Improvement In Periodontal Parameters Research Articles

Clinical efficacy of amino bisphosphonate on periodontal disease status in postmenopausal women: Randomized double-blind placebo-controlled trial.

Objectives:Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women.Materials and Methods:Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months.Results:A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179).Conclusion:Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy.

EFFICACY OF CURCUMIN AS AN ADJUNCT TO SCALING AND ROOT PLANING IN PERIODONTITIS PATIENTS – A CLINICAL AND MICROBIOLOGICAL STUDY

Background: The goal of periodontal therapy is to eliminate bacterial plaque and the factors favoring its formation. Conventional therapy includes scaling, root planing and curettage along with appropriate maintenance of oral hygiene. However, complete elimination of sub gingival micro flora is difficult from areas inaccessible to periodontal instrumentation, which demands the use of antimicrobials as adjuncts in periodontal therapy. Periodontal pocket provides an ideal environment for the growth of anaerobic pathogenic bacteria. In the course of initiation and progression of the inflammatory process, the sub gingival bacteria increase in numbers and invade the pocket epithelial cells and subsequently, the underlying tissues.
 Aim: To evaluate the efficacy of the adjunctive use of curcumin with scaling and root planing as compared with scaling and root planing alone in the treatment of the periodontitis.
 Materials and Methods: Twenty patients with two contralateral sites were identified for the study having probing pocket depths (PPDs) of >5mm. Full mouth scaling and root planing (SRP) was done followed by subgingival application of curcumin gel only on one side. Assessment of Plaque index (PI), Gingival index (GI), Probing Pocket Depth, Clinical attachment levels (CALs) were done at both baseline and at 4th week. Subgingival plaque samples was collected from the root surface and standard microbiologic assessment was done both from the control and the test sites before scaling and root planing.
 Result: There was a reduction in PI, GI, PPD, CAL and microbiologic parameters in test sites followed by SRP and curcumin gel application, when compared with SRP alone in control group.
 Conclusion: The subgingival application of curcumin gel in adjunct with scaling and root planing has shown good improvement in periodontal parameters and has a beneficial effect in periodontitis patients.
 Keywords: Curcumin, Periodontitis, Scaling and root planing.

Do adjunctive statins improve periodontal treatment outcomes in patients with chronic periodontitis?

Data sources Medline-PubMed, Scopus and Embase databases.Study selection Controlled clinical trials studies with at least one month follow-up that utilised locally or systemically delivered statins as a sole adjunctive treatment to mechanical periodontal therapy in patients diagnosed with chronic or aggressive periodontitis were included. Selection was carried out independently by two reviewers. Data extraction and synthesis Data were extracted to a spreadsheet with authors being contacted for missing data. Risk of bias for randomised controlled trials was assessed using the Cochrane tool with the ROBINS-I tool being used for non-randomised studies. Weighted mean differences between baseline and six months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD) and intrabony defect (IBD) were calculated.Results Fifteen studies were incorporated in the systematic review, with ten investigations included in the meta-analysis. In the meta-regression, the additional use of simvastatin, rosuvastatin and atorvastatin decreased pocket depth in contrast with mechanical periodontal treatment and a placebo gel (p < 0.05). Simvastatin and rosuvastatin significantly reduced the development of intrabony defect in contrast with control group (p < 0.05). Statins failed to provide a statistically significant difference between the adjunct therapy for both periodontal pocket depth and intrabony defect (p < 0.05). Simvastatin provided a statistically significant improvement in clinical attachment level gain, as compared to the control group (2.02 ± 0.79 mm; p = 0.043). Conclusions Improvements in periodontal parameters were observed with the use of statins as adjunct to mechanical periodontal therapy. Simvastatin was the main medication that demonstrated additional advantages in all assessed parameters. The use of statins in relationship with non-surgical scaling and root planing provided better clinical periodontal outcomes.

Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial

Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B ( p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A ( p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.

Diode Laser as an Adjunct to Kirkland Flap Surgery-A Randomized Split-Mouth Clinical and Microbiological Study.

