Effect Of Non-surgical Periodontal Therapy Research Articles

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels.

Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Interrelationship between Porphyromonas gingivalis and complement C3 and factor B Levels in chronic periodontitis individuals

Background: To evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) and serum levels of complement C3 and factor B and their correlation with Porphyromonas gingivalis levels in chronic periodontitis (CP) individuals. Materials and Methods: Thirty individuals were divided into three groups. Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Probing depth (PD) and Clinical attachment level (CAL) were recorded and P. gingivalis levels were measured at baseline in Group I (periodontally healthy) and II( chronic periodontits) and 3 months post scaling and root planning (SRP) in Group III subjects. Serum and GCF samples were collected from all the individuals at baseline 3-month post-SRP to evaluate complement C3 and complement factor B levels by spectrophotometer and enzyme-linked immunosorbent assay, respectively. Levels of P. gingivalis were determined by anaerobic culture. Results: Complement C3 and factor B levels in serum and GCF along with P. gingivalis levels in plaque samples showed statistical significance between the groups (P < 0.001). SRP resulted in decrease in C3, factor B, and P. gingivalis levels after 3 months in CP group at P < 0001. Among the periodontal parameters, PD showed significant correlation with biochemical and microbiological parameters in both the groups before and after periodontal therapy. Conclusion: P. gingivalis correlated strongly with factor B values in CP and SRP resulted in reduction of these values suggesting a possible modulation of alternate complement pathway by P. gingivalis.

Effect of Non-Surgical Periodontal Therapy on the Serum Sialic Acid Levels in Diabetic Patients with Periodontitis.

Sialic acid (SA), a family of acetylated derivatives of neuraminic acid, an acute phase reactant by itself. It usually occurs as a terminal component at the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. SA participates in multiple physiological functions, such as cell-to-cell interactions, cell migration and proliferation. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by rise in blood glucose level. Periodontitis is a chronic inflammatory disease of the periodontal tissue, leading to destruction of bone surrounding the tooth and ultimately tooth loss. There is a two way relationship between diabetes mellitus and periodontitis. Periodontitis is the sixth complication of diabetes along with retinopathy, nephropathy, neuropathy, macrovascular disease, and altered wound healing. Inflammatory mediators like interleukin-6 and tumor necrosis factor-alpha produced during periodontal inflammation can interfere with the actions of insulin receptors and worsen the glycemic control of diabetic patients. Periodontitis is a major cause of tooth loss, affecting over 300 million people and bacteria associated with periodontitis are also linked with systemic problems like endocarditis, atherosclerosis. Recent work has highlighted a major role for the host sugar sialic acid in the biofilm physiology and host-pathogen interactions of T. forsithya, a key periodontal pathogen. There exists a need for a biomarker, for early detection of disease evolution and more robust therapy efficacy measurements. Serum sialic acids were estimated in Indian population by diphenylamine method and Thiobarbituric acid method. The average values were 68 ± 2.6 mg percent by DPA method and 56 ± 5 mg percent by TBA (thiobarbituric acid assay) method. Age and sex showed no influence on serum sialic acid level. Objectives of the present study was to compare (TSSA) level in healthy subjects, subjects with (CMP) with and without (NIDDM) and its effect on non-surgical periodontal therapy. In the present study, the participants were divided into three groups: Group A, B and C. Group A consists of systemically healthy subjects, Group B consists of subjects with (CMP) while Group C consists of subjects with (CMP) with (NIDDM) and results of this study indicated that, at baseline, there were significant differences between Group A, B and Group C with respect to all the clinical parameters, including (GI), (OHI-S), (PPD), (CAL), (TSSA) and (HbA1c) levels. Thus (TSSA) level could be considered as novel biomarker in the progression of periodontal disease and diabetic status. Periodontitis could be considered as a potential, modifiable, and independent risk factor for the development of diabetes. Early detection of elevated (TSSA) level may help in interpreting the progression of periodontitis, risk of development of diabetes mellitus in future and also to prevent complications.

