Effect Of Non-surgical Periodontal Therapy Research Articles

Effect of nonsurgical periodontal therapy on serum and gingival crevicular fluid cytokine levels during pregnancy and postpartum

A low-grade systemic inflammatory status originating from periodontal infection has been proposed to explain the association between periodontal disease and systemic conditions, including adverse obstetric outcomes. The aim of this study was to evaluate the effect of periodontal therapy during pregnancy on the gingival crevicular fluid and serum levels of six cytokines associated with periodontal disease and preterm birth. A subsample of 60 women (18-35 years of age) up to 20 gestational weeks, previously enrolled in a larger randomized clinical trial, was recruited for the present study. Participants were randomly allocated to receive either comprehensive nonsurgical periodontal therapy before 24 gestational weeks (n = 30, test group) or only one appointment for supragingival calculus removal (n = 30, control group). Clinical data, and samples of blood and gingival crevicular fluid, were collected at baseline, at 26-28 gestational weeks and 30 d after delivery. The levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor-α were analyzed by flow cytometry. After treatment, a major reduction in periodontal inflammation was observed in the test group, with bleeding on probing decreasing from 49.62% of sites to 11.66% of sites (p < 0.001). Periodontal therapy significantly reduced the levels of IL-1β and IL-8 in gingival crevicular fluid (p < 0.001). However, no significant effect of therapy was observed on serum cytokine levels. After delivery, the levels of IL-1β in the gingival crevicular fluid of the test group were significantly lower than were those in the control group (p < 0.001), but there were no significant differences between test and control groups regarding serum cytokine levels. Although periodontal therapy during pregnancy successfully reduced periodontal inflammation and gingival crevicular fluid cytokine levels, it did not have a significant impact on serum biomarkers.

Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD). Sixteen CKD pre-dialysis individuals (CKD) and 14 individuals without clinical evidence of kidney disease (C) presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05). After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05) were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05) than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial

This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW). Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (n = 147, test group) or after delivery (n = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits. At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected <15% of sites. Compared to controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%, p < 0.001), gingival bleeding (23.3% vs. 2.5%, p < 0.001), calculus (21.3% vs. 4.1%, p < 0.001), bleeding on probing (38.1% vs. 2.6%, p < 0.001) and probing depth ≥3 mm (19.97% vs. −2.45%, p < 0.001). No significant differences were observed between the groups in the occurrence of PT (11.7% vs. 9.1%, p = 0.57), LBW (5.6 % vs. 4.1%, p = 0.59), and PTLBW (4.15% vs. 2.60%, p = 0.53). Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.

Effect of nonsurgical periodontal therapy on crevicular fluid and serum glutathione peroxidase levels.

Background: Plasma glutathione peroxidase (eGPx) is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF) eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT) by correlating GCF and serum levels of eGPx. Materials and methods: Thirty subjects (16-Males and 14-Females; age: 30–38 years) participated in the study. The subjects were divided, based on gingival index, probing pocket depth and clinical attachment level into: Healthy (group-1, n=10), Gingivitis (group-2, n=10) and Periodontitis (group-3, n=10). Chronic periodontitis patients after NSPT constituted group 4. GCF and serum samples collected from each subject were quantified for eGPx levels using Enzyme linked Immunosorbent Assay. Results: The mean eGPx concentrations increased from health (14.01 ng/μl and 78.26 ng/ml) to gingivitis (22.86 ng/μl and 90.44 ng/ml) and then to periodontitis (29.89 ng/μl and 103.43 ng/ml), in GCF and serum respectively. After NSPT, there was statistically significant reduction in eGPx concentration in GCF and serum (19.41 ng/μl and 85.21 ng/ml). Further, all the GCF eGPx values showed a positive correlation to that of serum eGPx level. Conclusion: Thus, increased eGPx concentration in GCF can be considered as an indicator of local increase in oxidative stress. While, increase in serum eGPx levels indicates that periodontal disease can also lead to increased oxidative stress at the systemic level.

