Clinical Attachment Level Values Research Articles

Evaluation of Neutrophil Extracellular Trap Formation on Smokers and Non-Smokers with Periodontitis

Objevtive: In this study, we aimed to evaluate neutrophil extracellular trap (NET) in smoker and non-smoker periodontitis patients. Materials and Methods: 21 subjects [non-smokers and periodontally healthy (S-P-) 7 people, non-smokers with periodontitis (S-P+) 7 people, smokers with periodontitis (S+P+) 7 people] were included in this study. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) parameters were recorded. The peripheral neutrophils isolated from the subjects were activated by phorbol 12-myristate 13-acetate (PMA) to induce NET formation. NET formed after the activation was measured with the fluorometer. Results: In the S-P- group PI, GI, PD and CAL values were found statistically significantly low (P=0,001; P=

Impact of Suturing Techniques on the Periodontal Health Status of Mandibular Second Molar After Extraction of Fully Impacted Third Molars

Mandibular third molars are appeared to be the most common congenitally impacted teeth the fact that may cause many problems in different fields of dentistry. surgical removal of the impacted tooth seems to be the only solution for these problems. An important complication to address is the risk of developing periodontal breakdown ( loss of attachment) and deep periodontal pocket on the distal aspect of the adjacent mandibular second molar after surgical removal of third molar. The aim of the present study is to evaluate and compare the effect of 4 suturing techniques: (Simple loop , Figure 8 suture, Anchor suture and Closed anchor suture) on the periodontal health status on the distal aspect of the adjacent mandibular second molar after surgical removal of lower impacted third molar.Forty patients having fully impacted mandibular third molars were enrolled in this study and divided to 4 groups (Group A: Simple loop , Group B: Figure 8 suture, Group C: Anchor suture and Group D: Closed anchor suture), each group consisted of 10 patients. Surgical extraction of impacted third molars were carried out for them. Probing pocket depth (PPD) and clinical attachment level (CAL) were recorded preoperatively and 6 months after surgery. On 6 months after surgery the mean values of PPD and CAL were significantly increased on the distal surface of the adjacent mandibular second molar in simple loop & figure 8 techniques. On the other hand, no significant difference has been noticed between anchor & closed anchor techniques in comparison with preoperative values. After 6-months, PPD and CAL values of were significantly higher in thesimple loop and figure 8 techniques compared to anchor andclosed anchor techniques. The present study concluded that closedanchor suture & anchor suture techniques are preferable to closethe flaps in surgical removal of impacted mandibular third molarsto maintain a good health status on the distal side of the adjacentmandibular second molar.

Correlation of Serum and Gingival Crevicular Fluid Levels of Caspase-3 and Milk Fat Globule-Epidermal Growth Factor 8 on Gingival Health.

This study aimed to estimate and correlate the serum and gingival crevicular fluid (GCF) levels of caspase-3 and milk fat globule-epidermal growth factor 8 (MFG-E8) in healthy, gingivitis and generalised chronic periodontitis subjects. A total of 24 subjects were selected and divided into three groups. After recording the periodontal parameters (plaque index (PI), modified gingival index (MGI), probing depth (PD) and clinical attachment level (CAL)), the serum and GCF samples were collected and the levels of caspase-3 and MFG-E8 were estimated using enzyme-linked immunoassay (ELISA). The mean values of PI, MGI, PD and CALs were significantly higher in group III when compared to group II and group I. The mean value of serum and GCF caspase-3 increased with increasing disease severity, whereas the mean serum and GCF values of MFG-E8 decreased with increasing severity of disease. Spearman's correlation showed a strong positive correlation between the serum and GCF levels of caspase-3 and periodontal parameters, whereas serum and GCF levels of MFG-E8 showed a strong negative correlation with the periodontal parameters. The findings of this study are suggestive that the serum and GCF levels of caspase-3 and MFG-E8 could serve as a potential biomarker for the role of apoptosis in periodontal disease. However, further studies are required to explore the mechanism and understand the relationship between these apoptotic markers and periodontitis.