A study on the change in HbA1c levels before and after non-surgical periodontal therapy in type-2 diabetes mellitus in generalized periodontitis.

Aim:The aim of this study was to evaluate and investigate changes in HbA1c levels before and after non-surgical periodontal therapy in type-2 diabetes mellitus patients with generalized periodontitis.Materials and Methods:A statistically significant number of type-2 diabetes mellitus subjects diagnosed with chronic generalized periodontitis were included in the study. The selected subjects were randomly allocated to 2 groups. Group 1: Control group: Subjects who received only scaling and root planning. Group 2: Test group: Subjects received antibiotic coverage with non-surgical periodontal therapy (scaling and root planning). Clinical parameters included plaque index, gingival index, PRO MIG pocket depth, and clinical attachment level. In addition, the metabolic parameters were recorded at the same time intervals, which included fasting blood sugar, random blood sugar, and HbA1c levels.Statistical Analysis:ANOVA test was applied to the parameters.Results:HbA1c more significantly reduced by test group compared to the other group. Conclusion: there is definitely a positive effect of nonsurgical on HbA1c levels in type 2 diabetes mellitus. This point levels significantly reduced after conventional non-surgical periodontal therapy.Conclusion:There is definitely a positive effect of non-surgical periodontal therapy on HbA1c levels in type 2 diabetes patients with chronic periodontitis.

Effects of Periodontal Intervention on Levels of Serum High-sensitivity C-reactive Protein and Interleukin 6, and on Carotid Artery in Rats with Chronic Periodontitis and Hyperlipidemia.

To investigate the effects of nonsurgical periodontal therapy on the serum interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) and on the carotid artery in rats with chronic periodontitis (CP) and with or without hyperlipidemia (HL). A total of 29 Sprague-Dawley rats were randomly divided into two groups: group A (CP, n = 14) and B (CP + HL, n = 15), and subjected to the corresponding treatment. Groups A and B were further divided into groups A1/B1 (without periodontal interventions) and A2/B2 (with periodontal interventions). The serum IL-6 and hsCRP levels were evaluated before periodontal intervention and at 1, 3, 5, and 7 weeks after periodontal intervention. The rats were euthanised 8 weeks after the periodontal intervention and the histopathologic changes in the carotid artery were observed. The serum hsCRP and serum IL-6 levels in groups A1 and B1 were elevated with time; they were significantly higher in group B1 than in group A1 (P < 0.001) at all time points. The hsCRP and IL-6 levels in groups A2 and B2 increased with time and reached the maximum level 1 week after the second intervention, and then gradually decreased. Atherosclerotic plaques, fibrous cap, and calcium salt deposits were apparent in the rats of group B1, whereas no obvious atherosclerotic changes were observed in the rats of groups A2 and B2. Periodontal interventions resulted in acute, short-term systemic inflammation. However, it was beneficial in long-term as it improved the carotid artery integrity.

Effect of non-surgical periodontal therapy on stress and salivary Chromogranin-A levels: A clinico-biochemical study.

The aim of the study was to compare chromogranin A (CgA) and stress levels before and after non-surgical periodontal therapy (NSPT). A sample of 40 patients in the age range 25-60 years were included in the study and were divided into gingivitis (10 subjects), chronic periodontitis (CP) (15 patients) and aggressive periodontitis (AgP) (15 patients). The patients were asked to complete two sets of stress questionnaires, plaque index, gingival index, probing depth and clinical attachment levels (CAL) were recorded. Salivary samples were taken at baseline and were repeated three months post NSPT. CgA was detected in saliva samples of all the groups. A statistically significant correlation was established between levels of CgA and stress parameters, which was shown to be the highest in AgP (P < 0.001), followed by CP group (P < 0.005) at baseline. Following NSPT, an overall reduction was observed in the levels of CgA, which was correlated with the overall reduction in stress levels for AgP group (P < 0.005) followed by CP group (P < 0.037). Amongst the clinical parameters, CAL showed the strongest correlation with CgA both at baseline and after NSPT (P < 0.001). Stress was directly correlated to the levels of salivary CgA levels, which was the highest for aggressive periodontitis at baseline. NSPT showed a marked improvement in all the parameters. Levels of CgA and CAL showed a significant correlation in both the CP and AgP groups.