Effect of Nonsurgical Periodontal Therapy on Crevicular Fluid and Serum Glutathione Peroxidase Levels

Background: Plasma glutathione peroxidase (eGPx) is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF) eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT) by correlating GCF and serum levels of eGPx.Materials and methods: Thirty subjects (16-Males and 14-Females; age: 30–38 years) participated in the study. The subjects were divided, based on gingival index, probing pocket depth and clinical attachment level into: Healthy (group-1,n=10), Gingivitis (group-2,n=10) and Periodontitis (group-3,n=10). Chronic periodontitis patients after NSPT constituted group 4. GCF and serum samples collected from each subject were quantified for eGPx levels using Enzyme linked Immunosorbent Assay.Results: The mean eGPx concentrations increased from health (14.01 ng/μl and 78.26 ng/ml) to gingivitis (22.86 ng/μl and 90.44 ng/ml) and then to periodontitis (29.89 ng/μl and 103.43 ng/ml), in GCF and serum respectively. After NSPT, there was statistically significant reduction in eGPx concentration in GCF and serum (19.41 ng/μl and 85.21 ng/ml). Further, all the GCF eGPx values showed a positive correlation to that of serum eGPx level.Conclusion: Thus, increased eGPx concentration in GCF can be considered as an indicator of local increase in oxidative stress. While, increase in serum eGPx levels indicates that periodontal disease can also lead to increased oxidative stress at the systemic level.

Effect of non surgical periodontal therapy on gingival crevicular fluid and serum visfatin concentration in periodontal health and disease.

Visfatin is a pleiotropic mediator which acts as growth factor, cytokine, enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and has been recently demonstrated to exert several pro-inflammatory functions. The purpose of this study is to evaluate the Visfatin concentration in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the GCF and serum visfatin concentration. 30 subjects (age range: 25 to 52 years) were selected and divided into two groups based on the gingival index, probing depth, periodontal attachment level, and radiologic parameters (bone loss): group 1 (15 subjects with healthy periodontium), group 2 (15 subjects with chronic periodontitis), while, Group 2 patients after 8 weeks of the treatment (scaling and root planning, SRP) constituted group 3. GCF samples (by microcapillary pipettes) and serum samples (by venipuncture) were collected to estimate the levels of Visfatin using enzyme linked immunosorbent assay kit. The mean Visfatin concentration in GCF and serum was observed to be the highest in group 2 and lowest in group 1. While concentration in group 3 was similar to group 1. The concentration of Visfatin in GCF and serum decreased after SRP. The Visfatin concentration in GCF and serum found to be highest in chronic periodontitis group and decreases after treatment. Hence Visfatin values can be considered as an “inflammatory marker” can be explored in future as a potential therapeutic target in the treatment of periodontal disease.

Evaluation of Serum Resistin Levels in Periodontal Health and Disease and Effects of Non Surgical Periodontal Therapy on Its Levels

Resistin and adiponectin are the adipokines secreted by adipocytes and various inflammatory cells. These adipokines are known to play an important role in insulin resistance. The aim of this study was to determine the serum resistin levels in periodontal health and disease and also, to determine the effect of nonsurgical periodontal therapy on its levels. A total of 40 patients (20 Males and 20 Females; age range 20-50 years) participated in the study. Subjects were categorized as healthy (group 1; Controls) and chronic periodontitis (group 2; Study) groups based on their periodontal status. Periodontal parameters (Plaque index (PI), Gingival index (GI), Bleeding index (BI), Probing pocket depth (PPD), Clinical attachment loss (CAL)) together with serum resistin levels were assessed at baseline and between 6-8 weeks following nonsurgical periodontal therapy for subjects in group 2 and only at baseline in group 1. Sera were tested in duplicate (single run), and the results were averaged. Study group showed higher (1.89 ± 1.83 ng/ml) serum resistin levels, compared to control group (1.35 ± 0.70 ng/ml). However, this difference was not statistically significant (P = 0.227). Also, resistin levels decreased following nonsurgical periodontal therapy but, this decrease failed to show any statistical significance, with pretreatment levels being 1.89 ± 1.83 ng/ml and post treatment levels being 1.59 ± 1.01 ng/ml (P = 0.386). Observations of the present study revealed that there was not much difference in the serum resistin levels between the cases and the controls. Also the decrease in the resistin levels following nonsurgical periodontal therapy did not show any statistical significance.

