Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis

BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.

Treating severe periodontitis with staged load applied implant restoration: A case report

BACKGROUND Because immediate implant surgery is not recommended for patients who have been diagnosed with periodontitis,researchers have treated these patients with a variety of methods,including combining orthodontic and periodontal surgeries as well as implantation.However,these treatments cost time and money for the patient.Although it has been reported that temporary implants released a severe gag reflex in 1 case,only a few studies have documented using temporary implants to treat patients diagnosed with severe periodontitis.CASE SUMMARY The patient was a 49-year-old female who was missing the majority of her teeth and had gingival atrophy and severe alveolar bone atrophy.After being diagnosed with severe periodontitis,the patient underwent staged load applied implant restoration therapy.The first load-bearing stage was carried out immediately by inserting temporary Osstem mini implants.Maxillary teeth were extracted by using the guided bone regeneration technique,and lateral maxillary sinus lifting was conducted on both sides.During the second load-bearing stage,temporary implants were removed,and permanent implants were placed.The resin bridge was segmented during the third load-bearing stage.During the fourth load-bearing stage,the permanent prosthesis was positioned in the patient’s mouth.CONCLUSION By conducting the load-bearing treatment in stages,the patient’s mouth contained restorations throughout the procedure,thus guaranteeing basic function and appearance.