Treatment Of Chronic Periodontitis Research Articles

A Comparative Clinical Evaluation of Subgingivally Delivered 0.5% Azithromycin Gel and 1% Chlorhexidine Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis

ABSTRACT Background: Chronic periodontitis is a prevalent inflammatory condition affecting the supporting structures of teeth. Adjunctive therapies to scaling and root planing (SRP) play a crucial role in enhancing treatment outcomes. This study aimed to compare the clinical effectiveness of subgingivally delivered 0.5% azithromycin gel and 1% chlorhexidine gel as adjuncts to SRP in the management of chronic periodontitis. Materials and Methods: A comparative clinical evaluation was conducted involving 60 participants diagnosed with chronic periodontitis. They were randomly assigned to two groups: Group A received subgingival application of 0.5% azithromycin gel after SRP, whereas Group B received 1% chlorhexidine gel in a similar manner. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and 3-month follow-up. Results: Both groups demonstrated significant improvements in clinical parameters after treatment. However, Group A exhibited a greater reduction in PPD (mean decrease of 2.5 mm) compared with Group B (mean decrease of 1.8 mm). Similarly, Group A showed a higher gain in CAL (mean gain of 2.3 mm) compared with Group B (mean gain of 1.5 mm). In addition, a significant reduction in GI was observed in both groups, with Group A showing slightly better outcomes. Conclusion: Subgingivally delivered 0.5% azithromycin gel demonstrated superior clinical efficacy as an adjunct to SRP in the treatment of chronic periodontitis compared with 1% chlorhexidine gel. The findings suggest that azithromycin gel may serve as a promising therapeutic option in managing periodontal disease.

Effectiveness of photodynamic therapy on the treatment of chronic periodontitis: a systematic review during 2008–2023

ObjectiveThis study investigated the effect of photodynamic therapy on chronic periodontitis patients and then evaluated the microbial, immunological, periodontal, and clinical outcomes. The significant effects of photodynamic therapy obtained by in vitro and in vivo studies have made it a popular treatment for periodontal diseases in recent years. Photodynamic therapy is a novel bactericidal strategy that is stronger, faster, and less expensive than scaling and root planing.MethodThis study registered on PROSPERO (CRD42021267008) and retrieved fifty-three randomized controlled trials by searching nine databases (Medline, Embase, Scopus, Open Gray, Google Scholar, ProQuest, the Cochrane Library, Web of Science, and ClinicalTrials.gov) from 2008 to 2023. Of 721 records identified through database searches following title and full-text analysis, and excluding duplicate and irrelevant publications, 53 articles were included in this systematic review. Fifty of the 53 eligible studies fulfilled all the criteria in the Joanna Briggs Institute’s (JBI’s) Checklist for RCTs; the remaining articles met 9–12 criteria and were considered high quality.ResultsThe present study showed that photodynamic therapy in adjunct to scaling and root planing has the potential to improve periodontal parameters such as clinical attachment loss or gain, decrease in bleeding on probing, and probing pocket depth. In addition, photodynamic therapy decreases the rate of periodontal pathogens and inflammation markers, which, in turn, reduces the progression of periodontitis.ConclusionPhotodynamic therapy is considered a promising, adjunctive, and low-cost therapeutic method that is effective in tissue repair, reducing chronic periodontitis, reducing inflammation, and well-tolerated by patients.

Antibiotics for Treatment of Chronic Periodontitis, in Conditions of Increased Resistance

Antibiotics for Treatment of Chronic Periodontitis, in Conditions of Increased Resistance

Cost-effectiveness and cost-utility analyses of three different gargles in the treatment of chronic periodontitis.