Background: Mechanical methods of periodontal therapy alone may fail to eliminate the tissue-invasive pathogenic flora; therefore, considerable attention has been given to adjunctive antimicrobial measures. Objective: The aim of this study was to investigate and compare the clinical and microbiological effects of diode laser (DL) as an adjunct to Kirkland flap surgery versus Kirkland flap surgery alone for the treatment of generalized chronic periodontitis. Materials and methods: A total of 20 patients with generalized chronic periodontitis with probing pocket depth ≥5 mm after phase I therapy were included in this split-mouth study. Two contralateral quadrants of each patient were randomly assigned to either test or control group. Control group was treated with Kirkland flap surgery alone, whereas test group was treated with DL as an adjunct to Kirkland flap surgery. Periodontal parameters were recorded, and subgingival plaque samples were collected from both the control and test groups at baseline and third and sixth month. The plaque samples were then analyzed for red complex organisms using quantitative real-time polymerase chain reaction. Results: Compared with baseline, both treatments showed an improvement in periodontal parameters at the third and sixth month. However, test group produced a significant improvement in plaque index (1.039 ± 0.069 vs. 1.392 ± 0.17, p < 0.001), bleeding on probing (16.512 ± 5.982 vs. 37.051 ± 7.459, p < 0.001), probing pocket depth (1.727 ± 0.39 vs. 3.016 ± 0.47, p < 0.001), and clinical attachment level (2.054 ± 0.524 vs. 3.354 ± 0.728, p < 0.001) at third and sixth month compared with the control group. Moreover, in the test group, levels of red complex bacteria were significantly reduced at third and sixth month compared with the control group. Conclusions: DL as an adjunct to Kirkland flap surgery has resulted in a greater reduction in clinical and microbiological parameters compared with Kirkland flap surgery alone, thereby offering additional benefit in treating generalized chronic periodontitis patients.

Efficacy of Curcumin as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients: A Randomized Controlled Clinical Trial

The aim of the present study is to evaluate the efficacy of curcumin gel as local drug delivery post-scaling and root planing and its effect on clinical parameters like plaque, gingival scores, pocket depth, and clinical attachment level (CAL). Ten patients with two sites in the contralateral quadrants having probing pocket depths (PPDs) of ≥5 mm were selected. Full-mouth scaling and root planing (SRP) was performed followed by the application of curcumin gel on a single side. Assessment of plaque index (PI), gingival index (GI), PPD, and CALs were done at the baseline and at the 4th week. The results revealed that there was a statistically significant reduction in PI and probing depth in the test group when compared with the control group. CAL was improved but the results were not statically significant. The local application of curcumin gel when used in conjunction with SRP showed a significant improvement in periodontal parameters and has a beneficial effect in patients with chronic periodontitis. Curcumin gel as an adjunct to SRP showed a marked improvement in restoring gingival health by an improvement in clinical parameters. It has proven properties like anti-inflammatory, antioxidant, antimicrobial, hepatoprotective, immunostimulant, antiseptic, antimutagenic, and it also accelerates wound healing. It may be a more acceptable and viable option for the common man. Curcumin can be used as an effective alternative local drug delivery agent.

Effect of two periodontal treatment modalities in patients with uncontrolled type 2 diabetes mellitus: A randomized clinical trial.

To evaluate the impact of two non-surgical periodontal treatment modalities on metabolic and periodontal clinical parameters in subjects with type 2 diabetes mellitus (T2DM) and poor glycaemic control and chronic periodontitis. A randomized controlled clinical trial was conducted. Ninety-three T2DM subjects with glycosylated haemoglobin (HbA1c)>7% were randomly assigned to one of two groups receiving scaling with root planing in multiple sessions quadrant-by-quadrant (Q by Q) or within 24hr (one stage). Periodontal parameters, HbA1c, glycaemia blood levels (FPG) and C-reactive protein (CRP) values were assessed at baseline and at 3 and 6months post-therapy. At 6months, HbA1c had decreased by 0.48% in the Q by Q group and by 0.18% in the one-stage group (p=0.455). After therapy, subjects with an initial HbA1c<9% showed an increase of 0.31% (p=0.145), compared with a decrease of 0.88% (p=0.006) in those with an initial HbA1c≥9%. Periodontal parameters improved significantly (p<0.0001) post-therapy, with similar results for both treatment modalities. Periodontal therapy had the greatest impact on HbA1c reduction on patients with an HbA1c>9% regardless of treatment modality. Both modalities resulted in significant improvements in periodontal parameters.