Effect of nonsurgical periodontal therapy on interleukin-35 level in gingival crevicular fluid

ABSTRACT Background: Clinical attachment level (CAL), alveolar bone loss, and periodontal pockets constitute the major signs of periodontitis. The interaction between the host and the bacteria that forms a biofilm on the tooth surface is one of the major etiologies of periodontal disorders. Aim: The aim of this study was to assess interleukin-35 (IL-35) levels pre and post nonsurgical periodontal therapy (NSPT) in healthy individuals and gingivitis and periodontitis patients. Materials and Methods: IL-35 level in gingival crevicular fluid (GCF) and clinical parameters were assessed in 60 individuals. Biochemical analysis was done by enzyme-linked immunosorbent assay. Individuals in Group I were in good health; those in Groups II and III had gingivitis and periodontitis, respectively. Study individuals were evaluated at baseline and 3 months after NSPT. Results: Group III differed from Group II in that it had higher CAL (7.60), plaque index (2.8929), and periodontal probing depth (5.8500 mm) values, as well as lower papillary bleeding index (2.1170) and gingival index (2.1085) values. The concentrations of IL-35 in GCF varied among the groups, with Group III having the lowest concentrations and rising gradually to Groups II and I. In addition, from baseline to 3 months, the IL-35 levels in GCF significantly decreased in both Groups II and III. The results show that Groups II and III have lower GCF levels of IL-35 than Group I, suggesting that IL-35 is a major factor in the development of periodontal diseases. Conclusion: Group I had considerably greater GCF IL-35 values than Group II and III both before and after NSPT.

The Treatment of Severe Periodontitis Using a Local Antiseptic Desiccant and Subgingival Mechanical Instrumentation: A Pilot Study.

This randomized, split-mouth, controlled clinical study assessed the additional clinical benefits of a local desiccant antimicrobial agent (HY) combined with subgingival mechanical instrumentation (SRP) vs. SRP alone in treating severe periodontitis. Patients with stages III and IV periodontitis received full-mouth periodontal examinations at baseline and after a three-month follow-up. Two randomly selected hemiarches in each periodontitis patient were treated with SRP plus HY and were included in the test group, while the other two hemiarches received only SRP and were included in the control group. In thirty patients, the analyses of the evolution of the periodontal parameters over time showed statistically significant mean differences for the probing depths and clinical attachment level values resulting from all the examined sites, as well as from the interproximal sites (p < 0.001) in both the test and control groups. The intergroup comparisons of the same four parameters showed no significant differences (p = 0.322, p = 0.36, p = 0.516, and p = 0.509, respectively). Based on these study results, no additional benefits were obtained after HY subgingival applications.

Salivary Antioxidant Profile in Patients with Systemic Sclerosis and Periodontitis.

The aim of the present study was to compare periodontal status and antioxidant profile in unstimulated saliva of systemic sclerosis (SSc) patients with periodontitis and systemically healthy periodontitis patients. Twenty patients with established diagnoses of systemic sclerosis and periodontitis (SSc group) and 20 systemically healthy individuals with periodontitis (P group) were enrolled in the study. Clinical periodontal parameters (clinical attachment level (CAL), gingival recession (GR), periodontal probing depth (PPD), and gingival index (GI)) and concentration of uric acid (UA), superoxide dismutase (SOD), and glutathione peroxidase (GPX) in unstimulated saliva samples were assessed. There were significantly higher mean values of CAL (4.8 ± 0.21 mm versus 3.18 ± 0.17 mm; p ≤ 0.001) and GR (1.66 ± 0.90 mm versus 0.46 ± 0.54 mm; p ≤ 0.001) in the SSc group when compared to the P group. Significantly higher level of GPX (p ≤ 0.001) and SOD (p ≤ 0.001) in unstimulated saliva was detected in the SSc group in comparison with the P group. The specific activity of UA did not significantly differ between the two groups (p = 0.083). The results may indicate higher periodontal destruction and antioxidant perturbations in unstimulated saliva of SSc patients with periodontitis compared to systemically healthy periodontitis patients.