Effect of Nonsurgical Periodontal Therapy on Serum Lipid Profile-Prospective Study

Introduction: Periodontitis is a chronic inflammatory disease which considered to be linked with altered lipid metabolism there by resulting in cardiovascular disease. Thus the aim of the present study was to investigate the effect of nonsurgical periodontal therapy (NSPT) on the lipid profiles in patient with chronic periodontitis. Materials and Methods: Blood samples were obtained from 15 systemically healthy chronic periodontitis patients before and after 1 month of nonsurgical periodontal therapy and 15 healthy control subjects from those attending the outpatient department of Saveetha Dental College and Hospital. Lipid profile was estimated using calorimetric method by using ERBA CHEM 5PLUS. The data extracted were tabulated, statistically analysed using SPSS software and results were obtained. The data were analysed using Paired ‘t’ test (among chronic periodontitis before and after 1month of NSPT) and independent students ‘t’ test (between healthy controls and chronic periodontitis patients). Results: There was significant difference in the HDL value between healthy controls and chronic periodontitis patients. There was significant reduction in total cholesterol, LDL, HDL among chronic periodontitis before and after nonsurgical periodontal therapy. Conclusion: The results of our study showed there was significantly low HDL value among chronic periodontitis compared to healthy controls and all the other values Total cholesterol, Triglycerides, LDL and VLDL had no significant difference between healthy controls and chronic periodontitis. Whereas there was significant reduction in total cholesterol, LDL level and there was significant increase in HDL in chronic periodontitis patient 1 month after nonsurgical periodontal therapy.

Effect of non-surgical periodontal therapy on the fibrinogen levels in chronic periodontitis patients

ObjectiveThis study aimed to evaluate the effect of non-surgical periodontal therapy on the fibrinogen levels in chronic periodontitis patients when compared to the levels seen in healthy subjects. Materials and methodsA total of 30 subjects, with an average age of 38 ± 25 years, were enrolled in the present study. They were divided into two groups, namely Group 1 (15 periodontally healthy subjects) and Group 2 (15 moderate to severe chronic periodontitis patients). The periodontal condition of each periodontitis patient was assessed by recording the probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI) both before and after periodontal therapy had been administered for one month. Additionally, blood samples were collected from the healthy subjects and the periodontitis patients before and after the periodontal treatment in order to assay the plasma fibrinogen levels. ResultsThe clinical parameters were found to be improved after one month of periodontal therapy, with the statistical difference in the mean values of the BI and PD being highly significant (P < 0.01), while the statistical differences concerning the PI and CAL were significant (P < 0.05). The fibrinogen levels (mg/dL) for the periodontitis patients before and after treatment were 342.26 ± 69.00 and 352.93 ± 64.3 mg/dL, respectively. The level was 269.85 ± 43.68 mg/dL for the healthy subjects. In terms of the between-group comparison, the fibrinogen levels of the healthy subjects were observed to be highly significantly lower than the levels of the periodontitis patients before and after the treatment (P < 0.01), in contrast the statistical analysis showed a non-significant difference in the fibrinogen levels (P > 0.05) before and after the periodontal treatment. In addition, the statistical analysis revealed non-significant correlation between the fibrinogen levels and all the periodontal parameters (P > 0.05). ConclusionThe non-surgical periodontal therapy proved to be effective in improving the clinical periodontal condition of the periodontitis patients, while the plasma fibrinogen levels were not found to be influenced by the periodontal therapy. Further studies are needed to evaluate the fibrinogen levels over a longer duration after periodontal treatment in patients following a periodontal maintenance program.