This study aimed to investigate the economics of three different gargles in the treatment of chronic periodontitis. A total of 108 patients with periodontitis received one of the following three gargles: xipayi, compound chlorhexidine, or Kangfuxin gargle. The basic information of the patients, the costs of the gargles, the periodontal indexes before and after treatment, and the scores of the 3-level version of the EuroQol Five Dimensions Questionnaire were collected. The cost-effectiveness and cost-utility of the various gargles were determined. The cost-effectiveness ratios (CER) of the three groups after treatment were 1828.75, 1573.34, and 1876.92 RMB, respectively. The utility values before treatment were 0.92, 0.90, and 0.91, respectively, and the utility values after treatment were 0.98, 0.98, and 0.97, respectively. The cost-utility ratios (CURs) were 213.43, 195.61, and 301.53 RMB, respectively. For each increase in effective rate and quality-adjusted life years, the treatment cost of periodontitis patients was lower than the gross domestic product per capita of Jiangsu Province, indicating that the treatment cost is completely worth it. The CER and CUR results were the same, and the compound chlorhexidine group was the lowest, demonstrating that when the same therapeutic effect was achieved, it cost the least.

Clinical evaluation of 0.8% hyaluronic acid gel adjunctive to scaling and root planning in the treatment of chronic periodontitis in Hyderabad Sindh.

Objective: To determine the effect of hyaluronic acid as an adjuvant to root planning and scaling for the management of chronic periodontitis patients. Study Design: Prospective Randomized-controlled Clinical study. Setting: Department of Periodontology, Faculty of Dentistry Isra Dental College Hyderabad. Period: 1st July 2022 to 31st June 2023. Methods: A total of 50 diagnosed patients of chronic periodontitis and assigned into two groups according to the treatment given. Group A received Hyaluronic acid+Scaling and Root Planning whereas group B patients received Scaling and Root Planning alone. Patients were clinically evaluated before receiving treatment. Periodontal Depth (PD), Clinical Attachment level (CAL), Blood on Probe (BOP), and Plague Index (PI) were recorded at Baseline appointments, 3rd-month appointments, and 6th-month appointments after receiving treatment. The results were analyzed by SPSS version 21. Results: in both groups, significant improvement was observed in the mean value of PD, and CAL after receiving treatment, while comparing both groups, Group A patients found more significant results (<0.05) as compared to Group B. The study also found a significant reduction in BOP and PI of both groups of patients after receiving treatment but there was not any significant difference found in the mean value of BOP and PI in both groups. Conclusion: The study was conducted to determine the effectiveness of Hyaluronic acid as an adjuvant therapy that may affect chronic periodontitis along with SRP. The current study concluded hyaluronic acid gel is an effective adjuvant therapy with SRP.

Incidence of Postoperative Flare-Up After Single-Visit and Multi-visit Endodontic Therapy.

The aim of the survey was to obtain data from the studied patients on the frequency and the type of postoperative pain after treatment of chronic apical periodontitis, as well as whether there is a relation between gender, age, and postoperative pain. A visual analog scale was used to study the intensity of postoperative pain in the treatment of teeth diagnosed with CPP, which are treated by one of two methods - single-visit ormulti-visit method. The total number of surveyed patients is 71. The patients were examined and treated at the Dental Clinic "Imperial" in Varna, Bulgaria, in 2020.Thirty-one of them were treated by the single-visit method, and the remaining 40 by the multi-visitmethod with placement of a temporary dressing or sterile swab. A relatively large proportion (70%) of patients reported mild pain immediately after the root canal filling. A relatively large proportion (90.3%) of patients did not report pain one week after the root canal filling. The more frequent symptoms were observed in cases treated by the multi-visitmethod, after the application of a temporary dressing. Patients who reported taking analgesics were treated in the multi-visitmethod. More frequent pain symptoms with both methods of treatment were observed in men aged 36-60 years. Although exacerbation has been shown to have no significant effect on the outcome of endodontic treatment, it is highly undesirable. In the short term, the postoperative pain in patients treated by the multi-visitmethod through the use of intracanal medication is more pronounced. Patients receiving the single-visit treatment reported less postoperative pain.

Therapeutic Effect of a Novel M1 Macrophage-Targeted Nanodrug in Chronic Periodontitis Mice.