Effect of Non-surgical Periodontal Therapy on Salivary Melatonin Levels

Objective: Melatonin, a hormone secreted predominantly by pineal gland in a circadian manner, has antioxidant and anti-inflammatory effects. The current research is conducted to explore the influence of non-surgical periodontal therapy (NSPT) on levels of salivary melatonin in subjects with gingivitis and periodontitis. Methods: Sixty systemically healthy participants were included in this study; the groups are as follows: gingivitis (G), chronic periodontitis (CP), generalized aggressive periodontitis (GAP) and periodontally healthy (H). NSPT was applied to G group patients for 2 sessions, to CP and GAP group patients for 4 sessions. Plaque and gingival indices, probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL) were documented at baseline and 3 months post – treatment and early morning salivary samples were collected. ELISA was used to detect melatonin levels in saliva. Pittsburgh Sleep Quality Index (PSQI) questionnaire was performed to evaluate of sleep quality of patients. Results: At baseline, significant difference in gingival index, PD, BOP and CAL values was detected among all groups (p

Berry as an adjunct to nonsurgical periodontal therapy: A clinical trial.

Periodontal disease, a persistent inflammatory condition affecting the tissues around the teeth, is brought on by an imbalance between dental biofilm and the host's reaction, with the potential for tooth loss. Periodontal disease has been linked to an excess of free radicals induced by oxidative stress or antioxidant deficiency. There is a notable oxidative process early in the course of periodontal disease, especially in periodontitis. The objective of the study is to assess if berry supplements can be used as a supplement to nonsurgical periodontal therapy. Forty individuals with chronic periodontitis in total were divided into two groups for this study. Group A received scaling and root planing (SRP), whereas Group B received SRP plus berry supplements. At baseline and on the 28th day, both groups had their probing pocket depth (PPD) and clinical attachment level (CAL) assessed. After then, the data from both time periods were compared. The SPSS software was used to examine the data (Version 23.0). Using an unpaired t-test, the mean PPD and CAL values were compared between the groups. The mean PPD in Group A decreased on day 28 from 4.18 ± 0.12 to 3.06 ± 0.02 while in Group B reduced from 4.21 ± 0.13 to 2.05 ± 0.08. The CAL in Group A improved from 5.05 ± 0.09 to 3.04 ± 0.11 and in Group B from 4.52 ± 0.17 to 2.02 ± 0.08. There was evidence of a statistically significant difference between two groups in terms of mean pocket depth and clinical attachment degree (P < 0.05). Therefore, berries may be an effective treatment for chronic periodontitis when used in conjunction with SRP.

Periodontal disease status in the diabetic patients with different glycemic levels – A cross sectional study

