Evaluation of Clinical Periodontal Indices and Serum Interleukin-27 by One-stage Full-mouth Disinfection and Quadrant Scaling and Root Planing in Periodontitis
Citation Information :
Rahbar M, Babaloo A, Babaloo Z, Ghasemi S, Amini A. Evaluation of Clinical Periodontal Indices and Serum Interleukin-27 by One-stage Full-mouth Disinfection and Quadrant Scaling and Root Planing in Periodontitis. J Contemp Dent Pract 2018; 19 (8):997-1004.
Introduction: One-stage oral disinfection technique has been developed to prevent cross-contamination between the treated and untreated areas between treatment sessions. Considering the role of inflammatory mediators in periodontitis, this study has been designed to compare the effects of one-stage oral disinfection with quadrant scaling and root planing (Q-SRP) on serum interleukin-27 (IL-27) levels in patients with moderateto- advanced periodontitis.
Materials and methods: In this study, two groups were considered. One group was treated with one-stage full-mouth oral disinfection (FMD), while the other group was treated with Q-SRP. In each group, 20 patients with chronic periodontitis were randomly selected based on the inclusion criteria. To evaluate the periodontal status, the clinical parameters of bleeding on probing (BOP), clinical attachment level (CAL), and probing depth (PD) were measured before treatment as well as at 2- and 4-month intervals after treatment. At the same intervals, the immunological index of the study (serum IL-27) was measured by special laboratory kits. The data were analyzed using the Statistical Package for the Social Sciences, version 16 (SPSS 16) software. In this study, p-value < 0.05 was considered statistically significant.
Results: The results of this study indicate that there has been an elevation in the mean of serum IL-27 after treatment in both treatment groups. There is no significant difference between the levels of IL-27 in the FMD group during the study period (p = 0.20). All periodontal indices (BOP, CAL, and PD) show clinical improvement in each group (p < 0.001). However, no significant difference was observed in the improvement of periodontal indices of CAL and PD (p < 0.05).
Conclusion: According to the findings of this study, it can be said that both FMD and Q-SRP improve the periodontal indices and increase the serum level of the inflammatory mediator IL-27 in patients with periodontitis.
Clinical significance: Considering the benefits of the FMD method, such as patient and dentist comfort, systemic effects, and its cost-effectiveness, use of this method is suggested in patients suffering from periodontitis.
Ryan ME. Nonsurgical approaches for the treatment of periodontal diseases. Dent Clin North Am 2005 Jul;49(3):611-636.
Hannigan E, O'Connell DP, Hannigan A, Buckley LA. Soluble cell adhesion molecules in gingival crevicular fluid in periodontal health and disease. J Periodontol 2004 Apr;75(4):546-550.
American Academy of Periodontology. Proceedings of the 1996 World Workshop in Periodontics. Consensus report. Periodontal diseases: pathogenesis and microbial factors. Ann Periodontol 1996 Nov;1(1):926-932.
Slots J, Rams TE. New views on periodontal microbiota in special patient categories. J Clin Periodontol 1991 Jul;18(6):411-420.
Socransky SS, Haffajee AD. The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol 1992 Apr;63(4 Suppl):322-331.
Wolff L, Dahlén G, Aeppli D. Bacteria as risk markers for periodontitis. J Periodontol 1994 May;65(5 Suppl):498-510.
Beikler T, Abdeen G, Schnitzer S, Sälzer S, Ehmke B, Heinecke A, Flemmig TF. Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy. J Clin Periodontol 2004 Sep;31(9):777-783.
Danser MM, Timmerman MF, van Winkelhoff AJ, van der Velden U. The effect of periodontal treatment on periodontal bacteria on the oral mucous membranes. J Periodontol 1996 May;67(5):478-485.
Danser MM, van Winkelhoff AJ, de Graaff J, Loos BG, van der Velden U. Short-term effect of full-mouth extraction on periodontal pathogens colonizing the oral mucous membranes. J Clin Periodontol 1994 Aug;21(7):484-489.
Petit MD, van Steenbergen TJ, Timmerman MF, de Graaff J, van der Velden U. Prevalence of periodontitis and suspected periodontal pathogens in families of adult periodontitis patients. J Clin Periodontol 1994 Feb;21(2):76-85.
von Troll-Linden B, Saarela M, Mättö J, Alaluusua S, Jousimies- Somer H, Asikainen S. Source of suspected periodontal pathogens reemerging after periodontal treatment. J Clin Periodontol l 996 Jun;23(6):601-607.
Cugini MA, Haffajee AD, Smith C, Kent RL, Socransky SS. The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 2000 Jan;27(1):30-36.