Effect of Non‐Surgical Periodontal Therapy on C‐Reactive Protein, Oxidative Stress, and Matrix Metalloproteinase (MMP)‐9 and MMP‐2 Levels in Patients With Type 2 Diabetes: A Randomized Controlled Study

It is well accepted that glycemic control in patients with diabetes mellitus (DM) is affected by systemic inflammation and oxidative stress. The effect of periodontal therapy on these systemic factors may be related to improvement on glycemic status. The aim of the present study is to assess over a period of 6 months the effect of non-surgical periodontal therapy on serum levels of high-sensitivity C-reactive protein (hsCRP), d-8-iso prostaglandin F2a (d-8-iso) as a marker of oxidative stress, and matrix metalloproteinase (MMP)-2 and MMP-9 on patients with type 2 DM. Sixty participants with type 2 DM and moderate to severe periodontal disease were randomized into intervention (IG) and control (CG) groups. IG received scaling and root planing, whereas CG received supragingival cleaning at baseline and scaling and root planing at 6 months. Participants of both groups were evaluated at baseline and 1, 3, and 6 months. Periodontal data recorded at each visit included probing depth, clinical attachment loss, bleeding on probing, and gingival index. Blood was collected at each visit for the assay of serum glycated hemoglobin A1c (A1c), hsCRP, d-8-iso, MMP-2, and MMP-9. Although there was a trend to a reduction in hsCRP, d-8-iso and MMP-9 it did not reach statistical significance. MMP-2 levels remained unchanged after periodontal treatment. Effective non-surgical periodontal treatment of participants with type 2 DM and moderate to severe periodontal disease improved significantly A1c levels but did not result in a statistically significant improvement in hsCRP, d-8-iso, MMP-2, and MMP-9 levels.

Effect of Non Surgical Periodontal Therapy on Gingival Crevicular Fluid and Serum Visfatin Concentration in Periodontal Health and Disease

Visfatin is a pleiotropic mediator which acts as growth factor, cytokine, enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and has been recently demonstrated to exert several pro-inflammatory functions. The purpose of this study is to evaluate the Visfatin concentration in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the GCF and serum visfatin concentration. 30 subjects (age range: 25 to 52 years) were selected and divided into two groups based on the gingival index, probing depth, periodontal attachment level, and radiologic parameters (bone loss): group 1 (15 subjects with healthy periodontium), group 2 (15 subjects with chronic periodontitis), while, Group 2 patients after 8 weeks of the treatment (scaling and root planning, SRP) constituted group 3. GCF samples (by microcapillary pipettes) and serum samples (by venipuncture) were collected to estimate the levels of Visfatin using enzyme linked immunosorbent assay kit. The mean Visfatin concentration in GCF and serum was observed to be the highest in group 2 and lowest in group 1. While concentration in group 3 was similar to group 1. The concentration of Visfatin in GCF and serum decreased after SRP. The Visfatin concentration in GCF and serum found to be highest in chronic periodontitis group and decreases after treatment. Hence Visfatin values can be considered as an “inflammatory marker” can be explored in future as a potential therapeutic target in the treatment of periodontal disease.

Effects of nonsurgical periodontal therapy on C-reactive protein and serum lipids in Jordanian adults with advanced periodontitis

Data on whether periodontal therapy affects serum CRP levels are inconclusive. The aim of this study was to determine if nonsurgical periodontal therapy has any effect on CRP and serum lipid levels in patients with advanced periodontitis. Thirty-six systemically healthy patients, ≥ 40 years of age and with advanced periodontitis, were recruited for the study. Patients were randomized consecutively to one of two groups: the treatment group (n = 18) or the control group (n = 18). Treated subjects received nonsurgical periodontal therapy, which included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers [C-reactive protein (CRP) and the lipid profile] were measured at baseline and 3 mo after periodontal therapy. Nonsurgical periodontal therapy in the treatment group resulted in a significant reduction in the serum CRP level. The average CRP level decreased from 2.3 mg/dL at baseline to 1.8 mg/dL (p < 0.005) after 3 mo of periodontal therapy. The average reduction (95% confidence interval) in CRP was 0.498 (95% confidence interval = 0.265-0.731). In the treatment group, the reduction in CRP was significantly, linearly and directly correlated with the reduction in the plaque index, the gingival index and the percentage of sites with pocket depth ≥ 7 mm (Pearson correlation coefficient = 0.746, 0.425 and 0.621, respectively). Nonsurgical periodontal therapy had no effect on the lipid parameters. This study demonstrated that nonsurgical periodontal therapy results in a significant reduction in the serum CRP level. The effect of this outcome on systemic disease is still unknown.