Periodontitis is often associated with diabetes and might be considered one of the chronic complications of diabetes mellitus (DM), both in Type 1 (T1DM) and Type 2 (T2DM). This cross sectional study was designed to evaluate the possible association between clinical periodontal disease status and glycemic levels in diabetes patients (T2DM) among the population of city Hyderabad, INDIA. A total of 200 individuals were examined and out of which 179 were enrolled fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic data, oral hygiene practices. Based on Fasting plasma glucose (FPG) levels, they were grouped into: Good, Moderately and Poorly controlled Type 2 Diabetic patients. Oral hygiene index-simplified, CPI and clinical attachment level (CAL), Tooth mobility and Tooth loss due to mobility were evaluated. Nearly Half the individuals have good glycemic control. (47.5% are &amp;#60;121mg/dl), 29.1% have moderately controlled (&amp;#60;121-180mg/dl), 23.5% have poorly controlled (&amp;#60;181-240mg/dl) plasma sugar levels. Average Patients showed 5-10 years of diabetic history with 121- 180mg/dl fasting plasma glucose (FPG) levels. Average participants had fair OHI-S scores. Patients with Good FPS levels showed fair oral hygiene status. Community periodontal index (CPI) scores showed (14.52%) Gingivitis, (20.11%) mild, (8.93%) moderate, (2.79%) severe periodontitis patients with good controlled FPS Levels. Average CAL values ranged between 3-5mm in good to moderately controlled FPS levels. Tooth mobility and tooth loss is less in over all participants. Patients with high plasma sugar levels were more susceptible for severe periodontal disease. CPI values and mobility of teeth was less in subjects with FPG&amp;#60;126mg/dl. With Loss of attachment up to 5mm was observed. Both Periodontist and Diabetologist individually and together should improve awareness regarding periodontal health and diabetic control.

Association between Dietary Patterns and the 5-year Progression of Periodontal Disease

ObjectivesThis study aims to examine the association between dietary pattern scores and the 5-year progression of periodontal disease among participants in the Buffalo Osteoporosis and Periodontal Disease Study (OsteoPerio).MethodsWe conducted analyses among 920 postmenopausal women with complete data and a mean age of 67 (SD = 7) at baseline 1997–2000. Average scores for the Healthy Eating Index-2015 (HEI), Alternative HEI (AHEI), Dietary Approaches to Stop Hypertension (DASH), and alternate Mediterranean Diet Score (aMed) were calculated using data from two FFQs administered 1994–1998 and 1997–2001. Periodontal assessments were conducted at baseline and the 5-year follow-up (2002–2005) to obtain whole mean mouth alveolar crestal height (ACH) in mm, percentage of gingival sites bleeding on probing (%BOP), pocket probing depth (PPD) in mm, and clinical attachment level (CAL) in mm. Linear regression models were used to examine the association between each score (10 points for HEI and AHEI [possible range 0 to 100 points], 4 points for DASH [possible range 8 to 40 points], and 1 point for aMed [possible range 0 to 10 points]) and these periodontal measures at follow-up with adjustment for baseline periodontal measures, age, race, recreational physical activity (metabolic equivalent-hours/week), neighborhood socioeconomic status, smoking, education, and dental hygiene. Sensitivity analyses were run after adding 10 mm to the baseline values of ACH and CAL to define the 5-year measure for each tooth lost over follow-up due to periodontal disease.ResultsHigher AHEI, DASH, and aMed were associated with higher whole mean mouth ACH (indicative of greater oral bone loss) with adjusted βs (95%CI) of 0.037 (0.003, 0.072), 0.075 (0.003, 0.147), and 0.019 (0.001, 0.037), respectively. In sensitivity analyses, no statistically significant association was found after accounting for tooth loss due to periodontal disease.ConclusionsAHEI, DASH, and aMed were found to have a modest and positive association with ACH. However, after accounting for tooth loss due to periodontal diseases, no association was found between dietary patterns and periodontal measures.Funding SourcesNational Heart, Lung, and Blood Institute, National Institute of Dental and Craniofacial Research, and the Department of Defense.

Ten-Year Stability of Clinical Attachment after Regenerative Treatment of Infrabony Defects and Controls.