Effect of Non-surgical Periodontal Therapy With and Without 0.2% Chlorhexidine Rinse on Metabolic Control of Type 2 Diabetic Patients

Background: The prevalence of periodontal diseases in patients with type 2 diabetes and improper glucose control is significantly higher. The aim of this study is to investigate the effect of scaling and root planning and chlorhexidine digluconate rinse on metabolic control in type 2 diabetic patients. Methods: A total of 60 patients with poorly controlled type 2 diabetes and moderate chronic periodontitis were selected, and randomly divided into three groups. We performed scaling and root planning in 2 test groups (T1, T2), with 0.2% chlorhexidine rinse used only for test group 2. Follow-up including one evaluation 3 months later and a visit 6 months later, was to evaluate glycemic control (FBS and HbA1c) and periodontal status (PI and CPI). Data were presented as mean ± standard deviation (SD) and analyzed using Student’s t test and Wilcoxon test in SPSS 20.0. Results: The mean changes in all variables in both test groups except FBS were significantly reduced (P <0.01). T2 group showed better results at 3-month evaluation. Conclusions: Non-surgical periodontal therapy improves periodontal health indicators and metabolic control in type 2 diabetic patients. Chlorhexidine is more effective on periodontal status and metabolic control in the short term.

Cigarette Smoking Aggravates the Activity of Periodontal Disease by Disrupting Redox Homeostasis- An Observational Study

The aim of this study was to evaluate the associations between cigarette use and five salivary oxidative stress biomarkers, copper-zinc superoxide dismutase (Cu/Zn SOD), manganese superoxide dismutase (MnSOD), catalase, thioredoxin-1 (TRX1), and peroxiredoxin-2 (PRX2), to assess the effectiveness of non-surgical periodontal therapy. Materials and Methods: This is an observational study,167 patients diagnosed with periodontitis were recruited. Both saliva samples and clinical measurements (plaque index (PI), bleeding on probing (BOP), and pocket depth (PD)) were taken at baseline and after completing non-surgical periodontal therapy. The Levels of salivary biomarkers were determined using a MILLIPLEX® MAP Human Oxidative Stress Magnetic Bead Panel kit. The overall reductions in PI and BOP were 31.56% and 42.16%, respectively. BOP reduction after treatment in female or male non-smokers was significantly higher than in male former smokers (p < 0.05). After completing non-surgical periodontal therapy, Cu/ZnSOD, MnSOD, catalase, and Prx2 significantly decreased. There was a significant interaction between smoking status and ΔCu/ZnSOD on PI and a significant interaction between smoking status and ΔCatalase on BOP. Conclusions: Cigarette smoking interferes with redox homeostasis in the body, alters antioxidants levels, and influences the periodontal disease activity.

Effect of non-surgical periodontal therapy on the degree of gingival inflammation and stress markers related to pregnancy.

ObjectivesThe purpose of this study was to determine the impact of nonsurgical periodontal therapy considering the salivary stress-related hormone and cytokine levels in the gingival crevicular fluid (GCF) on pregnant and nonpregnant women.Material and MethodsThirty non-pregnant (control group) and 30 pregnant women (test group) that met the study inclusion criteria were chosen. Only participants with gingivitis were included. Clinical data and samples of GCF and saliva were collected at baseline and after periodontal therapy. The levels of interleukin-1 beta (Κ-1β) and IL-10, and concentration of salivary chromogranin A (CgA) hormone were analyzed by enzyme-linked immunosorbent assay (ELISA). The repeated measures analysis of variance was used for intragroup and intergroup analyses.ResultsA major decrease in the gingival inflammation was observed in both groups after periodontal therapy (p<0.05). Periodontal treatment decreased the level of IL-1β in GCF (p<0.05) in control group, but no statistical difference was determined for GCF IL-1β in the test group. However, after periodontal therapy, the CgA hormone concentration was reduced in both groups (p<0.05). However, there was no difference in salivary CgA concentration, GCF IL-10 levels, and perceived stress scale (PSS)-10 between the groups (p>0.05).ConclusionsWithin the limitations of this study, periodontal therapy significantly improved the periodontal status and stress level. In addition, the severity of the gingival inflammation during pregnancy was related to stress. However, further studies will be needed to substantiate these early findings.