Chronic periodontitis is a chronic, progressive, and destructive disease. Especially, the large accumulation of advanced glycation end products (AGEs) in a diseased body will aggravate the periodontal tissue damage, and AGEs induce M1 macrophages. In this project, the novel nanodrugs, glucose-PEG-PLGA@MCC950 (GLU@MCC), are designed to achieve active targeting with the help of glucose transporter 1 (GLUT1) which is highly expressed in M1 macrophages induced by AGEs. Then, the nanodrugs release MCC950, which is a kind of NLRP3 inhibitor. These nanodrugs not only can improve the water solubility of MCC950 but also exhibit superior characteristics, such as small size, stability, innocuity, etc. In vivo experiments showed that GLU@MCC could reduce periodontal tissue damage and inhibit cell apoptosis in periodontitis model mice. In vitro experiments verified that its mechanism of action might be closely related to the inhibition of the NLRP3 inflammatory factor in M1 macrophages. GLU@MCC could effectively reduce the damage to H400 cells caused by AGEs, decrease the expression of NLRP3, and also obviously reduce the M1-type macrophage pro-inflammatory factors such as IL-18, IL-1β, caspase-1, and TNF-α. Meanwhile, the expression of anti-inflammatory factor Arg-1 in the M2 macrophage was increased. In brief, GLU@MCC would inhibit the expression of inflammatory factor NLRP3 and exert antiperiodontal tissue damage in chronic periodontitis via GLUT1 in the M1 macrophage as the gating target. This study provides a novel nanodrug for chronic periodontitis treatment.

Clinical effects of Lactobacillus reuteri probiotic in chronic periodontitis - a systematic review.

This systematic review examines the effectiveness of Lactobacillus reuteri as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Scopus, PubMed, and Web of Science databases were searched according to specific inclusion and exclusion criteria in October 2022. Randomized control trials that evaluated the effects of Lactobacillus reuteri in patients with periodontitis were included. The primary outcome was pocket depth and clinical attachment levels, while the secondary outcome considered was bleeding on probing, microbial levels, and gingival index score. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. A total of eleven studies that examined 369 subjects were included in the review. Adults in the age group of 18-70 years of age suffering from chronic periodontitis were evaluated. Eight out of the eleven studies reported statistically significant improvement in the intergroup pocket depths, whereas seven studies showed a statistically significant reduction in the clinical attachment levels in the probiotic group. Three studies showed no significant improvement in the pocket depth levels in the probiotic group as compared to the controls. Four studies showed no significant reduction in clinical attachment levels between the two groups. The overall risk of bias was high in four studies, while seven studies reported some concerns about the risk of bias. Based on the limited evidence available, the adjunctive use of Lactobacillus reuteri to scaling and root planing may provide some additional benefit in improving periodontal parameters.

Efficacy of Intra-Pocket Application of Two Antimicrobial Agents as an Adjunct to Mechanotherapy of Chronic Periodontitis (a Comparative Study)

Numerous studies have been performed to evaluate the effectiveness of the use of locally delivered antimicrobials as an adjunct to mechanotherapy in treatment of chronic periodontitis. Some studies were resulted in improved clinical outcomes and others were not. The aim of this study is evaluation of the efficacy and safety of subgingival application of a (10 mg metronidazole gel), (1% chlorhexidine collagen gel) and (CHLOSITE® GHIMAS, Italy) gel which is a combination of two chlorhexidine formulations: 0.5% chlorhexidine digluconate and 1.0% chlorhexidine dihydrochloride), as an adjunct to mechanical treatment (scaling and root planing) (SRP) of chronic periodontitis. A total of 120 sites from 15 patients with age range of (24-55 years), who had periodontal pockets measuring 5-9 mm and had been diagnosed as chronic periodontitis cases, were selected for the study. The 4-quadrant split-mouth design was used in this study. The pocket sites in each patient were randomly assigned to 4 groups (30 sites for each):(Group A) GA=(SRP) only.(Group B) GB=(SRP) + 10 mg metronidazole gel.(Group C) GC=(SRP) + 1% chlorhexidine collagen gel. (Group D) GD=(SRP) + CHLOSITE®Clinical parameters including (plaque index PI), (gingival index GI), (gingival bleeding index) GBI, (probing pocket depth PPD) & (clinical attachment level CAL) were measured and recorded at baseline before any treatment at (day 0) then the treatment was performed at the same day, The clinical parameters were also recorded at (day 30) & (day 90), in the selected sites of the four groups. The results of this study obviously showed a statistically significant reduction of all clinical parameters in all groups at (day 30 & day 90) from the base line (day 0). GD=(SRP) + CHLOSITE® revealed a reduction of the clinical parameters than groups (A, B and C) and the differences were highly statistically significant.