Effect of non-surgical periodontal therapy on the levels of Th17/Th1/Th2 cytokines and their transcription factors in Chinese chronic periodontitis patients

A new subset of CD4(+) T cells, Th17, has been recently discovered independent from Th1/Th2 paradigm. The aim of this study was to investigate the effects of non-surgical periodontal therapy on the expression of Th17/Th1/Th2 cytokines and transcription factors, and Th17 cell vibration in Chinese chronic periodontitis patients. The levels of Th17/Th1/Th2 cytokines (IL-17, IL-21/IFN-γ/IL-4) in gingival crevicular fluid from 30 chronic periodontitis patients before and after treatment were determined by ELISA. The expression of transcription factors (RORC, T-bet and GATA-3) in peripheral blood was measured by real-time PCR, and the levels of Th17 cells in CD4(+) T cells were determined by flow cytometry. After treatment, the levels of IL-17 and IL-21 were down-regulated (P<0.05), and IL-4 was increased (P<0.05), but there were no differences in the level of IFN-γ (P>0.05). Correspondingly, the expression of RORC was decreased 1.99-fold (P<0.05), and GATA-3 was increased 1.76-fold (P<0.05). However, there were no differences in the level of T-bet (P>0.05). Moreover, the quantity of Th17 cells in peripheral blood was decreased (P<0.05), especially IL-17(+) IFN-γ(+) subgroup. These results suggest that Th17 cells play a destructive role in the immune balance of periodontitis, and the effect of Th1 cells is not significant, while Th2 cells have a protective effect.

Anemia of Chronic Disease and Chronic Periodontitis: Does Periodontal Therapy Have an Effect on Anemic Status?

As the periodontal tissues mount an immune inflammatory response to bacteria and their products, the systemic challenge with these agents also induces a major vascular response. Certain inflammatory cytokines produced during periodontal inflammation can depress erythropoietin production leading to the development of anemia. The aim of this study is to investigate whether patients with chronic periodontitis have an anemic status, and subsequently, to analyze the effect of non-surgical periodontal therapy on the anemic status of subjects over a 6-month period. A total of 187 patients with chronic periodontitis participated in the study. After red blood cell analyses, 60 patients with hemoglobin concentrations below reference ranges entered into the second part of the study in which patients were treated with non-surgical periodontal therapy. Clinical parameters and red blood cell analyses were repeated at 3 and 6 months. In the first part of the study, 33.6% of patients had hemoglobin concentrations below normal reference ranges. In the second part of the study, all red blood cell parameters and clinical parameters showed statistical improvements over a 6-month period. The present study strengthens the hypothesis that chronic periodontitis may lead to anemia and provides evidence that non-surgical periodontal therapy can improve the anemic status of patients with chronic periodontitis with greater improvement in females.

Effect of non-surgical periodontal therapy on glycemic control and the level of serum IL-6 in type 2 diabetic patients with chronic periodontitis

To evaluate the effect of non-surgical periodontal therapy on periodontal status, glycemic control and the level of serum interleukin (IL)-6 in type 2 diabetic patients with chronic periodontitis (DMCP). Fifty-five DMCP and 55 systemically healthy patients with chronic periodontitis (CP) were recruited in this study. The diabetes were classified into two groups, the well-controlled group [glycated hemoglobin (HbA1c) < 7.00%] and the poorly controlled group (HbA1c ≥ 7.00%). All subjects received non-surgical periodontal therapy. Periodontal clinical parameters including periodontal probing depth(PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were recorded at baseline, 6 weeks and 3 months after the treatment. Fasting plasma glucose (FPG), HbA1c and the concentration of serum IL-6 were measured. At 6 weeks and 3 months after treatment, PD, AL, BI, PLI and the concentration of serum IL-6 of both groups significantly reduced (P < 0.05). The level of IL-6 in diabetic patients reduced significantly from (3.47 ± 0.33) ng/L to (3.21 ± 0.66) ng/L and to(3.03 ± 0.54) ng/L. The HbA1c of diabetic patients reduced significantly 3 months after treatment [(6.80 ± 1.21%] compared with the baseline [(7.35 ± 1.73)%, P < 0.05]. HbA1c of the poorly controlled group reduced significantly (P < 0.05), while HbA1c of the well-controlled diabetes did not show any apparent reduction (P > 0.05). Non-surgical periodontal therapy can effectively reduce the concentration of serum IL-6, thereby improving glycemic control in type 2 diabetes patients with chronic periodontitis. However, there was no any significant reduction of HbA1c in the well-controlled diabetes.