The effect of periodontal disease treatment in patients with continuous ambulatory peritoneal dialysis.

Chronic inflammation is an obvious risk factor of atherosclerotic diseases, and the presence of periodontal disease is one of the important sources of chronic inflammation in patients with chronic kidney disease (CKD) and diabetes mellitus (DM). Thus, we aimed to investigate the effects of non-surgical periodontal therapy of the patients undergoing CAPD due to diabetic nephropathy, diabetic patients without CKD, and healthy controls on inflammation exponents. Thirty-two CAPD patients due to diabetic nephropathy (group III), 31 diabetic patients without nephropathy (group II), and 38 healthy subjects (group I) were enrolled to the study. All patients enrolled to the study (to all groups) suffered from chronic periodontitis. Plaque index, Gingival index, pocket depth (PD) measurements were recorded before and after periodontal therapy. All blood samples for biochemical parameters were measured by using standard laboratory techniques with an automatic analyser. Blood samples for TNF-α, IL-6, and PTX-3 were centrifuged, and separated serum and plasma samples were stored at - 80 °C until analysis. All inflammatory markers were significantly higher in group III than the other two at baseline. TNF-α levels were significantly decreased after periodontal treatment at 3-month visit in all groups. PTX-3, IL-6, and Hs-CRP levels were significantly reduced after periodontal treatment at 3months in group III. Periodontal disease is an important source of inflammation in diabetic CAPD patients and treatment of periodontal disease can be monitored by inflammatory markers including TNF-alpha, PTX-3, IL-6, and Hs-CRP. TNF-alpha may be useful and more sensitive monitoring inflammation in healthy patients and diabetic patients after periodontal treatment.

Effect of NonSurgical Periodontal Therapy on Plasma Levels of IL-17 in Chronic Periodontitis Patients with Well Controlled Type-II Diabetes Mellitus-A Clinical Study.

For years the pathogenesis of periodontitis was under an immunological Th1/Th2 paradigm. Th1 cells are considered to afford protection against the intracellular pathogens. These cells produce the interferons (IFN) that are involved in macrophage activation, which, in turn, plays an important role in phagocytosis, complement fixation, and opsonization. Th2 cells are thought to have evolved as a form of protection against parasitic helminthes. Th17 subset of CD4Not Necessary+ T cells was identified in the year 2005, which added greater complexity to Th function and are pro inflammatory in nature. Interleukins (ILs) have the ability to alter immunological changes and they also possess the ability to regulate lymphocyte differentiation and haemopoietic stem cells, cell proliferation, and motility, which are classified as pro-inflammatory and anti-inflammatory. There are numerous studies that reported IL-17 levels associated with chronic periodontitis (CP) development. Type II diabetes mellitus (DM) is considered a risk factor for the development of periodontal diseases because the incidence, progression, and severity of periodontal diseases are more common with Type II DM than without DM. This study was aimed at evaluating whether non-surgical periodontal therapy had any effect on plasma concentrations of Interleukin-17 in systemically healthy chronic periodontitis patients and in chronic periodontitis patients with well controlled Type II Diabetes mellitus. Patients were divided into the two groups including the chronic periodontitis group (20 subjects) and the chronic periodontitis with well-controlled Type II Diabetes mellitus group (20 subjects). The Gingival Index and Plaque Index as well as the clinical Attachment Level (CAL) were taken from all the patients of two groups after evaluating fasting blood sugar, post prandial blood sugar, and the Glycated Hemoglobin Level (HbA1c). Then 5 mL blood samples were collected from each patient and plasma was separated and the IL-17 level is evaluated using the ELISA method. Then, as part of phase I periodontal therapy, scaling and root planning was performed. Patients were recalled after one month and clinical and biochemical parameters were reevaluated. Non-surgical periodontal therapy resulted in a reduction of plasma levels of IL-17 in chronic periodontitis patients with and without well controlled Type II Diabetes mellitus.