Longitudinal Improvement in Periodontal Parameters between RPD Abutment Teeth with Direct and Indirect Retainers, after Periodontal Therapy.

To evaluate the effect of basic periodontal treatment on clinical periodontal parameters associated with abutment teeth of patients with mandibular Kennedy class I removable partial dentures (RPD) 18 months after treatment. Thirty patients with periodontal disease were treated and evaluated according to the following periodontal parameters: visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), clinical attachment loss (CAL), and keratinized mucosa (KM). These parameters were compared between abutment teeth with direct and indirect retainers at baseline, and after 6 and 18 months. Data were analyzed by Friedman Test and Wilcoxon Test for all variables. Most patients (n=26; 86.7%) included in the study were female and had a mean age of 61 years (±7.54). Results showed that VPI and BOP decreased over time, and that VPI values were higher in abutment teeth with direct retainers (p=0.001). There was a reduction in PD after 6 months, which was maintained up to 18 months. In general, abutment teeth with direct retainers had significantly higher values for PD, GR, and CAL (p=0.029). Data also indicated that the parameters for VPI, BOP, and PD improved; however, abutment teeth with direct retainers presented smaller improvements, compared with abutment teeth with indirect retainers, which presented significant improvements for almost all variables. Periodontal treatment and oral hygiene care of patients were adequate for maintenance of adequate periodontal conditions, regardless of the use of prostheses.

Clinical usability of aspartate aminotransferase to evaluate the prognosis of periodontal regeneration therapies: prospective, longitudinal study.

To evaluate the degree of periodontal tissue destruction, aspartate aminotransferase (AST) levels in the gingival crevicular fluid (GCF) are utilized as a predictor of periodontal therapy. We have previously shown that the usefulness of AST activities [periodontal tissue monitor (PTM) values] using a PTM-kit to evaluate the effects of initial periodontal therapy and periodontal regeneration therapy by enamel matrix derivative (EMD). This prospective, longitudinal study was conducted using 38 healthy and 80 periodontitis sites with probing depth (PD) of 5-10mm for guided tissue regeneration (GTR) and EMD from 36 patients. GCF samples were used to evaluate PTM values at base line (BL) and after 6months of surgeries (re-evaluation: RE), and periodontal examinations were performed concurrently. PTM values at BL were statistically improved at RE, accompanied by the improvement of periodontal parameters in both groups. PTM values and PD, and the clinical attachment level (CAL) showed high correlations. PD, CAL and bleeding on probing (BOP) were highly correlated with PTM values in both groups, whereas only PD showed a significant correlation with PTM values at RE in the GTR group. Change in the amounts of PD, CAL and BOP between BL and RE in both groups showed no correlation with PTM values. In the negative PTM value sites at BL in EMD group, the mean PD was significantly reduced at RE compared with positive PTM sites at BL. PTM values are able to be utilized as the biochemical predictor of prognosis after periodontal regeneration therapy.

The Effects of Diode Laser Therapy as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A 1-Year Randomized Controlled Clinical Trial

The aim of this study was to investigate and compare the clinical, microbial, and inflammatory effects of a diode laser as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of generalized aggressive periodontitis (GAgP). Using a split-mouth design, 31 patients with GAgP were enrolled in the study. The maxillary right and left quadrants were randomly assigned to SRP+diode laser or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable chosen. In addition, subgingival biofilm samples and gingival crevicular fluid (GCF) inflammatory mediators were analyzed at each follow-up session. Compared to baseline, both treatments demonstrated an improvement in periodontal parameters at 1 year. However, SRP+diode laser produced a significant improvement in probing depth (PD; 2.56 ± 0.44 vs. 3.36 ± 0.51 mm, p < 0.05) and CAL (3.47 ± 0.25 vs. 4.11 ± 0.26 mm, p < 0.05) values compared to SRP alone. Similarly, in the SRP+diode laser group, the bacteria of orange complex group were significantly reduced at 30 and 60 days compared to SRP alone. Moreover, SRP+diode laser determined a reduction in mean GCF level of interleukin (IL)-1β and IL-1β/IL-10 ratio at 15 and 30 days compared to SRP alone (p < 0.05). At 1 year, SRP+diode laser yielded a significant reduction in some clinical parameters, while microbial and inflammatory mediator changes were not significantly reduced compared to SRP alone.

