Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis

Background and objective: Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a systematic review and meta-analysis to assess severity of periodontitis in subjects with dementia. Methods: The search was conducted in Pubmed, Embase/MEDLINE. Two independent reviewers extracted data and assessed the risk bias (Newcastle–Ottawa scale). Meta-analyses were performed using the means of probing depth (PD) and clinical attachment loss (CAL) in patients with or without dementia. The mean difference were analyzed (P ≤ 0.05). Results: Fourteen studies were included in the systematic review. In the qualitative analysis, most studies reported higher prevalence of periodontal disease in dementia patients. The studies had low risk of bias and two meta-analyses were performed for each parameter, including or not a cross-sectional study. The meta-analyses including the cross-sectional study demonstrated significant association between dementia and periodontal disease (mean difference: PD = 1.41; CAL = 1.40, P < 0.05), however, it wasn't confirmed when the cross-sectional study was removed (1.25 mm, P < 0.22) and CAL (1.20 mm, P < 0.22). Conclusion: Although the qualitative analysis have suggested worse periodontal conditions in dementia patients, due to different study types and the high heterogeneity among them, the meta-analysis does not support the association between dementia and severity of periodontal disease

Experimental periodontal disease treatment by subgingival irrigation with tetracycline hydrochloride in rats

OBJECTIVE: The aim of this study was to compare subgingival irrigation with tetracycline hydrochloride (TTC-HCL) as adjunctive treatment to scaling and root planning (SRP) on induced periodontitis in rats. MATERIAL AND METHODS: In 60 rats, periodontal disease was ligature-induced at the mandibular left first molar. After 7 days, the ligature was removed and all animals were submitted to SRP, and divided into 2 groups according to the following treatment: C (n=30) - subgingival irrigation with 1 mL of saline; T (n=30) - subgingival irrigation with 1 mL of TTC-HCL (50 mg/mL). Ten animals in each group were euthanized at 7, 15 and 30 days posttreatment. The histometric values were statistically analyzed (p<0.05). RESULTS: In the histometric analysis, at 7, 15 and 30 days, Group T (0.72±0.05 mm(2), 0.57±0.14 mm(2), 0.62±0.07 mm(2)), showed less bone loss (p<0.05) than Group C (1.35±0.25 mm(2); 1.40±0.31 mm(2); 1.29±0.27 mm(2)), respectively. CONCLUSIONS: Subgingival irrigation with TTC-HCL was an effective adjunctive treatment for periodontal disease induced in rats

Antibiotics plus probiotic as an adjunct to the treatment of periodontitis in smokers: a short-term study

Aim: The purpose of this study was to perform a short-term evaluation of the effects of a probiotic, associated with the use of antibiotics as an adjuvant treatment of periodontitis in smokers. Materials and Methods: Thirty-four patients were randomly divided into: PRO group (n = 17), patients received a single session of scaling and root planing (SRP) associated with the systemic administration of Lactobacillus reuteri tablets; ANT+PRO group (n=17), patients received a single session of SRP followed by the systemic administration of Amoxicillin and Metronidazole 3x/day for 7 days and administration of Lactobacillus reuteri seven days after conclusion of antibiotic therapy. Clinical periodontal parameters were evaluated. Results: After treatment, both groups showed a reduction in BOP, PI, and residual pockets compared to baseline, while in the ANT+PRO group there was a significant reduction in PD and CAL gain (p5mm was observed in the ANT+PRO group (p<0.05). Conclusion: Both adjuvant treatments reduced the residual pockets and controlled inflammation after treatment. Only the association of antibiotic with probiotic therapy was able to efficiently reduce mean PD, the number of pockets with PD >5 mm, and promote additional CAL gains in a short-term evaluation period