Effect of non-surgical periodontal therapy on the levels of C-reactive protein: a pilot study

Purpose: C-reactive protein (CRP) is a marker of inflammation that is naturally present in the plasma at levels that may rise due to inflammatory processes, associated with a greater risk of cardiovascular events such as acute myocardial infarction. Periodontal disease is responsible for a host immune-inflammatory response, contributing towards clarifying its association with cardiovascular disease. The aim of this study was to investigate the effect of periodontal therapy on the levels of this inflammatory marker. Methods: The sample consisted of 62 patients of both genders, between the ages of 30 to 60 years, who were referred to dental treatment at the Bahia Foundation for the Development of Sciences, and they were divided into two groups: with and without periodontitis. The clinical descriptors used were the bleeding index, gingival recession, probing depth and clinical attachment level. For CRP analysis, peripheral blood was collected from these individuals and sent to a single clinical analysis laboratory. Results: The group with periodontitis was treated and the results showed that there was a statistically significant difference between the CRP levels before and after periodontal treatment (P < 0.05). Conclusion: From the final findings, it may be concluded that non-surgical periodontal therapy showed a tendency to reduce the CRP serum levels.

A randomized, controlled trial on the effect of non-surgical periodontal therapy in patients with type 2 diabetes. Part I: effect on periodontal status and glycaemic control

the purpose of the present study was to assess the effect of non-surgical periodontal therapy on glycaemic control of type 2 diabetes patients with moderate-to-severe periodontitis. this was a randomized, controlled clinical trial of patients with type 2 diabetes. A total of 60 patients with moderate-to-severe periodontal disease were assigned to either a periodontal treatment arm, consisting of scaling and root planing (intervention group [IG]), or a delayed treatment arm that received periodontal care after 6 months (control group [CG]). Periodontal parameters and glycosylated haemoglobin (A1C) were evaluated at 1, 3 and 6 months. all periodontal parameters improved significantly in the IG. A1C levels decreased statistically significantly more in the IG versus the CG (0.72%versus 0.13%; p<0.01) independently of other confounders. this study provides evidence that periodontal treatment contributes to improved glycaemic control in type 2 diabetes mellitus patients. Larger controlled trials are needed to confirm if this finding is generalizable to other populations of patients with type 2 diabetes.

Clinical evaluation of topical subgingival application of biodegradable xanthan based 1.5% Chlorhexidine gel for treatment of periodontal pockets

Background & Objectives: Local delivery of antimicrobials in sustained or controlled delivery systems are used to enhance the effect of non-surgical periodontal therapy; it might be possible to achieve gingival health without the need for invasive techniques with the use of local drug delivery systems. Thus the aim of the present study was to evaluate efficacy of topical subgingival application of xanthan based 1.5% chlorhexidine gel in the treatment of periodontal pockets. Methods: A randomized controlled clinical trial was carried out for a period of 6 months. 60 sites in 10 patients suffering from chronic periodontitis were divided into experimental and control sites. The experimental sites were treated with Scaling & root planing (SRP) in combination with subgingival application of biodegradable Xanthan based 1.5 % chlorhexidine gel. The control sites received SRP & subgingival application of placebo gel. Plaque index (PI) Gingival index (GI), Probing pocket depth (PD), clinical attachment level (CAL) and gingival margin position (GMP) were recorded at baseline, 3 & 6 months. Results: All the treatments showed significant reductions in PI, GI, PPD, CAL at 3 & 6 months when compared to baseline values (p<0.05). At 6 months, experimental group showed significantly greater improvement in all clinical parameters than control group. The difference between PPD reduction between the treatment groups were 3.0 & 2.4 mm at 3 & 6 months, respectively (p<0.001). For CAL these were 3.11 & 2.4 mm, respectively (p<0.001). The mean percentages of probing depth reduction & clinical attachment level gain ≥ 2 mm were greater in the experimental sites than control sites (p<0.001). Interpretation & Conclusion: Overall, both therapies led to significant improvements of the investigated parameters. The adjunctive use of Xanthan based 1.5% chlorhexidine gel showed greater PPD reductions CAL gains compared to combination of SRP & placebo gel.