The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial.

Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP. Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored. Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23±0.31mm vs. desiccant: 3.25±0.57mm, p<0.05), CAL (SRP: 3.16±0.29mm vs. desiccant: 4.21±0.34mm, p<0.05mm) and bleeding on probing (BOP) (SRP: 4.56±1.5% vs. desiccant: 34.23±4.2%, p<0.001) at 12months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p<0.05); and the level of inflammatory mediators was significantly reduced (p<0.003) compared to SRP alone. SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone. Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.

Lack of adjunctive effect of 0.1% sodium hypochlorite mouthwash combined to full-mouth ultrasonic debridement on supragingival plaque, gingival inflammation, and subgingival microbiota: A randomized placebo-controlled 6-month trial.

To test the adjunctive effect of 0.1% sodium hypochlorite (NaOCl) mouthwash combined to full‐mouth ultrasonic debridement (FMUD) on reducing supragingival plaque, gingival inflammation, and microbial pathogens. In this 6‐month double‐blinded randomized clinical trial, individuals with gingivitis were assigned to test (n = 16) or placebo group (n = 16) and received FMUD followed by rinsing with 0.1% NaOCl (test) or distilled water (placebo), respectively, twice a day for 1 month. Full‐mouth periodontal examination was performed at baseline, 1, 3, and 6 months posttherapy, and subgingival plaque samples were obtained at the same time points and analysed for their composition by checkerboard. Differences between groups over time were examined by Student t test, Mann–Whitney, generalized linear model, and Friedman and chi‐square tests. Both therapeutic protocols resulted in significant clinical improvement in periodontal parameters over time, except for probing depth and attachment level, which had a slight mean increase of 0.2 mm (p < .01). No significant differences between groups were observed for any clinical parameter (p > .05). Most species (>65%) decreased similarly in levels in both groups over time. Significant reductions in the microbial complexes were seen mainly at 1 and 3 months, but they returned to baseline levels in both groups, except for the red and yellow complexes, and other oral species, which were kept in low levels at 6 months (p < .05). A 0.1% NaOCl mouthwash did not provide additional benefits to FMUD in reducing supragingival plaque, gingivitis, and/or microbial pathogens.

Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis.

AIMTo evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis (CHP).METHODSSixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters (plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin (HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.RESULTSBoth groups were comparable at baseline. Three months after non surgical periodontal therapy (NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was -0.056 ± 0.10 and -1.66 ± 6.04 respectively, which was significant between case and control group (P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT (P < 0.05).CONCLUSIONThis study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

Platelet-Rich Fibrin With 1.2% Rosuvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial.

Regenerative periodontal therapy encompasses use of various bioactive agents that are not only inflammomodulatory but also osteoclast-inhibitory or, rather, osteostimulative. Hypolipidemic statin drugs, particularly rosuvastatin (RSV), are known to be associated with alveolar bone formation and periodontal improvements. Platelet analogs such as platelet-rich fibrin (PRF), being rich sources of growth factors, have also come into widespread periodontal regenerative use. The aim of this study is to evaluate and compare efficacy of open flap debridement (OFD) with or without PRF or PRF + 1.2% RSV gel in treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP). Ninety individuals with a total of 90 IBDs were randomly assigned to one of three treatment groups: 1) OFD alone; 2) OFD + PRF; and 3) OFD + PRF + 1.2% RSV gel placement. Measurements recorded at baseline and 9 months after surgery were: 1) plaque index (PI); 2) modified sulcus bleeding index (mSBI); 3) probing depth (PD); 4) clinical attachment level (CAL); and 5) IBD depth. Significant PI and mSBI reductions were observed in all three groups. PRF placement significantly enhanced improvements in periodontal parameters compared with OFD alone. Addition of 1.2% RSV gel to PRF resulted in significantly greater CAL gain and PD and IBD depth reductions over 9 months compared with other groups. OFD with RSV (1.2%) and PRF results in significantly greater periodontal benefits compared with OFD alone or with PRF.

