Bleeding On Probing Levels Research Articles

Air-polishing followed by ultrasonic calculus removal for the treatment of gingivitis: A 12-month, split-mouth randomized controlled clinical trial.

To evaluate the advantages of a novel protocol involving full-mouth erythritol-powder air-polishing followed by ultrasonic calculus removal in the maintenance of patients treated for gingivitis, with a focus on time and comfort. Systemically healthy patients with gingivitis were selected. Following a split-mouth design, quadrants 1-4 and 2-3 were randomly allocated to receive air-polishing followed by ultrasonic calculus removal following a protocol known as Guided Biofilm Therapy (GBT) or traditional full-mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US + P). Bleeding on probing (BoP) and the plaque index (PI) were collected at baseline (T0), 2 weeks (T1), 4 weeks (T2), 3 months (T3), and 6 months (T4) and 12 months (T5). Following the same randomization, prophylactic therapy was provided at 3 months (T3) and 6 months (T4). Clinical parameters, treatment time and patient comfort and satisfaction were evaluated. A total of 41 patients were selected, 39 completed the study. The clinical parameters were clinically satisfactory for both treatments at every time. At 4 months after treatment, GBT maintained significantly lower BoP and PI. GBT protocol required a significantly lower treatment time, especially at T3 and T4, when it saved 24.5% and 25.1% of the time, respectively. Both treatments were rated positively by most patients. However, GBT was perceived as more comfortable, and a higher number of patients preferred it. No significant difference was observed between GBT and conventional ultrasonic debridement and rubber cup polishing in terms of BoP and PI levels. The GBT protocol allowed less time expenditure and higher patients' perceived comfort.

Saliva and GCF cytokine levels in insulin-dependent diabetic teens and their relationship with metabolic status and disease duration

ObjectiveHyperglycemia damages periodontal tissues by several mechanisms, primarily via dysregulated cytokine production. However, studies examining the relationship between cytokine levels, periodontal status, and diabetes-related parameters in teenage Type 1 Diabetes Mellitus (T1DM) patients are scarce. This investigation aimed to determine the levels of cytokines such as IL-33, IL-22, IL-17, IL-6, TNF-α and interferon (IFN)-γ in the saliva and gingival crevicular fluid (GCF) of T1DM teens and correlate these values with the patients’ periodontal health and DM-related parameters such as FBG, HbA1c, and diabetes duration. Material and methodsSaliva, GCF samples and full-mouth clinical periodontal recordings were obtained from 40 T1DM and 40 non-diabetic teenagers. IFN-γ, TNF-α, IL-6, IL-17, IL-22, and IL-33 levels were analyzed by ELISA. ResultsClinical bleeding on probing (BOP) and periodontal probing depth measures did not differ between the groups. The plaque and gingival index, as well as saliva and GCF levels of all cytokines tested were found to be comparatively higher in the cases. Correlations were detected between the duration of DM and salivary IL-17 and IL-33 levels, between FBG and GCF IL-17 levels, and between BOP and salivary IL-33 levels. Salivary IL-17 and IL-33 levels showed significant correlation solely with the duration of DM. ConclusionsIL-33 and IL-17 appear to be a potent combination of cytokines in regulating salivary composition over time in Type I diabetic teens. A better understanding of the time-dependent release of salivary cytokines in Type I diabetic teens may help develop treatment strategies and improve oral health.

Periodontitis in young individuals: Important factors for disease progression.

To investigate the progression of periodontitis in young individuals and identify factors that contribute to progression rate and whether periodontitis stage and grade have an impact on disease progression. This retrospective cohort study was based on patients younger than 36 years at two periodontal clinics between 2003 and 2009. At least 10 years later, a clinical and radiographic examination was performed on 215 patients. The marginal bone loss between baseline and follow-up for the tooth with the most severe bone loss at follow-up was estimated by radiographic measurements. Linear regression analysis was used to investigate the influence of potential risk indicators on periodontitis progression. Most patients (83%) were classified as periodontitis stage III at baseline. At follow-up, 70% of these patients remained in stage III. The frequency of patients with grade C decreased from 79% to 17% at follow-up. The median (Q25%; Q75%) of the longitudinal marginal bone loss was 0.5 mm (0.0; 2.0). High bleeding on probing (BOP) index at baseline, smoking and interruption of periodontal treatment were found to significantly increase longitudinal bone loss. High levels of BOP at baseline, smoking and interruption of periodontal treatment increased the risk of marginal bone loss. The stage and grade at baseline had no significant impact on disease progression.