PR071: The effect of nonsurgical periodontal therapy on salivary visfatin in diabetic patients with chronic periodontitis

PR071: The effect of nonsurgical periodontal therapy on salivary visfatin in diabetic patients with chronic periodontitis

PR101: Effect of nonsurgical periodontal therapy with additional photodynamic therapy on the level of MMP‐9 and TIMP‐1 in GCF in chronic periodontitis patients

PR101: Effect of nonsurgical periodontal therapy with additional photodynamic therapy on the level of MMP‐9 and TIMP‐1 in GCF in chronic periodontitis patients

Effects of non-surgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis

To compare the effect of non-surgical periodontal therapy on clinical and inflammatory parameters in patients with moderate to severe chronic periodontitis (CP) and rheumatoid arthritis (RA) (RA-CP) with that in CP patients without RA. Eighteen patients with RA-CP and 18 systemically healthy patients with CP were treated with scaling and root planing (SRP) within 24h. At baseline, and at 3 and 6months after SRP, clinical periodontal parameters, inflammatory markers, and microorganisms in subgingival biofilm were assessed. In addition, disease activity markers of RA (DAS28, CRP, ESR) and specific antibodies (RF) were monitored in the RA-CP group. In both groups, non-surgical therapy yielded to statistically significant improvements in all investigated clinical periodontal variables; in RA patients, a statistically significant decrease in serum-CRP was seen at 3months. At all time-points, levels of inflammatory markers in GCF were higher in RA-CP than in CP patients. Counts of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola decreased statistically significantly in CP but not in the RA-CP group. Changes of DAS28 correlated positively with those of P. gingivalis and negatively with the plaque index. Within their limits, the present data suggest that (a) non-surgical periodontal therapy improves periodontal conditions in CP patients with and without RA and (b) in patients with RA, eradication of P. gingivalis in conjunction with a high level oral hygiene may transiently decrease disease activity of RA. In patients with RA and CP, non-surgical periodontal therapy is a relevant modality not only to improve the periodontal condition but also to decrease RA activity.

Effect of nonsurgical periodontal therapy on interleukin-34 levels in periodontal health and disease.

Interleukin-34 (IL-34) is a recently identified alternative ligand for colony-stimulating factor-1 receptor plays an important role in osteoclastogenesis. The aim of this study was to evaluate the IL-34 levels in gingival crevicular fluid (GCF) and plasma in subjects with chronic periodontitis and to evaluate the effect of nonsurgical periodontal therapy on the GCF and plasma IL-34 levels. Thirty individuals (age range: 30-56 years) were selected and divided into groups based on the gingival index, probing pocket depth, clinical attachment level, and radiologic parameters (bone loss): Group I (15 individuals with healthy periodontium), Group II (15 individuals with chronic generalized periodontitis) while Group II patients after 8 weeks of the treatment (scaling and root planning) constituted Group III. GCF samples and plasma samples were collected to estimate the levels of IL-34 using enzyme-linked immunosorbent assay kit. The mean IL-34 concentration in GCF and plasma was highest for Group II compared to Group I and decreased after nonsurgical periodontal therapy in chronic generalized periodontitis group. The difference between them was statistically significant (P < 0.05). IL-34 can be considered as an "inflammatory marker" of periodontal disease and can be explored in the future as a potential therapeutic target in the treatment of periodontal disease.