Evaluation of efficacy of photodynamic therapy as an adjunct to nonsurgical periodontal therapy in treatment of chronic periodontitis patients: A clinico-microbiological study.

Photodynamic therapy (PDT) is a local noninvasive treatment modality without side effects caused by antibiotics. The aim of this study was to evaluate the efficacy of adjunctive use of PDT with scaling and root planing as compared with SRP alone in the treatment of chronic periodontitis. Twenty participants with chronic periodontitis having probing pocket depths (PDs) of ≥5 mm were selected for the study. Patients were randomly divided into control group and test group with ten patients in each group. Full-mouth SRP was performed in both the groups, followed by PDT in test group. Assessment of plaque index (PI), gingival index (GI), PD, and clinical attachment level (CAL) was done at baseline and after 3 months. Microbiological assessment of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola was done by polymerase chain reaction (PCR) at baseline and 3 months after the therapy. There was a significant reduction in PI, GI, PD, CAL, and microbiologic parameters in test group, following SRP and PDT, when compared with SRP alone in control group. PDT in conjunction with SRP has shown additional improvement in periodontal parameters when compared to SRP alone and has a beneficial effect in chronic periodontitis patients.

Azithromycin buccal patch in treatment of chronic periodontitis.

Aim:This study aims to explore the clinical, microbiological, and biochemical impact of azithromycin (AZM) buccal patch in chronic generalized patients as a monotherapy as well as an adjunct to nonsurgical therapy.Materials and Methods:A parallel design was used forty periodontitis patients were randomly allocated into five groups, namely Group 1 scaling root planing (SRP) alone, Group 2 (SRP + AZM patch group), Group 3 (SRP + AZM tablet group), Group 4 (AZM patch monotherapy), and Group 5 (AZM tablet as monotherapy). Plaque index, gingival bleeding index, modified gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and 21 and 90 days. Subgingival pooled plaque sample was collected to assess periodontopathogens like Porphyromonas gingivalis and Prevotella intermedia (Pi) by anaerobic culture method. Tumor necrosis factor alpha (TNF-α) was also evaluated at baseline and 21 days. Periodontal maintenance was performed in Group 1 until 90th day, and clinical parameter was assessed at the end of 90th day.Results:SRP + AZM tablets showed greater reduction in clinical parameters (P < 0.05) AZM as monotherapy did not offer clinical benefits over SRP. Baseline data were compared at the end, i.e., 90th day a significant reduction in plaque scores, gingival bleeding, and PPD was observed however no significant gain in the clinical attachment was observed.Conclusion:The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients.

The effects of periodontal therapy on serum and salivary leptin levels in chronic periodontitis patients with normal body mass index

Summary. Leptin concentrations are altered in favour of pro health after periodontal therapy. Background. Leptin, a non-glycosylated peptide hormone, not only maintains fat stores, but is also an integral part of host defense repertoire. Leptin levels have been found to be altered in an array of inflammatory diseases including chronic periodontitis (CP), but the role of non-surgical periodontal therapy (NSPT) in altering the leptin concentrations in saliva and serum of CP patients is yet to be ascertained. The aim of the present study is to quantify leptin levels in CP patients having normal body mass index (BMI) pre-therapy as compared to periodontally healthy controls and to address whether successful NSPT alters leptin concentration in serum and saliva. Materials and methods. Twenty-two saliva (modified draining method) and serum samples (by venipuncture) were collected from CP patients with normal BMI (n = 22), before and at 4 and 12 weeks after completion of NSPT, and periodontally healthy, age- and gender-matched controls (n = 22). Leptin levels were estimated using enzyme linked immunosorbent assay kits. Results. At baseline, CP patients had significantly different periodontal clinical parameters and the leptin concentrations in saliva of CP patients were found to be significantly lower than periodontally healthy volunteers (4710.10 ± 1133.21 vs 8721.10 ± 1019.58 pg/ml) (p < 0.05), whereas in serum the leptin concentrations were significantly higher than healthy controls (10749 ± 2062.24 vs 8085.00 ± 2859.68 pg/ml). Significant improvement in periodontal parameters, serum and salivary leptin levels were observed in CP patients at 4 and 12 weeks post-therapy (p < 0.01). Conclusion. Altered concentrations of leptin in serum and saliva are observed in CP patients which can be restored in favor of health after periodontal therapy.