The "double-edged" role of progesterone in periodontitis among perimenopausal women undergoing or not undergoing scaling and root planing.

Progesterone (PG) is an important sex steroid hormone commonly administered to protect the endometrium in perimenopausal women. The present study aimed to explore differential responses of periodontitis to PG in perimenopausal women who did or did not undergo scaling and root planing (SRP). A total of 129 perimenopausal women with mild-to-moderate periodontitis were enrolled and underwent treatment as follows: SRP (n = 35); SRP + PG (n = 34); PG (n = 31); and no treatment (s) (n = 29). Pocket probing depth (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and bleeding on probing (BOP) were measured using periodontal probes. Three inflammatory markers, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) were measured using ELISA techniques. PPD, CAL, SBI, BOP, and levels of inflammatory factors in GCF were all significantly decreased in perimenopausal women with periodontitis after SRP. In patients who did not undergo SRP, 6 months of PG treatment significantly elevated PPD, SBI, BOP, and GCF levels of CRP, IL-6, and TNF-α. In contrast, PG exhibited inhibitory effects on periodontal inflammation in patients who underwent SRP, evidenced by significantly decreased BOP and IL-6, and slightly decreased SBI, CRP, and TNF-α. PG-induced changes dissipated 6 months after withdrawal of PG (at 12 months). Among perimenopausal women with periodontitis, PG enhanced periodontal inflammation in the absence of SRP but inhibited periodontal inflammation in those who underwent SRP.

Fermented lingonberry juice's effects on active MMP-8 (aMMP-8), bleeding on probing (BOP), and visible plaque index (VPI) in dental implants-A clinical pilot mouthwash study.

We aimed to study the effects of fermented lingonberry juice (FLJ) as a mouthwash on the levels of active matrix metalloproteinase-8 (aMMP-8) in peri-implant sulcular fluid (PISF), bleeding on probing (BOP), and visible plaque index (VPI). We hypothesized that FLJ rinsing could reduce inflammation (aMMP-8 and BOP) and microbial load (VPI) in the oral cavity, especially around dental implants. A clinical pilot study was performed using FLJ as a mouthwash. The inclusion criteria were at least one dental implant in the anterior or posterior areas with a screw-retained crown. Ten participants used 10 ml of mouthwash twice a day for 15 days, and 10 participants served as the control group. Point-of-care tests (POCTs) were used to measure aMMP-8 levels in the PISF, and BOP and VPI were recorded at the beginning of the trial and after 15 and 30 days. The FLJ mouthwash had a reductive effect on aMMP-8, VPI, and BOP in the mouthwash group; however, there was no significant difference compared to the control group. The difference in VPI and BOP levels between the groups diminished after the lingonberry regimen ended. The decrease in aMMP-8 levels appeared to continue even after discontinuation of the mouthwash regimen. The reduction in the amount of plaque, aMMP-8, and BOP by FLJ was promising and continuous considering the relatively short study period and sample size. FLJ is a natural and safe supplement for oral and dental implant home care. Further studies are required to verify these promising results.

The effect of oolong tea as an adjunct to nonsurgical management of chronic periodontitis: A randomized controlled clinical trial

Introduction: Oolong tea, a functional food, has numerous therapeutic benefits owing to the presence of bioactive polyphenols, theasinensins (TS) and catechins. The present study aimed to evaluate the influence of systemic administration of oolong tea as an adjunct to nonsurgical periodontal therapy (NSPT) in the management of chronic periodontitis (CP).Methods: A total of 60 subjects with mild to moderate CP were randomly divided into two groups of tests (n = 30) and the controls (n = 30). They underwent NSPT with adjunctive oolong tea supplementation in the test group only. At baseline, 1, and 3 months, their gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment loss (CAL), percentage of sites with bleeding on probing (BOP), and lobene stain index (LSI) were recorded. Furthermore, the levels of glutathione peroxidase (GPx), total antioxidants (TAO), and malondialdehyde (MDA) were also estimated in gingival crevicular fluid (GCF), saliva and serum. Additionally, colony-forming units (CFUs) of selective supra and subgingival plaque bacteria were estimated in the plaque samples.Results: In both groups, at 1 month, the GI, PI, BOP, GPx, and TAO levels were improved with a reduction in the levels of MDA and CFU’s and no staining of teeth (P < 0.05). The results were maintained in the test group at 3-month recall visit.Conclusion: Adjunctive administration of oolong tea with NSPT reduced the local and systemic oxidative burden and rapidly resolved the inflammation in CP. This would be specifically beneficial in CP subjects with systemic conditions.

Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri‐implantitis: A prospective clinical case series

Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p< 0.001) and 14% (p< 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p< 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p< 0.001). The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow-up and constitutes a viable option for the management of peri-implantitis.

Effect of alveolar ridge preservation on clinical attachment level at adjacent teeth: A randomized clinical trial.

To test whether or not alveolar ridge preservation (ARP) changes the clinical attachment level (CAL) at adjacent teeth of extraction sockets after 6months. Seventeen patients requiring bilateral tooth extractions of the upper molars were recruited. After tooth extraction, the sockets were randomly allocated to two groups applying a split-mouth design: (1) ARP using deproteinized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen membrane and (2) spontaneous healing (control). CAL, probing pocket depth (PD), bleeding on probing (BOP), gingival recession (REC), and bone levels were evaluated at the adjacent teeth of the extraction sockets at baseline and after 6months of follow-up. A total of 14 patients were available for reexamination. From baseline to 6months of follow-up mean CAL changes of all six sites at adjacent teeth of the extraction sockets amounted to -0.23 ± 0.65 mm (gain) in ARP group and 0.05 ± 0.86 mm (loss) in the control group with significant differences in favor of ARP (p=0.04). The CAL gain was significantly more favorable at mesiopalatal sites (p=0.01). Consistently, the mean reduction of PD of all six sites amounted to -0.68 ± 0.84 mm in ARP and -0.34 ± 0.74 mm in the control group (intergroup p=0.02). The PD reduction was significant (p=0.001) at the mesiopalatal sites in ARP. BOP, REC, and bone levels showed no significant differences between the groups (intergroup p > 0.05). Although ARP with DBBM-C revealed a trend toward CAL gain and PD reduction at adjacent teeth of extraction sites, these adjunctive benefits seem to be clinically negligible.

Comparison of the Effect of Er,Cr:YSGG Laser and Halita Mouthwash on Oral Malodor in Patients With Chronic Periodontitis: A Randomized Clinical Trial.

Introduction: Periodontal disease and tongue coatings are among the major factors associated with oral malodor. The present study, comparatively evaluated the effects of the Er,Cr:YSGG laser and Halita mouthwash as adjunctive treatments to nonsurgical periodontal debridement on oral malodor reduction in chronic periodontitis patients. Methods: Sixty patients with stage II and III chronic periodontitis and bad breath. The patients were randomly divided into two groups (n=30). After conventional scaling and root planing, patients in group 1 underwent Er,Cr:YSGG laser (Waterlase; Biolase, San Clemente, CA, USA) irradiation of the internal surface of the pockets (1.5 W, 30 Hz, 20% A, 40% W) and the dorsum of the tongue (1 W, 30 Hz, 20% A, 40% W) immediately after SRP and on the third and seventh days. Group 2 patients were asked to use Halita mouthwash twice daily for one week. Baseline, 1 and 3-month post-treatment measurements of plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and organoleptic assessment of Halitosis severity were performed. Results: Significant improvement in all parameters was noted in both groups after 1 and 3 months, compared with baseline (P < 0.05). The two groups had significant reductions which occurred in PPD, CAL and BOP levels and the organoleptic score in 1 and 3 months after the intervention (P < 0.05). Conclusion: Er,Cr:YSGG laser irradiation and Halita mouthwash as adjuncts to non-surgical periodontal therapy are both effective in the treatment of oral malodor and improvement of periodontal parameters.

Salivary Metalloproteinase-8 and Metalloproteinase-9 Evaluation in Patients Undergoing Fixed Orthodontic Treatment before and after Periodontal Therapy.