Efficacy of Minocycline Hydrochloride Ointment with Metronidazole in the Treatment of Chronic Periodontitis and its Impact on Periodontal Microecology

Efficacy of Minocycline Hydrochloride Ointment with Metronidazole in the Treatment of Chronic Periodontitis and its Impact on Periodontal Microecology

A whole-course-repair system based on ROS/glucose stimuli-responsive EGCG release and tunable mechanical property for efficient treatment of chronic periodontitis in diabetic rats.

Elevated glucose levels, multiple pro-inflammatory cytokines and the generation of excessive reactive oxygen species (ROS) are pivotal characteristics within the microenvironments of chronic periodontitis with diabetes mellitus (CPDM). Control of inflammation and modulation of immune system are required in the initial phase of CPDM treatment, while late severe periodontitis requires a suitable scaffold to promote osteogenesis, rebuild periodontal tissue and reduce alveolar bone resorption. Herein, a whole-course-repair system is introduced by an injectable hydrogel using phenylboronic acid functionalized oxidized sodium alginate (OSA-PBA) and carboxymethyl chitosan (CMC). Epigallocatechin-3-gallate (EGCG) was loaded to simultaneously adjust the mechanical property of the OSA-PBA/CMC + EGCG hydrogel (OPCE). This hydrogel has distinctive adaptability, injectability, and ROS/glucose-triggered release of EGCG, making it an ideal drug delivery carrier. As expected, OPCE hydrogel shows favourable antioxidant and anti-inflammatory properties, along with a regulatory influence on the phenotypic transition of macrophages, providing a favourable immune microenvironment. Apart from that, it provides a favourable mechanical support for osteoblast/osteoclast differentiation regulation at the late proliferation stage of periodontal regeneration. The practical therapeutic effects of OPCE hydrogels were also confirmed when applied for treating periodontitis in diabetic rats. In summary, OPCE hydrogel may be a promising whole-course-repair system for the treatment of CPDM.

A Novel Era of Probiotics in Dentistry. A Double-Blind Randomised Clinical Trial

Introduction: The use of chemical agents has dramatically increased and holds a great promise for the prevention of dental plaque, of which chlorhexidine is considered the gold standard. New novel probiotic mouthrinses are being developed to combat the adverse effects of chlorhexidine mouthrinse. Objective: The objective of this study was to compare the effectiveness of probiotic mouthrinse with chlorhexidine mouthrinse for the treatment of chronic periodontitis as an adjunct to scaling and root planing. Materials and Methods: The patients were randomly divided into two groups of 7 subjects each. Group A (Control) and Group B (Test) had scaling and root planing along with chlorhexidine mouthrinse and probiotic mouthrinse, respectively. Clinical parameters measured at baseline and 45 days were gingival index, plaque index, probing pocket depth, and clinical attachment loss. Microbial analysis was done by collecting plaque samples at baseline and 45 days. Paired t-test was used for intragroup and intergroup comparisons, whereas independent t-test was used for intergroup comparisons. Keeping the level of significance at 5%, the significant difference was adjusted at P ≤ 0.05. Results: The mean clinical parameters were significantly reduced for both treatment groups posttherapy. The microbiological data analysis (colony-forming units/ml) showed that after the therapy, there was a significant reduction in both the groups with Group B > Group A. Conclusion: Probiotics can in the near future and with more research serve to be as natural candidates to substitute antibiotics and their derivatives.

Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases

To study the effectiveness of the drug Cholisal as part of the conservative treatment of chronic periodontitis. We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute stage with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of periodontitis, patients were divided into two groups of 50 people. In the main group, Cholisal dental gel was used as part of complex conservative treatment, and in the control group, Metrogil-denta gel was used. To assess the effectiveness of treatment, a dental examination of patients was carried out with an index assessment of the condition of periodontal tissues and a biochemical analysis of the content of arachidonic acid and prostaglandin E2 in gingival blood, comparing the indicators before treatment and 14 days after the start of treatment. When the drug Cholisal was included in complex treatment, 14 days from the start of treatment, patients experienced a statistically significant decrease in the depth of periodontal pockets from 4.7±0.32 mm to 3.6±0.19, and the Green-Vermillion hygiene index by 60.7%, Silness-Loe plaque index by 73.1%, PMA index by 68.8%, Muhlemann-Cowell bleeding index by 68.0% (p<0.001 compared to baseline). When Metrogil-denta gel was used in complex therapy, the effectiveness of treatment was lower: the depth of periodontal pockets did not change significantly (from 4.5±0.22 mm to 4.2±0.17 mm, p>0.05), reduction in the hygiene index Green-Vermillion was 51.9%, Silness-Loe plaque index - 64.0%, PMA index - 43.7%, Muhlemann-Cowell bleeding index - 45.8% (p<0.001 compared to baseline, p<0.001 compared to the main group). A laboratory study showed that in patients of the main group, after completing a course of conservative treatment, the content of biomarkers of inflammation significantly decreased compared to the initial level (p<0.05), while in patients of the control group the content of arachidonic acid and prostaglandin E2 in the gingival blood during the study period did not change significantly (p>0.05 compared to the initial level). The use of the drug Cholisal in the conservative treatment of chronic periodontitis has demonstrated more pronounced positive dynamics of clinical and biochemical parameters compared to traditional therapy, which suggests its high effectiveness.

Effect of Systemically Administered Amoxicillin and Metronidazole in the Treatment of Chronic Periodontitis

Introduction: Nonsurgical periodontal therapy reduces periodontal inflammation, but complete removal of toxin and bacterial deposits is not always possible. Thus, adjunctive therapeutic strategies like use of systemic amoxicillin and metronidazole have evolved. Objective: To evaluate effect of systemically administered amoxicillin and metronidazole in the treatment of chronic periodontitis. Methods: A pretest post-test study was conducted from February 2021 to November 2021 in Department of Periodontics and Oral Implantology at Peoples Dental College and Hospital after ethical clearance from Institutional Review Committee of PDCH. Thirty-six patients with chronic periodontitis were recruited through convenient sampling. The patients were assigned into two groups meeting the criteria of at least six teeth with probing pocket depth 5-7 mm. Group A received scaling and root planing and Group B received adjunctive systemic Amoxicillin and Metronidazole three times daily for seven days. Clinical parameters were evaluated at one month, three months and six months post-treatment. Data were analysed in SPSS v.20. Results: Mean values of pocket depth (PD), clinical attachment level (CAL), plaque index (PI) and gingival index (GI) were reduced significantly after treatment in both treatment groups with more clinical improvement in adjunctive systemic amoxicillin and metronidazole. However, on intergroup comparison, clinical attachment level and plaque index was not significantly reduced. Conclusions: The findings of the current study showed significant improvements in both groups compared with baseline. Thus, adjunctive systemic amoxicillin and metronidazole provide better results than scaling root planing alone.

Chlorhexidine and doxycycline gel versus chip as adjuncts in oral hygiene among Indians.

The effectiveness of newly released medications such as Chlorhexidine (CHX) chip, Doxycycline hyclate (DH) chip, CHX gel, DH chip as adjunct to scaling and root planing in the treatment of chronic periodontitis is important. 90 adult Indian patients with moderate chronic periodontitis were enlisted. It was observed that reduction in periodontal pocket depth (PPD) and increase in clinical attachment level (CAL) was seen in patients in CHX group as compared to DH treated study participants. It was observed that CHX and DH in gel form were more effective in improving periodontal health as compared to CHX and DH in chip form in this group of subjects.

