is to compare the reduction in the number of specific periodontopathogens in two test groups according to different therapeutic approaches in periodontal disease and to show possible differences. This article is based on a prospective clinical study involving eighteen subjects with forty-four average periodontal pockets assigned to study groups treated by two different methods, SRP and SRP followed by a single PDT application. Efficiency in removing specific bacterial species was evaluated by PCR testing, at baseline and immediately after treatment. The hypothesis that using SRP + aPDT results in an increased decontamination potential was confirmed statistically, when all five specific bacterial pathogens were investigated together. When the pathogens were considered separately, two of the five microorganisms tested were significantly lower in the SRP + PDT group (p < 0.00), and important germ counts reductions were also observed for the other three. There is also a statistically significant relation between the pain at 48 h postoperatively and the type of treatment the patients received, as resulted from the Questionnaire Form. Our results demonstrate that aPDT, as an adjunctive treatment to conservative mechanical cleaning of root surfaces at sites affected by periodontitis, represents an effective tool in terms of reducing specific periodontopathogen germs.

/pdf/the-efficiency-of-photodynamic-therapy-in-the-bacterial-3q9gwf4l.pdf

The Efficiency of Photodynamic Therapy in the Bacterial Decontamination of Periodontal Pockets and Its Impact on the Patient

AIM
Periodontitis is an inflammatory, infectious disease of polymicrobial origin that can damage tooth-supporting bone and tissue. Tree shrews, evolutionarily closer to humans than commonly used rodent models, have been increasingly used as biomedical models. However, a tree shrew periodontitis model has not yet been established.


MATERIALS AND METHODS
Periodontitis was induced in male tree shrews/Sprague-Dawley rats by nylon thread ligature placement around the lower first molars. Thereafter, morphometric and histological analyses were performed. The distance from the cemento-enamel junction to the alveolar bone crest was measured using micro-computed tomography. Periodontal pathological tissue damage, inflammation and osteoclastogenesis were assessed using haematoxylin and eosin staining and quantitative immunohistochemistry, respectively.


RESULTS
Post-operatively, gingival swelling, redness and spontaneous bleeding were observed in tree shrews but not in rats. After peaking, bone resorption decreased gradually until plateauing in tree shrews. Contrastingly, rapid and near-complete bone loss was observed in rats. Inflammatory infiltrates were observed 1 week post operation in both models. However, only the tree shrew model transitioned from acute to chronic inflammation.


CONCLUSIONS
Our study revealed that a ligature-induced tree shrew model of periodontitis partly reproduced the pathological features of human periodontitis and provided theoretical support for using tree shrews as a potential model for human periodontitis.

The tree shrew as a new animal model for the study of periodontitis.

Periodontal screening is an important tool in dental practice, and the BPE system is recommended. Clinically, visual examination should identify inflammatory change, recession and enlargement. However, detailed periodontal charting is required in all patients with significant levels of disease. In addition, radiographic examination is important to verify loss of bone and to show root anatomy.

Periodontal Examination and Screening

Supragingival plaque control on a daily basis should resolve gingivitis and is fundamental to the management of periodontitis. Subgingival plaque control has been termed subgingival scaling, root planing, root surface debridement and professional mechanical plaque removal (PMPR). Most cases of periodontitis should respond well to this treatment.

Non-surgical Treatment and Supportive Periodontal Care

Periodontal assessment of multirooted teeth can be difficult because the entrances of the furcations may be inaccessible. Furcation involvement is graded according to the distance to which the furcation can be probed in a horizontal direction from each of the entrances. Treatment options are conceptually consistent with those for single-rooted teeth, with the addition of root resection, root separation and hemisection. Regenerative treatments may produce less predictable results because of the complicated anatomy.

Treatment of Multirooted Teeth

The lateral periodontal abscess is normally associated with a deep pocket on a vital tooth. The first line of treatment is drainage via the pocket and root surface debridement under local anaesthesia.

Diagnosis and Management of Acute Conditions

Surgical techniques for the regeneration of the periodontal ligament include the use of membranes and grafts, and the application of biological agents and growth factors.

Reconstructive and Periodontal Plastic and Aesthetic Surgery

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