(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. When gingival inflammation is present, the forces produced during orthodontic tooth movement can aggravate tissue reaction and cause the destruction of supportive periodontal tissue. This study aimed to identify biomarkers that facilitate the assessment of periodontal status during orthodontic treatment. (2) Methods: Our study was conducted on 111 patients who were about to receive fixed orthodontic treatment. We determined the salivary levels of MMP-8 and MMP-9 and bleeding on probing (BOP) before applying the orthodontic fixed appliance (T1), one week after appliance placement (T2), and during orthodontic treatment, one month after non-surgical periodontal treatment (T3). (3) Results: Patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement (T2) and a decrease in these parameters one month after periodontal treatment (T3). Statistically significant correlations were found between MMP-8 levels and BOP values at T1, T2, and T3. (4) Conclusion: In our study patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement and a decrease in these parameters one month after periodontal treatment. Strong positive statistically significant correlations were found between MMP-8 levels and BOP and medium positive statistically significant correlations between MMP-9 and BOP values before and after orthodontic treatment and periodontal treatment. MMP-8, MMP-9, and BOP could be used to assess the periodontal status of orthodontic patients.

Effect of Age on Bleeding on Probing (BOP) as an Indicator of Periodontal Inflammation in Patients Enrolled in Supportive Periodontal Therapy.

To assess the effect of age on the mean percentage of bleeding on probing (BOP) during supportive periodontal therapy (SPT) in patients enrolled in SPT for at least 5 years. Materials and Methods: This study was performed as a retrospective analysis of data collected from SPT patients initially diagnosed with gingivitis or mild to severe periodontitis. Two groups of patients were selected: in group A, younger adults (age ≤ 35 years) were included while group B consisted of older SPT patients (age ≥ 65 years). BOP in the two groups was compared according to both disease severity and % compliance with SPT visits. Results: BOP in all patients (n = 236) was 19.2% (± 12.4). Group A (n = 110) presented mean BOP levels of 19.7% (± 11.8), while lower BOP levels of 18.7% (± 13.0) were found in group B (n = 126; p = 0.5272). Older patients demonstrating high % compliance had lower mean BOP levels (14.2% ± 9.5) than younger patients (18.0% ± 11.7; p = 0.0841). Similarly, BOP was lower in older patients with moderate (group B: 18.4% ± 12.1, group A: 19.3% ± 14.6, p = 0.0541) or severe periodontitis (group B: 22.4% ± 11.4, group A: 23.2% ± 14.0; p = 0.3440). In patients with moderate or severe periodontitis and higher % compliance with SPT, the mean BOP was statistically significantly lower in older patients than in younger patients (moderate: 14.4% ± 11.9 vs 19.4% ± 15.1, p < 0.0001; severe: 13.2% ± 11.1 vs 18.3% ± 17.5, p = 0.0170). Conclusion: Older patients enrolled in SPT may present lower levels of BOP. This finding should be considered when determining SPT intervals with elderly patients.

Low association between bleeding on probing propensity and the salivary aMMP-8 levels in adolescents with gingivitis and stage I periodontitis.

Bleeding on probing (BOP) is a widely accepted measure used in periodontal diagnostics. Previous studies suggest that several factors can affect BOP propensity. The aim of this study was to investigate the relative impact of different local and modifying factors on BOP levels. The oral health of five hundred and forty-four adolescents (two birth cohorts) aged 15-17years living in Kotka, Finland, was examined including periodontal probing depth, visible plaque index, root calculus, and BOP. Whole saliva samples were collected and measured for active matrix metalloproteinase-8 (aMMP-8) by time-resolved immunofluorometric assay (IFMA). Bacterial plaque/calculus accumulation (oral hygiene) had a major influence on BOP levels. The relative impact was several times greater compared with the extent of periodontal pocketing, aMMP-8 levels, smoking, toothbrushing, or gender. Furthermore, BOP levels were significantly elevated among adolescents with poor oral hygiene than good oral hygiene even if adjusted for the extent of periodontal pocketing (P<.001). BOP levels could be low even if several≥4mm deep periodontal pockets existed. The difference in the extent of periodontal pocketing was not significant between the two birth cohorts of adolescents (P=.731). BOP levels can be regarded as an important indicator of the extent of bacterial challenge and its adverse effects on the gingival inflammation. However, the level of oral hygiene may mask the association between the extent of gingival bleeding and the severity of the periodontal inflammatory condition. Thus, relying on BOP levels (below 10% or 20%) may provide insufficient information about the periodontal treatment need of an adolescent depending on his/her level of oral hygiene. Yet, more research is needed to confirm the results, also in adult populations.