Optimization of chronic periodontitis comprehensive treatment

Relevance. The increasing prevalence of mild to moderate chronic generalized periodontitis depends on endogenous and exogenous factors. In most cases, these include factors such as fair oral hygiene, oral microbiota characteristics, increased loads on periodontium, malocclusion, smoking, history of systemic disorders, genetic predisposition, neuroses, etc. Despite the variety of available treatment protocols for mild to moderate chronic generalized periodontitis, the result has a short-term effect. Thus, searching for new treatment algorithms and creating improved medications with the necessary properties to stabilize the process and prolong remission in chronic periodontitis are relevant. The study aimed to evaluate the effectiveness of the comprehensive chronic periodontitis treatment with netilmicin ointment and propolis extract combined with diode laser, considering periodontal and immune statuses.Material and methods. The study involved 70 patients with mild and moderate chronic generalized periodontitis and 30 controls without signs of inflammatory periodontal diseases (IPD). The main group consisted of 50 patients with IPD, who had comprehensive treatment with the ointment based on netilmicin and propolis extract and antiinflammatory therapy using the Doctor Smile diode laser. The comparison group comprised 20 patients whose treatment protocol did not include laser treatment. We conducted a clinical and immunological study of patients before and after the treatment.Results. The comprehensive treatment evaluation, including clinical and immunological analysis, revealed a significant improvement in the parameters when using a combination of ointment with netilmicin/propolis extract and laser therapy, compared to standard non-surgical treatment.Conclusion. The clinical and immunological analysis of the comprehensive treatment of patients with chronic periodontitis has established the advantage of the combined use of non-surgical treatment and physiotherapy procedures.

Analysis of the Effectiveness of Periodontitis Treatment Using Antimicrobial Agents

A combination of systemic antibiotics with scaling may provide an additional advantage over scaling alone in the periodontitis treatment in terms of clinical loss of attachment and change in pocket depth. The use of antibiotics should be justified by a determined need and should not replace adequate local treatment. Different treatment protocols have been proposed, but their indications and efficacy remain controversial. The study aims to analyse the literature on the use of antimicrobial agents for non-surgical periodontal therapy and to compare different protocols for prescribing antimicrobial agents. A search in MEDLINE and EBSCOhost electronic databases was conducted using relevant MeSH words. Targeted studies had to be published within the last five years. Studies were selected based on inclusion and exclusion criteria. Data from selected studies were extracted and analysed. Ten randomized clinical trials were included in the review. The general conclusions of this review indicate a positive effect of antibiotics as an adjunct to non-surgical treatment of chronic periodontitis, regardless of antimicrobial drugs used in the reviewed studies. A prospect for further research is a comparative analysis of the effectiveness of the use of antimicrobial agents and probiotics as an adjunct to the non-surgical treatment of chronic periodontitis.

THE EFFECT OF LASER DIODE IN TREATMENT OF CHRONIC PERIODONTITIS AT THE ODONTO-STOMATOLOGY DEPARTMENT OF FRIENDSHIP HOSPITAL

Objectives: The aim was to evaluate the effectiveness of chronic periodontitis treatment using the diode laser method in Odonto - Stomatology Department of Friendship Hospital.Subjects and methods: Our study was a case-control clinical trial. Sixty patients were randomized into two groups. The group of controls 30 patients with chronic periodontitis who were treated with conventional procedures (cleaning and polishing). The group of cases was 30 patients who were treatedwith conventional procedure and laser diode. Patients were followed up for 3 periods: pre-treatment, after 2 and 4 weeks of treatment.Results: Gingival Index (GI) and Gingival Sulcus Bleeding Index (SBI) decreased after treatment in both groups (p &lt; 0.005). The depth of periodontal pocket and the loss of attachment in the experimental group after 4 weeks were less than in the control group (p &lt; 0.05).Conclusions: The laser diode should be applied along with cleaning and polishing in the treatment of chronic periodontitis.

