title: Case Series Report of 66 Refractory Maintenance Patients Evaluating the Effectiveness of Topical Oxidizing Agents.
abstract: OBJECTIVE
  To evaluate the clinical effects of a prescription tray application of hydrogen peroxide gel as an adjunct to frequent maintenance appointments for refractory periodontal patients.
  
  
  METHODS
  Case series data were analyzed from 66 failing periodontal maintenance patients who had exhausted treatment options before using prescription trays with a 1.7% hydrogen peroxide gel once or twice daily for two-and-a-half to five years. Data included pocket probing depths (PPD), bleeding on probing (BOP), smoking status, and compliance with tray usage. Data were collected prior to tray usage and after tray delivery at six months, one year, and annual intervals.
  
  
  RESULTS
  A clinical and statistical reduction in BOP was maintained over the length of the study (p ≤ 0.01). No differences were seen in patients who used trays two times or one time a day or in patients who smoked or did not smoke. The 1.7% peroxide delivered via a prescription tray was most effective in shallow pockets. Aggregate PPD distribution did not change significantly. Of clinical relevance, only one tooth out of 1,745 teeth studied was lost due to periodontal disease during the study period.
  
  
  CONCLUSIONS
  Prescription tray application of peroxide gel, as an adjunct to frequent periodontal maintenance appointments for refractory patients, demonstrated significant reductions in BOP'for smokers and non-smokers who used tray delivery once or twice a day.
authors: R Bruce
authors: RB
authors: Cochrane
authors: Betty
authors: B
authors: Sindelar
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D005884:Gingival Hemorrhage / Q000188:drug therapy; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016877:Oxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D010349:Patient Compliance; D057747:Periodontal Debridement / Q000379:methods; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D012907:Smoking; D013524:Surgical Flaps / Q000601:surgery; D016388:Tooth Loss / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005782:Gels; D016877:Oxidants; D006861:Hydrogen Peroxide