The latest update on full-mouth disinfection shows no added benefit of chlorhexidine use.
Trisha E. O`Hehir, RDH, BS
The following abstracts were presented at the International Association of Dental Research meeting in April in Washington, D.C.:
- The extensive use of chlorhexidine following full-mouth instrumentation provided no added benefit over full-mouth instrumentation within 24 hours. At the end of eight months, both groups receiving treatment showed 2 millimeters of attachment gain. (As a footnote to this new research, Dr. Norman Trieger of the Albert Einstein College of Medicine), first published work on full-mouth debridement in 1982.) (Abstract #3723)
- The use of sub-antimicrobial-dose doxycycline, Periostat®, did not result in changes in the composition or resistance of fecal or vaginal microflora. (Abstract #3718)
- Preliminary results suggest beneficial use of Periostat for patients who have a positive periodontitis genetic test score. This finding is based on biochemical findings in a pilot study of four patients over five months. (Abstract #3719)
- Professional-assisted supragingival plaque control over four weeks resulted in significant reductions in the clinical signs of periodontal disease. Twenty-four periodontal patients were examined before and one week after the supervised plaque- control program. The patients in this program saw plaque reductions of 80 percent, bleeding on probing reductions of 32 percent, and a 42 percent reduction in the number of deep pockets. (Abstract #3502)
- Simple debridement without the use of local anesthesia, plus Atridox®, resulted in greater healing than thorough scaling and root-planing using local anesthesia. In the debridement plus Atridox group, 69 percent of pockets initially five millimeters or deeper required no further treatment, compared to 60 percent in the scaling and root-planing group. In the Atridox group, 38 percent of all sites showed improvement of 2 millimeters or more, compared to 29 percent of sites in the scaling and root-planing group. A total of 105 patients were treated. (Abstract #2992)
- A bioresorbable wafer containing silver was tested in nine volunteers, each with four sites of five millimeters or more. After 21 days, silver still was detected in the pockets, and significant reductions in subgingival bacteria were evident. Some staining was present on root surfaces, which was polished off after the study. Periodontix, Inc., in Watertown, Mass., makes these silver wafers. (Abstract #2990)
- Comparison of Atridox, PerioChip® and Elyzol® resulted in clinical improvements for all patients. Forty-seven patients received scaling and root-planing two to four months before baseline. Any remaining pockets measuring five millimeters or more with bleeding upon probing received the local-delivery products. Forty-two percent of Atridox-treated sites gained 1 millimeter of attachment Nine percent gained 2 millimeters. These figures were 36 percent and 6 percent, respectively, for PerioChip, and 34 percent and 8 percent for Elyzol. This is the first direct comparison of the newest local-delivery products. (Abstract #2989)
- Traditional toothbrushing was compared to an eyes-closed, meditative emphasis on feeling the bristles on the gum tissue. These two methods were compared in school children over a six-week period. The meditative, proprioceptive method resulted in greater reductions in both plaque and gingival bleeding. (Abstract #1248).
- Comparing 117 pairs of twins, researchers determined that approximately half of the variance in gingivitis and periodontitis in the population could be attributed to genetic differences. (Abstract #917)
- An indirect vaccine may provide effective caries protection. Pregnant cows were immunized with an altered strain of strep mutans. Milk was collected and used as a rinse by 12 volunteers twice daily for 20 days. Strep mutan levels in lingual plaque samples were reduced for 10 days following the rinsing. (Abstract #806)
- Results of an animal study suggest that tobacco products actually stimulate the production of MMPs, which are enzymes that break down connective tissue.(Abstract #689)
- Supragingival calculus may not be simply mineralized plaque, but rather a highly complex structure composed of both calcified and noncalcified regions, which may also contain viable bacteria. (Abstract #90)
- White blood cells (PMNs) sent to the gingival sulcus to fight bacterial infection may actually invade plaque biofilms, die by necrosis, and thus break up the biofilm. This may be a specific response of the host defense system to control bacterial biofilm. (Abstract #89)
- Increasing evidence supports the association between periodontal infections and cardiovascular disease, including atherosclerosis, heart attack, and stroke. Bacterial pathogens of periodontal disease may contribute to local vascular pathology. People with periodontal disease are twice as likely to have thick arterial walls. (Abstract #1481).
Trisha E. O`Hehir, RDH, BS, is a senior consulting editor of RDH. She also is editor of Perio Reports, a newsletter for dental professionals that addresses periodontics. The Web site for Perio Reports is www.perioreports.com. She can be reached by phone at (800) 374-4290 and by e-mail at [email protected].