Evaluation of Salivary Matrix Metalloproteinase (MMP-8) in Periodontal Patients Undergoing Non-Surgical Periodontal Therapy and Mouthwash Based on Ozonated Olive Oil: A Randomized Clinical Trial.

Background: Extracellular matrix metalloproteinases (MMPs) play a pivotal role in the damage to the periodontal tissue in patients with periodontitis. Scaling and root planning (SRP) attempt to control the plaque amount and consequentially reduce the bacterial load. Non-surgical periodontal treatment could be integrated with drug therapy and physiotherapy procedures such as ozone therapy. The aim of this study was to evaluate in a cohort of patients with a diagnosis of periodontitis: (1) the efficacy of non-surgical periodontal therapy assisted by the use of ozonated olive oil-based mouthwash on salivary metalloproteinase (MMP-8) and (2) the reduction of periodontal indices. Methods: Ninety-six subjects with a diagnosis of periodontitis were enrolled in this study and randomly assigned to the study group (SRP + mouthwash) or control group (SRP). The study duration was 3 months. Data on MMP-8, plaque index (PI), bleeding on probing (BoP) and probing pocket depth (PPD) were recorded at T0, T1 (14 days), T2 (1 month) and T3 (6 months). Group differences were assessed using Student’s t-test for independent samples. Results: A significant improvement in PI, BoP, PPD and salivary MMP-8 levels was observed in both groups. An analysis of differences in relative changes of indices revealed the efficacy of ozonated olive oil in decreasing MMP-8 level. Simultaneously, it slowed the decrease of BoP index. Conclusions: Scaling and root plaining with the aid of ozonated olive oil mouthwash were found to be more effective on salivary MMP-8 reduction than scaling and root plaining alone.

Efficacy of a novel post-foaming dental gel on gingival inflammation: A randomized controlled clinical trial.

A pilot randomized controlled clinical trial was performed to evaluate the efficacy of a post-foaming dental gel containing cetylpridinium chloride (CPC), hydrogen peroxide (H2 O2 ), sodium bicarbonate, and antioxidants on periodontal/oral health. Individuals with gingivitis or mild-moderate periodontitis (n=36) were included and randomly assigned to Group 1 and 2 with foaming gel loaded on a mouthpiece with a light source and controlled warming heat built-in unit or on a toothbrush, respectively, in addition to regular twice-daily brushing. Group 3 served as control with twice daily brushing and further assigned split-mouth to Group 3a-un-flossed and Group 3b-flossed. Gingival index (GI) and bleeding on probing (BOP) were evaluated in addition to plaque index (PI), pocket depth, and clinical attachment level at days 14, 28, 42 (treatment), and 60 (maintenance). Subgingival plaque microbial profiles and gingival crevicular fluid (GCF) cytokine levels were determined by DNA-DNA hybridization and multiplexing assays, respectively. Exploratory analyses included esthetic outcomes: changes in tooth color and levels of volatile sulfur compounds in breath. Statistical analyses were conducted using ANOVA with a post hoc analysis of Fisher's LSD. Use of post-foaming gel in both test groups resulted in significant changes in GI and BOP at Day 42 compared to control and un-flossed control (P<0.05). Device-enhanced foaming gel significantly reduced the PI in Group 1 at Day 42 compared to control and un-flossed control (P=0.02; P=0.007, respectively). GCF IL-6 and TNF-α levels were significantly reduced in Group 2 compared to control (PIL-6 =0.01, PTNF-α =0.02). Post-foaming gel resulted in greater reductions in periodontopathogens, whereas health-associated species remained stable. Despite cessation of adjunct treatments, Group 1 and 2 continued having reduced levels of GI, BOP, and PI at Day 60 (P<0.05). The novel post-foaming dental gel improves oral health by reducing gingival inflammation at the local site in addition to better esthetic outcomes.

Relationship between self-reported bruxism and periodontal status: Findings from a cross-sectional study.