Serum levels of oncostatin M (a gp 130 cytokine): an inflammatory biomarker in periodontal disease

Objective: Periodontitis is considered to be a risk factor for systemic diseases such as atherosclerosis, diabetes, etc., and cytokines play a key role. The present study was carried out to measure the level of serum oncostatin M (OSM) in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the serum OSM concentration.Materials and methods: Sixty subjects were divided into three groups (each group n = 20) based on the gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL): group I healthy; group II gingivitis; and group III chronic periodontitis. Group III patients were followed for 8 weeks after non-surgical periodontal therapy as the after-treatment group (group IV). Estimation of serum OSM was done using an enzyme-linked immunosorbent assay.Results: The mean OSM concentrations in serum were highest in the chronic periodontitis group (mean 68.05 pg ml−1) and decreased following treatment (39.65 pg ml−1) while OSM was undetectable in healthy subjects or in patients with gingivitis.Conclusion: Increased serum OSM concentration in patients with chronic periodontitis and its positive correlation with PPD and CAL, suggest its role as an inflammatory biomarker in periodontal disease and it may exaggerate other systemic conditions such as atherosclerosis and rheumatoid arthritis.

Age‐related treatment response following non‐surgical periodontal therapy

To date, no studies have evaluated the effect of patient age on the treatment response following non-surgical periodontal therapy (NSPT). To evaluate the outcomes of NSPT in two cohorts of patients with a substantial age difference. Two groups of periodontitis patients with a substantial age difference (younger group, Y, and older group, O) were retrospectively selected. The effectiveness of NSPT was assessed by evaluating the changes in the prevalence of sites with different pocket probing depths (PPD) as well as the changes in patient- and site-specific bleeding on probing (BoP) scores. Y group comprised 57 patients, mean age: 34.7 +/- 4.4 years, and O group comprised 60 patients, mean age: 58.9 +/- 5.3 years (p<0.0001). NSPT resulted in a significant improvement of PPD and BoP in both age groups. No statistically significant inter-group differences were observed in the investigated clinical parameters as well as their changes with respect to pre-treatment. However, multiple regression analysis showed a significantly higher risk of showing residual pockets following treatment in group O. The results of the present study seem to indicate that age has a limited effect on treatment response following NSPT in periodontitis patients.

Non‐surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient

Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient's doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.

Non‐Surgical Periodontal Therapy Lowers Serum Inflammatory Markers: A Pilot Study

Evidence suggests an association between periodontal disease and coronary heart disease (CHD). C-reactive protein (CRP), fibrinogen, and white blood cell (WBC) counts are markers of inflammation, and their systemic levels have been associated with CHD risk. This pilot study investigated the effect of non-surgical periodontal therapy on systemic levels of CRP, fibrinogen, and WBC counts in subjects with CHD or no CHD (NCHD). Twenty-seven angiographically defined patients with CHD and 18 subjects with NCHD aged >or=40 years were recruited for the study. Periodontal disease was measured through the clinical parameters bleeding on probing (BOP) and probing depth (PD). All subjects received non-surgical periodontal therapy that included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers (CRP, fibrinogen, and WBC counts) were measured prior to and 1 month after periodontal therapy. Seventeen subjects with CHD and 11 subjects with NCHD completed the study. Subjects with CHD or NCHD experienced significant reductions in BOP (59% and 34%, respectively; P <0.05) and PD (41% and 35%, respectively; P <0.05), with non-significant intergroup differences (P >0.05). In all subjects, CRP, fibrinogen, and WBC counts were reduced significantly (21% to 40%) after periodontal therapy (P <0.05). Periodontal treatment resulted in significant decreases in BOP and PD and lowered serum inflammatory markers in patients with CHD or NCHD. This may result in a decreased risk for CHD in the treated patients. These findings will allow pursuit of a large-scale randomized intervention trial in this population.