Cigarette use, oxidative stress biomarkers, and the effectiveness of non-surgical periodontal therapy

Cigarette use, oxidative stress biomarkers, and the effectiveness of non-surgical periodontal therapy

Non-Surgical Periodontal Therapy Impact on Progression of Chronic Periodontitis and Prevention of Further Tooth Loss

Objective: Prevention of tooth loss and maintaining favorable periodontal status are the ultimate goals of periodontal therapy. The aim of this study was to evaluate the effectiveness of non-surgical periodontal therapy and supportive periodontal care in arresting the progression of chronic periodontitis and in preventing tooth loss. Materials and methods: Periodontal charts, self-reported medical history, and two interleukin-1 (IL-1) polymorphism genotypes of 100 patients were obtained from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository after screening 4,825 subjects. We used tooth loss (TL) and clinical attachment loss (CAL) as outcomes of disease affection in our analysis. In our study, we have included third molars, teeth lost during active periodontal treatment (APT), and those lost during the supportive periodontal program. All subjects had at least 12 months of follow-up. Fisher’s exact test was used to investigate the association between tooth loss and different risk factors. Paired t-test was conducted to detect the difference in means of CAL at baseline and at final assessment. Results: There were 59 patients (36 males and 23 females with an average age of 52 years) that lost at least one tooth during supportive periodontal care. Tooth mortality rate declined by more than half in patients who enrolled in a supportive periodontal program for six years compared to those who dropped out after one year (0.52 vs. 3.4 teeth/patient/year, respectively). Increased risk of tooth loss was found to be associated with diabetes (p=0.01), as well as high blood pressure (p<0.0001). We did not find an association between tooth loss and polymorphisms in interleukin IL-1α/IL-1β (rs1800587, p=0.36 and rs1143634, p=0.51, respectively). During the first and the second year of supportive periodontal treatment, the clinical attachment loss decreased by 0.36 mm and 0.34 mm, respectively (p=0.025 and p=0.0697), when compared to baseline measurements. Moreover, a slight increase in CAL was found in the group of patients who attended regular periodontal maintenance program for six years (p=0.037, difference of 0.38 mm in comparison to the baseline measurement). Conclusion: Our findings suggested that supportive periodontal therapy is effective for the long-term preservation of teeth and the stability of periodontal tissue in patients with advanced chronic periodontitis.

Effect of nonsurgical periodontal therapy on plasma-reactive oxygen metabolite and gingival crevicular fluid resistin and serum resistin levels in obese and normal weight individuals with chronic periodontitis

Background:The hyperoxidative and a modified inflammatory state in obese individuals cause higher susceptibility to bacterial infection which influences the initiation and progression of periodontal disease.Aim:Our study was aimed to evaluate the role of nonsurgical periodontal therapy on the clinical parameters such as gingival index (GI), plaque index, pocket probing depth (PPD) and clinical attachment level (CAL), plasma-reactive oxygen metabolite (ROM) levels, and gingival crevicular fluid (GCF) resistin and serum resistin levels in obese or overweight and normal weight individuals with periodontitis.Material and Methods:Sixty individuals of age between 35 and 45 years of both the sexes were selected and categorized into two groups as thirty overweight or obese individuals with chronic periodontitis (Group I) and thirty normal weight individuals with chronic periodontitis (Group II). Clinical parameters, plasma ROM levels, and serum and GCF resistin levels were assessed at baseline and 2 months after periodontal therapy in both the groups and compared.Results:Intergroup comparison of clinical parameters (GI, CAL, PPD) 2 months after therapy showed a significant difference with more reduction in Group II compared to Group I. On comparison, mean plasma ROM, GCF, and serum resistin levels at baseline was higher in Group I compared to Group II. When plasma ROM, GCF, and serum resistin levels were compared 2 months after therapy, the reduction was more in Group II compared to Group I.Conclusion:It is concluded that along with periodontal therapy, motivation of patients for weight reduction program is mandatory for obese or overweight individuals with periodontitis in order to improve periodontal health.