Several studies seek to prove the relationship between bruxism and periodontal status although it remains unclear and debatable. We aimed to assess the association between self-reported (SR) bruxism with the periodontal status in a large scale survey. A total of 1064 individuals from the southern region of the Lisbon Metropolitan Area (Portugal) were enrolled. Patients were interviewed for the SR bruxism assessment through a self-report questionnaire. Full-mouth periodontal status was assessed with probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), and bleeding on probing (BoP) being measured. The American Association of Periodontology/European Federation of Periodontology 2018 case definitions were used. Logistic regression analyses provided information on the influence of SR bruxism towards periodontitis. SR bruxers exhibited lower prevalence of periodontitis. Additionally, SR bruxers with periodontitis had PD and CAL significantly lower than patients with only periodontitis. Multivariate analysis suggests that SR bruxism was significantly associated with a lower risk of periodontitis (odds ratio [OR]=0.42 95% CI: 0.32-0.56). Mean PD and CAL were significantly lower in SR bruxers. When assessing the type of SR bruxism, significant differences among mean PD, CAL, and BoP levels were also identified. SR bruxism and periodontal status are negatively associated. SR bruxers exhibit lower odds towards periodontitis and better periodontal clinical characteristics. Further studies are mandatory to clarify these findings.

Using ginger supplement in adjunct with non-surgical periodontal therapy improves metabolic and periodontal parameters in patients with type 2 diabetes mellitus and chronic periodontitis: A double-blind, placebo-controlled trial

BackgroundThe objective of this study was to investigate the effects of ginger supplementation in adjunct with non-surgical periodontal therapy (NSPT) on metabolic and periodontal parameters in patients with type 2 DM (T2DM) and chronic periodontitis (CP). Material and methodsIn this double-blind clinical trial study, 50 T2DM patients with CP were randomly allocated to intervention and control groups and received either 2 g ginger or placebo (4 tablets) twice a day for 8 weeks. All subjects underwent NSPT during the intervention period. Fasting blood glucose (FBG), glycosylated hemoglobin levels (HbA1c), triglyceride (TG), total cholesterol (CHOL), high-density (HDL-c) and low-density lipoprotein (LDL-c) cholesterol, very low-density lipoprotein (VLDL-c), total antioxidant capacity (TAC), malondialdehyde (MDA), clinical attachment loss (CAL), pocket depth (PD), plaque index and bleeding on probing (BOP) were measured in all subjects at baseline and post-intervention ResultsA significant reduction (P < 0.05) was observed in the mean levels of HbA1c, FBG, MDA, CAL, and PD in the intervention group post-intervention. There were no significant differences found in the mean levels of TG, CHOL, LDL-C, VLDL, TAC, plaque, and BOP in intervention group post-intervention. The mean serum levels of HDL was significantly increased in the intervention group post-intervention (P < 0.05). There were significant differences observed in the mean changes of HbA1c (-0.75 ± 1.17 vs -0.16 ± 0.44; P = 0.04), HDL (3.95 ± 8.54 vs -0.76 ± 5.04; P = 0.03), CAL (-0.57 ± 0.50 vs -0.14 ± 0.35; P = 0.003) and PD (-0.52 ± 0.51 vs - 0.19 ± 0.51; P = 0.04) between intervention and control groups after the intervention. ConclusionIt is recommended that ginger supplementation together with NSPT may be effective in control of the glycemic, lipid, antioxidant and periodontal status in T2DM with CP.

Folate-receptor 1 level in periodontal disease: a pilot study

BackgroundThe purpose of this study was to investigate gingival crevicular fluid (GCF) and serum folate-receptor 1 (FOLR1) levels in subjects with different periodontal status.MethodsThe study consists of three groups: Healthy group (n = 15), gingivitis group (n = 15) and chronic periodontitis group (n = 15). Clinical periodontal parameters including probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI) and bleeding on probing (BOP) were assessed. GCF and serum samples were collected from each patient and were analyzed FOLR1 levels by enzyme-linked immunosorbent assay.ResultsThe values of FOLR1 in GCF were higher in gingivitis and periodontitis groups than among patient in control group (p < 0.016). Serum FOLR1 levels showed no significant difference between the groups. A significant correlation was observed between FOLR1 levels of GCF and BOP (p < 0.05).ConclusionsOur preliminary data suggest that FOLR1 is not useful in monitoring the periodontal disease. Further studies are necessary to clarify the role, regulation and function of folate and it’s receptors in the pathogenesis of periodontal disease.