Haffajee AD, Cugini MA, Dibart S, Smith C, Kent RL, Socransky SS. The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol 1997 May;24(5):324-334.
Renvert S, Dahlén G, Wikström M. Treatment of periodontal disease based on microbiological diagnosis. Relation between microbiological and clinical parameters during 5 years. J Periodontol 1996 Jun;67(6):562-571.
Renvert S, Dahlén G, Wikström M. The clinical and microbiological effects of non-surgical periodontal therapy in smokers and non-smokers. J Clin Periodontol 1998 Feb;25(2):153-157.
Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol 1998 Feb;25(2):134-144.
Harper DS, Robinson PJ. Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing. J Clin Periodontol 1987 Apr;14(4): 190-196.
Wade WG, Moran J, Morgan JR, Newcombe R, Addy M. The effects of antimicrobial acrylic strips on the subgingival microflora in chronic periodontitis. J Clin Periodontol 1992 Feb;19(2):127-134.
Lamont RJ, Yilmaz O. In or out: the invasiveness of oral bacteria. Periodontol2000 2002 Sep;30:61-69.
Adriaens PA, De Boever JA, Loesche WJ. Bacterial invasion in root cementum and radicular dentin of periodontally diseased teeth in humans. A reservoir of periodontopathic bacteria. J Periodontol 1988 Apr;59(4):222-230.
Quirynen M, Bollen CM, Vandekerckhove BN, Dekeyser C, Papaioannou W, Eyssen H. Full- vs. partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations. J Dent Res 1995 Aug;74(8):1459-1467.
Jervoe-Storm PM, Koltzscher M, Falk W, Dörfler A, Jepsen S. Comparison of culture and real-time PCR for detection and quantification of five putative periodontopathogenic bacteria in subgingival plaque samples. J Clin Periodontol 2005 Jul;32(7):778-783.
Wennstrom JL, Tomasi C, Bertelle A, Dellasega E. Full-mouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis. J Clin Periodontol 2005 Aug;32(8):851-859.
Zanatta GM, Bittencourt S, Nociti FH, Sallum EA, Sallum AW, Casati MZ. Periodontal debridement with povidone-iodine in periodontal treatment: short-term clinical and biochemical observations. J Periodontol 2006 Mar;77(3):498-505.
Mongardini C, van Steenberghe D, Dekeyser C, Quirynen M. One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset penodontitis. I. Long-term clinical observations. J Periodontol 1999 Jun;70(6):632-645.
Quirynen M, De Soete M, Boschmans G, Pauwels M, Coucke W, Teughels W, van Steenberghe D. Bene.t of “one-stage fullmouth disinfection” is explained by disinfection and root planing within 24 hours: a randomized controlled trial. J Clin Periodontol 2006 Sep;33(9):639-647.
Quirynen M, De Soete M, Dierickx K, van Steenberghe D. The intraoral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol 2001 Jun;28(6):499-507.
Hussain Bokhari SA, Khan AA, Tatakis DN, Azhar M, Hanif M, Izhar M. Non-surgical periodontal therapy lowers serum inflammatory markers: a pilot study. J Periodontol 2009 Oct;80(10):1574-1580.
Apatzidou DA, Kinane DF. Quadrant root planing versus same-day full-mouth root planing. J Clin Periodontol 2004 Mar;31(3):152-159.
Teughels W, Dekeyser C, Van Essche M, Quirynen M. Onestage, full-mouth disinfection: fiction or reality?. Periodontol 2000 2009 Apr;50:39-51.
Carl JW, Bai XF. IL27: its roles in the induction and inhibition of inflammation. Int J Clin Exp Pathol 2008;1(2):117-123..
Shirmohammadi A, Babaloo Z, Eskandari A, Purabbas R, Babaloo A. The effects of one-stage full-mouth disinfection and Quadrant-Wise scaling and root planing on serum levels of IL-17 and IL-1 and clinical parameters (A randomized controlled trial study). J Dent (Tehran) 2013 May;10(3):248-255.
Zijnge V, Meijer HF, Lie MA, Tromp JA, Degener JE, Harmsen HJ, Abbas F. The recolonization hypothesis in a full mouth or multiple-session treatment protocol: a blinded, randomized clinical trial. J Clin Periodontol 2010 Jun;37(6):518-525.
Swierkot K, Nonnenmacher CI, Mutters R, Flores-de-Jacoby L, Mengel R. Onestage full-mouth disinfection versus quadrant and full-mouth root planing. J Clin Periodontol 2009 Mar;36(3):240-249.