Background: A similar long-term stable clinical attachment level (CAL) of infrabony defects (IBDs) after regenerative treatment compared to control teeth would indicate a high level of stability resulting from the regenerative approach. Methods: Patients with a regeneratively treated IBD were screened 120 ± 12 months postoperatively for eligibility for study participation, and were included if complete baseline and 12-month examinations (plaque (PlI), periodontal probing depth (PPD), CAL) were available and a respective control tooth could be identified. Re-examination included clinical examination (PPD, CAL, PlI/GI, bleeding on probing, plaque control record, gingival bleeding index). Results: A total of 27 patients (16 females; age (median; lower/upper quartile): 57.0; 44.0/60.0 years; 6 smokers) contributed 27 IBDs (test), for each of which a control tooth was identified. Five test teeth (18.5%) were lost between 12 and 120 months. The remaining 22 test teeth revealed a significant CAL gain after 1 (2.5 mm; 1.0/4.0 mm, p < 0.0001) and 10 (2.5 mm; 0.5/3.5 mm, p < 0.0001) years, whereas control teeth were stable (1 year: 0.0 mm; 0.0/1.0 mm, p = 0.396; 10 years: 0.0 mm; −1.0/1.5 mm, p = 0.215). The study did not detect any significant CAL change between 1 and 10 years for test (−0.5 mm; −1.0/0.5 mm, p = 0.414) and control teeth (0.0 mm; −1.0/1.0 mm, p = 0.739). In 15 patients, test and control teeth revealed stable CAL values between 12 and 120 months. Conclusion: Regenerative treatment of IBDs exhibited stability comparable to non-surgically treated, periodontally reduced sites over a 10-year period.

A thermosensitive gel with an active hyaluronic acid ingredient that contains an octenidine preservation system as an adjunct to scaling and root planning: a randomized prospective clinical study.

To evaluate the adjunctive effect of a thermosensitive gel formulation that contains 0.8% oligo hyaluronic acid (HA) combined with a preservation system of octenidine HCl 0.625% and phenoxyethanol to scaling and root planing (SRP) as compared with SRP alone in the treatment of residual pockets of patients with stage 3 periodontitis. Thirty-four patients (21 males and 13 females) aged 29-78years (51.3 ± 13.1) with stage 3 periodontitis were recruited to participate in the present split-mouth study. None of the patients has been previously treated for periodontitis. Plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated at baseline and at 3 and 6months posttreatment. Full-mouth SRP was performed in all residual pockets ≥ 5mm. Treatment was performed by means of ultrasonic and hand instruments and lasted 45-60min. The gel was applied subgingivally in the test sites immediately after SRP (baseline) and 1month later. The paired t-test for two means was applied to test the statistical significance of the change from baseline within each arm and determine the difference between groups. The level of significance was set at 0.05 for all tests. Mean PD reductions between baseline and 3 and 6months were 1.98mm and 2.79mm for the test and 1.22mm and 1.50mm for the control group, respectively. Comparisons between the test and control groups revealed that SRP + gel yielded statistically significantly higher PD reductions compared to SRP alone (p < 0.0001). Compared to baseline, CAL and BOP values improved statistically significantly in both groups, although the test group presented statistically significantly higher CAL gains and BOP reductions than the control group (P < 0.0001). In residual pockets of stage 3 periodontitis patients, the local application of a thermosensitive gel with an active HA ingredient and a preservation system of octenidine HCl 0.625% in conjunction with SRP may additionally improve the clinical outcomes obtained with SRP alone. A novel HA and octenidine containing thermosensitive gel effectively improved the clinical parameters in stage 3 periodontitis patients over a 6-month period.