Evaluation of the clinical parameters and volumetric analysis of gingival crevicular fluid for chlohexidine vying silver nanoparticle mouthwash the avant garde for chronic periodontitis

BACKGROUND: Oral cavity ecosystem represents a dynamic pattern. Scaling and root planing (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. Although chlorhexidine is the most effective mouthwash against oral microorganisms, the side effects of long- term use suggest the need for an alternative. Hence, this study has been undertaken to know effectiveness of silver nanoparticle mouthwash with chlorhexidine mouthwash which is effective on common microorganisms of oral cavity. OBJECTIVE: To evaluate and compare the clinical and biochemical outcome of chlorhexidine (CHX) and silver nanoparticle as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. METHODS: Ninety- two patients with generalized moderate to severe chronic periodontitis from the Dept. of Periodontology who fulfilled the inclusion and exclusion criteria were recruited for the study. In the experimental clinical trial, the clinical parameters likewise; Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. The volumetric analysis of gingival crevicular fluid (GCF) levels were assessed at baseline and follow up visits. The IBM SPSS Statistics for Windows software, v. 20.0 (IBM Corp., Armonk, USA), was used. The data was numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics were analyzed to compare the responses between the groups. RESULTS: The statistical analysis was carried out by descriptive as well as inferential statistics and both groups demonstrated significant intragroup reduction in PI, GI, PPD, CAL, GCF from baseline to 3 months follow-up. There were statistically significant intragroup differences between both the groups for all of the parameters. CONCLUSION: Silver nanoparticle mouthwash can be an alternative adjunct for non-surgical periodontal therapy in patients with chronic periodontitis. Results of this study indicated that both the mouth rinse demonstrated an equal range of effectiveness. These conclusions were supported by the clinical parameters and biochemical outcomes.

КЛИНИКО-ЛАБОРАТОРНАЯ ОЦЕНКА ЭФФЕКТИВНОСТИ ПРИМЕНЕНИЯ ФАРМАКОЛОГИЧЕСКОЙ КОМПОЗИЦИИ КОМБИНИРОВАННОГО ДЕЙСТВИЯ ПРИ ЛЕЧЕНИИ ПАРОДОНТИТА У ЛИЦ С НЕДОСТАТОЧНОЙ ПРИВЕРЖЕННОСТЬЮ ЛЕЧЕНИЮ

The treatment of chronic periodontitis is based on a comprehensive approach that includes supportive therapy, which requires patient commitment to treatment. Patient commitment to treatment is enhanced by the use of appropriate therapeutic regimens and the use of medications in the form of fixed combinations.&#x0D; Objective of the study: to assess the clinical effectiveness of a new pharmacological composition for the treatment of chronic periodontitis in patients with insufficient treatment adherence. &#x0D; Materials and methods: a study and treatment were conducted on 92 patients with moderate-severity chronic periodontitis with insufficient treatment adherence (control group, n = 62 – received standard treatment; main group, n = 30 – received standard treatment supplemented with the new pharmacological composition). The level of treatment adherence was determined using the Treatment Adherence Quantification Questionnaire. Comparative assessment of treatment effectiveness in the study groups was conducted dynamically at control points (7, 14 days, 1, 6 months) based on clinical-instrumental data, periodontal tissue condition index assessment (OHI-S, PMA, PI), microcirculation condition (linear and volumetric blood flow velocities, pulsatility index). Disease outcome was recorded after 6 months: compensation, stabilization, or development of a new disease related to the primary one. &#x0D; Results: The main group of patients showed statistically significantly lower PMA and PI index values at all control points. Microcirculation indicators significantly improved at the 14-day, 1-month, and 6-month control points compared to the control group. The recurrence rate after 6 months in the main group was 1.6 times lower than in the control group.&#x0D; Conclusion: The use of a new pharmacological composition for the treatment of chronic periodontitis in patients with insufficient treatment adherence showed clinical effectiveness, leading to longer stabilization of the process and compensation of the condition in over half of the cases.