Del Peloso Ribeiro E, Bittencourt S, Sallum EA, Nociti FH, Gonc alves RB, Casati MZ. Periodontal debridement as a therapeutic approach for severe chronic periodontitis: a clinical, microbiological and immunological study. J Clin Periodontol 2008 Sep;35(9):789-798.
Eberhard J, Jervoe-Storm PM, Needleman I, Worthington H, Jepsen S. Full mouth treatment concepts for chronic periodontitis: a systematic review. J Clin Periodontol 2008 Jul;35(7):591-604.
Fang H, Han M, Li QL, Cao CY, Xia R, Zhang ZH. Comparison of full mouth disinfection and quadrant wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta analysis. J Periodontal Res 2016 Aug;51(4):417-430.
Mitani A, Niedbala W, Fujimura T, Mogi M, Miyamae S, Higuchi N, Abe A, Hishikawa T, Mizutani M, Ishihara Y, et al. Increased expression of interleukin (IL)-35 and IL-17, but not IL-27, in gingival tissues with chronic periodontitis. J Periodontol 2015 Feb;86(2):301-309.
Meka RR, Venkatesha SH, Dudics S, Acharya B, Moudgil KD. IL-27-induced modulation of autoimmunity and its therapeutic potential. Autoimmun Rev 2015 Dec;14(12):1131-1141.
Predin T, Djuric M, Nikolic N, Mirnic J, Gusic I, Petrovic D, Milasin J. Clinical and microbiological effects of quadrant versus full-mouth root planing.a randomized study. J Dent Sci 2014 Dec;9(4):400-406.
Apatzidou D, Kinane D. Quadrant root planing versus same-day full-mouth root planing. I. Clinical finding. J Clin Periodontol 2004 Feb;31(2):132-140.
Koshy G, Kawashima Y, Kiji M, Nitta H, Umeda M, Nagasawa T, Ishikawa I. Effects of single-visit full-mouth ultrasonic debridement versus quadrant-wise ultrasonic debridement. J Clin Periodontol 2005 Jul;32(7):734-743.
De Genaro Modanese D, Tiosso-Tamburi R, Furletti de Goes VF, de Cassia Bergamaschi C, Martinez EF, Napimoga MH, Peruzzo DC. Clinical and immunoinflammatory evaluation of one-stage full-mouth ultrasonic debridement as a therapeutic approach for smokers with generalized aggressive periodontitis: a short-term follow-up study. J Periodontol 2016 Sep;87(9):1012-1021.
De Soete M, Mongardini C, Peuwels M, Haffajee A, Socransky S, van Steenberghe D, Quirynen M. One-stage full-mouth disinfection. Long-term microbiological results analyzed by checkerboard DNA-DNA hybridization. J Periodontol 2001 Mar;72(3):374-382.
Bollen CM, Vandekerckhove BN, Papaioannou W, Van Eldere J, Quirynen M. Full- versus partial-mouth disinfection in the treatment of periodontal infections. A pilot study: longterm microbiological observations. J Clin Periodontol 1996 Oct;23(10):960-970.
Quirynen M, Mongardini C, de Soete M, Pauwels M, Coucke W, van Eldere J, van Steenberghe D. The role of chlorhexidine in the one-stage full-mouth disinfection treatment of patients with advanced adult periodontitis. Long-term clinical and microbiological observations. J Clin Periodontol 2000 Aug;27(8):578-589.
Hellstrom MK, Ramberg P, Krok L, Lindhe J. The effect of supragingival plaque control on the subgingival microflora periodontitis. J Clin Periodontol 1996 Oct;23(10): 934-940.
Dahlen G, Lindhe J, Sato K, Hanamura H, Okamoto H. The effect of supragingival plaque control on the subgingival microbiota in subjects with periodontal disease. J Clin Periodontol 1992 Nov;19(10):802-809.
Listgarten MA. The structure of dental plaque. Periodontol 2000 1994 Jun;5:52-65.
McNabb H, Mombelli A, Lang NP. supragingival cleaning 3 times a week. The microbiological effects in moderately deep pockets. J Clin Periodontol 1992 May;19(5):348-356.
Westfelt E, Rylander H, Dahlen G, Lindhe J. The effect of supragingival plaque control on the progression of advanced periodontal disease. J Clin Periodontol 1998 Jul;25(7): 536-541.
Waerhaug J. Effect of toothbrushing on subgingival plaque formation. J Periodontol 1981 Jan;52(1):30-34.
Quirynen M, de Soete M, Pauwels M, Goossens K, Teughels W, van Eldere J, van Steenberghe D. Bacterial survival rate on tooth- and interdental brushes in relation to the use of toothpaste. J Clin Periodontol 2001 Dec;28(12):1106-1114.