THE EFFECT OF MENOPAUSE ON NADPH OXIDASE LEVELS AFTER NON-SURGICAL PERIODONTAL TREATMENTS ON PATIENTS WITH PERIODONTITIS

ABSTRACT Objectives: This study evaluated the clinical parameters [ plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) ] and the levels of Nadph Oxidase (NOX-1) in gingival crevicular fluid (GCF) samples of pre-menopausal and post-menopausal periodontally healthy and periodontitis patients. Materials and Methods: Study included pre-menopausal periodontitis 15, post-menopausal periodontitis 15, pre-menopausal periodontally healthy 15 and post-menopausal periodontally healthy 15; a total of 60 individuals were included. Results: Clinical periodontal evaluation indices in the 6th week after treatment were found to be statistically significantly lower than the initial values of PI, GI, PPD, CAL in the periodontitis groups(p&amp;lt;0.05). Pre-treatment baseline NOX-1 values were singificantly higher in both periodontitis groups than healthy groups (p&amp;lt;0.05). While the pre-menopausal and post-menopausal periodontitis groups before treatment had similar PI, PPD and CAL values, the GI was found to be significantly higher in the post-menopausal periodontitis group(p &amp;lt;0.05). While NOX-1 values in pre-treatment GCF samples were similar in pre-menopausal and post-menopausal periodontitis groups, NOX-1 values in the post-menopausal periodontitis group at the 6th week after treatment were found to be statistically higher than the pre-menopausal periodontitis group (p &amp;lt;0.05). Conclusion: According to the results of our study, oxidative stress that increases with menopause may negatively affect the healing potential after periodontal treatment. Accordingly, antioxidant supplementation can be predicted with hormone replacement during this period.

A Comparative Clinical Study of Er:YAG Laser and Hand Instruments in the Treatment of Moderate Chronic Periodontitis.

Moderate chronic periodontitis is the most common periodontal disease. The treatment of this condition should aim at achieving a biocompatible root surface and decontamination of the pocket, thereby restoring the health status. In the present study, the aim was to examine the clinical effectiveness of fibreless Er:YAG laser used for scaling and root planing and to compare it with a conventional treatment with Gracey curettes. The study included 909 periodontal pockets which were treated in a split-mouth design with either Gracey curettes or with Er:YAG laser (1.5 W). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index were recorded. There was a considerable decrease of PPD, CAL, BoP, and plaque presence values at 1 and 3 months after therapy in both treatment groups. Sites treated with Er:YAG laser demonstrated mean CAL gain of about 1.00 mm and 0.44 mm at the first and third month, respectively. In the control group, there was also significant gain of CAL of about 1.33 mm at the first and 0.30 mm at the third month. Significant difference was observed in all parameters between both groups in favour of the laser treatment. The results of the present study suggest that the Er:YAG laser shows clinical effectiveness in the treatment of moderate chronic periodontitis. It can be used as a single treatment modality for subgingival scaling and root planing resulting in greater improvements in all recorded data in contrast to conventional treatment.

Long-Term Assessment of Periodontal Tissues after Corticotomy-Assisted Orthodontic Arch Expansion.

Objectives: The aim of the study was the long-term assessment of the condition of periodontal tissues after corticotomy-assisted orthodontic expansion in patients with transverse maxillary deficiency. Materials and Methods: The study included a group of 18 adults (9 women, 9 men) aged between 24 and 40 years who were at least 5 years post treatment. The following parameters were assessed: the full mouth plaque index (FMPI), full mouth bleeding on probing (FMBOP), probing depth (PD), clinical attachment level (CAL), gingival recession height (GR), recession width (RW), papilla height (PH), papilla width (PW), bone sounding (BS), phenotype, and KT. Results: During examination performed at least 5 years after the completion of orthodontic treatment, the values of PD and CAL were found to be considerably decreased compared to the examination one year post treatment (PD: −0.23; 95% Cl: −0.29, −0.16) (CAL: −0.04; 95% Cl: −0.17, 0.10). The other parameters—FMPI, FMBOP, GR, RW, PH, PW, BS, phenotype, and KT—did not change significantly. Conclusions: Corticotomy-assisted orthodontic arch expansion does not have a negative effect on the periodontium in long-term observations. Clinical Relevance: Orthodontic arch expansion can lead to bone dehiscence and gingival recession. Long-term observations revealed that corticotomy-assisted orthodontic expansion of the upper arch is not followed by negative changes in periodontal status.

Comparison of Osteoimmunological and Microbiological Parameters of Extra Short and Longer Implants Loaded in the Posterior Mandible: A Split Mouth Randomized Clinical Study.