Assess the effect of periodontal treatment on glycemic control in type 2 diabetes patients

Background: Diabetes mellitus and periodontitis are common diseases, there is a two-way relationship between oral health and systemic disease. Periodontal treatment helps glycaemic control, and in contrast, glycaemic control can make periodontal status better. Aim: To assess the effect of periodontal treatment on glycemic control in type 2 diabetes mellitus (DM) patients Materials and Methods: Study design of clinical trials without control group, the sample included 50 type 2 diabetes patients with moderated periodontitis status. Patients received oral hygiene instructions, full-mouth scaling and root planing. Data collection included plaque index (PlI), gingival index (GI), probing pocket depth (PPD), clinical attachment levels (CAL), bleeding on probing (BOP) and glycated haemoglobin (HbA1c) were recorded at baseline and three month after treatment. Results: After 3-month treatment, there were a significant change in PlI, GI, PPD, CAL, BOP and HbA1c levels (p &lt; 0.01). A statistically significant effect could be demonstrated for PlI, GI, PPD, CAL, BOP and HbA1c levels. Conclusion: The results of this study showed that non-surgical periodontal treatment is improved not only periodontal health and also glycaemic control in type 2 diabetes mellitus patients. Key words: Type 2 diabetes mellitus, periodontitis, glycemic control

Does obstructive sleep apnea affect oral and periodontal health in children with down syndrome? A preliminary study.

Children with Down syndrome (DS) are at increased risk for obstructive sleep apnea (OSA) compared with children without DS, with reported prevalence of 31 ± 75% among clinical-based samples. We aimed to find out whether there is any effect of OSA on periodontal and dental health in children with DS. Overnight polysomnography (PSG) was performed. OSA was defined as Apnea-Hypopnea Index (AHI) ≥ 1/h. Children received a full mouth periodontal and dental examination that included probing depths (PD), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) on six sites per tooth. Decay, decay - Missing, missing - Filling, filling - Tooth, tooth (DMFT-for permanent tooth/dmft-for primary tooth) scores were calculated. Children were divided into two groups depending on whether they were diagnosed with OSA or no OSA. Group 1 (DS with OSA) and Group 2 (DS without OSA) included 11 children (age = 11.5 ± 2.2) and 7 children (mean age = 9.7 ± 2.3), respectively. Subjects in Group 1 displayed statistically significantly higher levels of GI (P = 0.020) and BOP (P = 0.006) than Group 2. OSA is an important problem for DS and may affect oral health negatively. Based on our findings, OSA can be associated with impaired gingival health in DS children and close follow-up may be necessary for this group.

A Novel Systemic Indicator of Periodontal Tissue Damage: Ischemia Modified Albumin.

Ischemia-modified albumin (IMA) is a systemic indicator of inflammatory diseases and is suggested as an oxidative stress marker. To determine the IMA and high-sensitivity C-reactive protein (hsCRP) serum levels for patients with chronic periodontitis (CP) and to evaluate the impact of non-surgical periodontal therapy on serum IMA and hsCRP levels. Twenty one systemically healthy patients with CP and 15 systemically and periodontally healthy controls (C) were enrolled in the study. Periodontal pocket depth (PPD), bleeding on probing (BOP) and attachment loss (AL) were recorded at the time of diagnosis and 6 weeks after the nonsurgical periodontal therapy. Blood samples were obtained before and after treatment from all groups, and serum IMA and hsCRP levels were evaluated by ELISA method. All of the clinical findings were found to be elevated in the CP group in comparison to C group (p<0.05). Levels of IMA and hsCRP were higher in the CP group (p<0.05) and decreased after non-surgical periodontal therapy (p<0.05). Positive correlations were determined between PPD, BOP and hsCRP (p<0.05) as well as between PPD, AL, BOP and IMA levels (p<0.01) before treatment. A significant positive correlation was also observed between hsCRP and IMA (p<0.01) before and after treatment. IMA is a marker indicating systemic inflammation during periodontal disease, and is significantly reduced as a result of non-surgical periodontal therapy. Therefore, IMA might be suggested as a useful indicator of periodontal disease.