Effect of Time Lapse between Endodontic and Periodontal Therapies on the Healing of Concurrent Endodontic-Periodontal Lesions without Communication: A Prospective Randomized Clinical Trial

IntroductionThe aim of this prospective randomized clinical trial was to evaluate the effect of a time lapse between endodontic treatment and nonsurgical periodontal treatment on periodontal healing of concurrent endodontic-periodontal lesions without communication. MethodsThirty-one patients were randomly divided into 2 groups: group 1: endodontic treatment and scaling and root planning (SRP) were performed simultaneously and group 2: SRP was performed 3 months after endodontic treatment. Both groups were followed for 3 and 6 months after SRP. Primary outcome variables were the probing depth, clinical attachment level, and periapical index score. ResultsBoth the groups showed a significant improvement in all the clinical parameters evaluated after the completion of endodontic and periodontal treatment (P < .05). No statistically significant difference in improvement was observed between the 2 groups at 3 and 6 months after SRP (P > .05). Periodontal healing responses were comparable in the 2 groups, with no apparent detriment resulting from simultaneous treatment. Improvements in periodontal parameters that were achieved in 6 months in group 2 were achieved only in 3 months in group 1 (P > .05). ConclusionsNonsurgical periodontal treatment may be performed simultaneously with endodontic treatment in the management of concurrent endodontic-periodontal lesions without communication, and an observation period after endodontic treatment may not be required.

Efficacy of curcumin as an adjunct to scaling and root planning in chronic periodontitis patients: A clinical and microbiological study.

Background and Objectives:Curcumin is a naturally occurring anti-inflammatory agent with various biologic and medicinal properties. Its therapeutic applications have been studied in a variety of conditions, but only few studies have evaluated the efficacy of curcumin as local drug delivery agent and in the treatment of periodontitis. The present study was to evaluate the efficacy of the adjunctive use of curcumin with scaling/root planing as compared with scaling/root planing alone in the treatment of the chronic periodontitis.Materials and Methods:Thirty patients with two sites in the contralateral quadrants having probing pocket depths (PPDs) of ≥5 mm were selected. Full mouth scaling and root planing (SRP) was performed followed by application of curcumin gel on a single side. Assessment of plaque index (PI), gingival index (GI), PPD, and clinical attachment levels (CALs) were done at baseline and at 4th week. Microbiologic assessment with polymerase chain reaction was done for Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola by collection of plaque samples.Results:The results revealed that there was a reduction in PI, GI, probing depth, CAL, and microbiologic parameters in test sites following SRP and curcumin gel application, when compared with SRP alone in control group.Conclusion:The local application of curcumin in conjunction with scaling and root planing have showed improvement in periodontal parameters and has a beneficial effect in patients with chronic periodontitis.

Type 2 diabetes mellitus and severe periodontal disease in an adult population; effect of a new local delivery approach

Objective: The aim of this study is to clarify association between diabetes mellitus and periodontitis, and assess the effect of metronidazole and chlorhexidine mixture as a local delivery. Methods: Sixty patients constituted three groups: (I) type 2 diabetes with advanced periodontitis; (II) diabetes mellitus without periodontitis; and (III) periodontitis without diabetes. Clinical attachment loss (CAL) and bleeding index (BI) were recorded. Periodontitis received first non-surgical therapy, and then metronidazole and chlorhexidine gel. Diabetics undertook blood analysis for diabetic factors. Results: Statistical differences were noticed between groups I and II at all periods (three and six month) except few sites, and between groups I and III at all sites of CAL and most sites of BI. Group I had the worst measurements at baseline and 3 month which reversed with less measurements at 6 month (following therapy) by demonstrating significant intergroup positive changes, without significance prior to therapy. No significant differences were noticed within groups I and III for CAL prior to therapy except few sites, but were present at 6 month at all sites in group III and except two sites in group I. For BI, no differences were noticed except three sites. Conclusion: The present study suggested evidence on improvement of periodontal parameters following treatment with the local mixture of metronidazole and chlorhexidine gel.