ObjectivesThis study aimed to evaluate the levels of TNF-α, PGE2, RANKL, RANK, OPG, the markers of periimplant bone loss in peri-implant crevicular fluid obtained around standard and extra short implants. Moreover, the levels of putative oral pathogens were investigated in the submucosal biofilm samples.Material and MethodsThe implants were divided into two groups according to their lengths: standard (≥8 mm) and extra short (4 mm). A total of 60 implants were researched in 30 patients. The probing depth (PD), clinical attachment level (CAL), presence of bleeding on probing (BOP), 3-year survival rate (CSR), and bone loss (BL) were measured.ResultsNo statistically significant difference was found in the values of PD, CAL, BOP, CSR, and BL between the groups (P> 0.05). Total amounts of PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG were not statistically significantly different between the groups (P> 0.05). The abundance of F. nucleatum, T. forsythia, P. intermedia, P. gingivalis, S. oralis and T. denticola was compared between the groups and the results were not statistically significant (P> 0.05).ConclusionThe results of this study suggested that PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG in PICF, as well as microbiological parameters in submucosal biofilms, were similar between standard (≥8 mm) and extra short (4 mm) implants. Therefore, the implant length does not seem to influence the bone loss, levels of osteoimmunological and microbiological markers in the peri-implant tissues and survival rates.

Efficacy of Nd:YAG laser-assisted periodontal therapy for the management of periodontitis: A double-blind split-mouth randomized controlled clinical trial.

This study aimed to explore the efficacy of Nd:YAG laser-assisted periodontal therapy for management of patients with stage II-IV periodontitis. Patients who presented with residual periodontal pockets were enrolled. After non-surgical periodontal therapy (NSPT), test sites received Nd:YAG laser (first entrance to pocket: 3 W, 100 μs, 20Hz; second entrance: 4 W, 600 μs, 20Hz) and control sites received placebo (laser off). Periodontal probing depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), and plaque index (PI) were recorded at baseline and 1, 2, 3, 4 and 6-month visits. Twenty patients completed the 6-month period. Significant reductions in PPD, CAL, BOP, and PI values and a significant increase in GR at all follow-up visits compared to the baseline (all P<0.001) were revealed in both groups. Test sites showed significantly greater improvement in PPD (P=0.0002) and greater increase in GR (P<0.0001) compared to the control sites at 6-month visit. There was no difference between two groups regarding CAL gain through the study period (P=0.23). NSPT+Nd:YAG laser with the current protocol results in greater PPD reduction compared to NSPT alone. However, this reduction is likely because of greater GR rather than attachment gain. Therefore, the adjunction of Nd:YAG laser (with the current setting) to the NSPT for the treatment of residual periodontal pockets did not ameliorate the clinical outcomes (ClinicalTrials.gov ID: NCT03365167).

Periodontal condition of mandibular incisors treated with modified Kazanjian vestibuloplasty compared to untreated sites: A prospective study.

A shallow vestibule, insufficient keratinized tissue width and pulling of marginal gingiva may be associated with gingival recession, plaque accumulation and gingivitis. Conventional techniques for treatment of gingival recession use autogenous or allogenic grafts. However, these methods result in soreness at the donor site and pose an economic burden, which may cause patients to withdraw from treatment. Alternative therapy is currently not available to treat such patients. The aim of this study was to evaluate changes in periodontal tissue at the mandibular incisors after vestibuloplasty, focusing on functional improvement of the existing soft tissue with no grafting. Thirty patients with a shallow vestibule, minimal keratinized tissue width (KTW; ≤1 mm), gingival recession (REC) and pulling of gingiva underwent modified Kazanjian vestibuloplasty were included into the test group, whereas 27 patients did not undergo any surgery (control group). The probing pocket depth (PPD), clinical attachment level (CAL), gingival recession depth (GRD), and KTW were assessed at baseline and 12 months post-surgery. The mean KTW, GRD and CAL values improved in the test group. A significant increase in mean KTW value (1.17 ±1.22 mm, p = 0.0406) was detected in the test group, while the control group showed a further reduction in mean KTW value (0.13 ±0.45 mm). The mean GRD value decreased from 2.09 ±1.78 mm to 1.22 ±1.46 mm (p = 0.0087) in the test group, whereas in controls the mean GRD value increased from 1.95 ±1.29 mm to 2.34 ±1.44 mm (p = 0.0164). The mean KTW value at 3, 6 and 12 months compared to baseline showed an increase in the test group, and the mean GRD and CAL values exhibited the potential to improve. Sites treated with vestibuloplasty showed increased KTW, improvement in the gingival margin and CAL gain, whereas untreated sites showed continuous deterioration of the evaluated parameters. Vestibuloplasty may be recommended for patients avoiding major surgery for which functional improvement in tissue alone would provide a sufficient therapeutic outcome.

Evaluation of the effect of periodontitis on quality of life using Oral-Dental Health-Related Quality of Life-United Kingdom scale.

The aim of this study was to investigate the impact of periodontitis on oral health-related quality of life (OHQoL) using Oral-Dental Health-Related Quality of Life-United Kingdom (OHRQoL-UK) scale and evaluate the contributing factors. 50 patients with untreated periodontitis and 50 individuals without periodontitis were enrolled in the study. All subjects received detailed periodontal examination. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) measurements were examined. OHRQoL was assessed by the Oral Health Quality of Life-United Kingdom (OHRQoL-UK) scale. Symptoms of periodontitis were monitored by visual analogue scale (VAS). Socio-demographic characteristics, medical history, smoking status, hygiene habits of the participants were recorded. This study is registered at ClinicalTrials.gov as NCT04240014. Total OHRQoL-UK scores were 38.24±6.47 in periodontitis patients and 55.88±9.38 in non-periodontitis individuals (p<0.001). The scores of all 4 parameters were significantly lower in patients with periodontitis compared to healthy individuals (p <0.001). Higher PI, GI, PD and CAL values were associated with extensive negative impacts of periodontitis on OHRQoL (p<0.001). According to the results of linear regression analysis, only periodontitis was found to associate with OHRQoL. Periodontal disease reduces the total quality of life score by 15.087 (ß= -15.087; 95% CI = [(-18.934)-(-11.240)]. Individuals with periodontitis has diminished OHRQoL compared to healthy individuals.

TOPICAL CHEMOTHERAPEUTIC ADJUNCTS IN NON-SURGICAL PERIODONTAL THERAPY – A RANDOMISED CONTROLLED DOUBLE BLINDED TRIAL.

Introduction: Topical chemotherapeutic agents used in treatment of chronic periodontitis are antimicrobial agents which help in plaque control. The present study evaluates the efficacy of ornidazole gel with gold standard chlorhexidine gel when used as adjunct to scaling and root planing.&#x0D; Material and Methods: 90 patients diagnosed as chronic periodontitis, having pocket depth ?3 mm and in good systemic health were selected by systematic sampling method and divided in 3 groups. In all 3 groups scaling and root planing was done. In group A, Ornidazole gel application was done while in Group B Chlorhexidine gel application was done while Group C was control group. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline, 1 and 3 months while Probing pocket depth (PPD) and Clinical attachment level (CAL) were recorded at baseline and 3 months.&#x0D; Results: PI and GI showed significant reduction in all three groups after 1 and 3 months compared to baseline. On inter group comparison, both PI and GI showed no significant difference in reduction of scores after 1 month and 3 months (p&gt;0.05). PPD and CAL values showed statistically significant reduction after 3 months when compared to baseline values. The intergroup comparison revealed statistically significant reduction in group A and B compared to control group C (p&lt;0.05).&#x0D; Conclusion: Ornidazole showed comparable efficacy as Chlorhexidine when used as adjunct to scaling and root planing for treatment of chronic periodontitis.