Improvement In Periodontal Status Research Articles

Exploring the bi-directional relationship between periodontitis and dyslipidemia: a comprehensive systematic review and meta-analysis.

As periodontitis and dyslipidemia are diseases that occur with high incidence, the relationship between them has attracted much attention. Previous studies on these diseases have tended to focus on lipid parameters and periodontitis, we aimed to investigate the relationship between dyslipidemia and periodontitis. A comprehensive search to identify the studies investigating the relationship between dyslipidemia and periodontitis was performed on PubMed, Web of Science and Cochrane Library before the date of August, 2023. Studies were considered eligible if they contained data on abnormal blood lipid parameters and periodontitis. Studies that reported mean differences and 95% confidence intervals or odds ratios were used. A total of 73 publications were included in the meta-analysis. Hyper total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and lower high-density lipoprotein (HDL) levels are risk factors for periodontitis. Periodontal disease is a risk factor for high TG and low HDL levels. Three months after periodontal treatment, the levels of TC, TG and HDL were significantly improved, and statin treatment only improved gingival index (GI) levels compared to that of the dietary control. The findings reported here suggest that the mutual promotion of periodontitis and dyslipidemia can be confirmed. Non-surgical periodontal therapy may improve lipid abnormalities. It can't be demonstrated whether systematic application of statins have a better effect on the improvement in periodontal status in patients with dyslipidemia compared to that of the control.

Effect of non-surgical periodontal therapy on glycemic control of patients with chronic periodontitis and type-2 diabetes mellitus: A 3 month follow-up intervention study

Periodontal pathogens and their by-products trigger production of cytokines, acute phase proteins and oxidative stress molecules that impair insulin sensitivity or action. The effect of mechanical treatment alone on metabolic control in diabetes is controversial. The present study compared changes in glycaemic control following full-mouth scaling and root planing (SRP) by measuring glycated haemoglobin (HbA1c) level in 15 chronic periodontitis patients with diabetes. At baseline, periodontal examination, HbA1c evaluation and full-mouth SRP was done. Periodontal examination and HbA1c evaluation were repeated after 3 months. Change in HbA1c levels at 3 months was the primary outcome and changes in clinical parameters were secondary outcomes. Statistically significant improvement in periodontal status and HbA1c levels were seen after a follow up of 3 months following SRP. Periodontal treatment improved clinical measures of chronic periodontitis in patients with diabetes, supporting use of nonsurgical periodontal treatment for lowering HbA1c levels.

CONDITION OF ENDOTHELIAL FUNCTIONS OF VASCULAR WALL IN HYPERTENSIVE PATIENTS DURING DENTAL IMPLANTATION

Preoperative correction of periodontal vascular endothelial dysfunction in patients with essential hypertension (HD) can improve the efficiency of dental interventions and reduce the incidence of complications during the implantation process. The periodontal status and functional state of the vascular endothelium were examined in 60 patients with essential hypertension, aged 35 to 45, before and after implantation. The first, main group included 40 people with hypertension, who, in preparation for implantation, along with traditional dental treatment, were prescribed an antioxidant drug Mexidol. Patients of the main group were divided into two subgroups: in subgroup A, a solution of Mexidol was used in the form of applications on the mucous membrane of the gums; in subgroup B, the drug was administered both locally and per os. In the second group, in 20 patients with hypertension, surgical intervention was performed after the traditional complex of therapy. The control group consisted of 10 apparently healthy patients of the same age, with normal blood pressure. Endothelial dysfunction was diagnosed by the level of stable end metabolites of nitric oxide. During the initial examination of patients with hypertension, a significant decrease in the content of nitric oxide metabolites in the blood serum was revealed in comparison with the indicators of patients in the control group. After the course of the therapy, the indicators of nitric oxide in the serum of patients with hypertension increased, more significantly in those who received Mexidol, both locally and orally, which was accompanied by a clear improvement in periodontal status and the absence of complications in the postoperative period.

Clinical and Radiographic Evaluation of Combined Treatment with Bisphosphonate Plus Platelet-Rich Fibrin versus Platelet-Rich Fibrin Alone for Severe Periodontitis with Furcation Defects

Background: This research assessed the clinical and radiographic evaluation of treatment with PRF plus bisphosphonate, compared to alone PRF in treatment of severe periodontitis with furcation defects. Methodology : This randomized, controlled radiological and clinical study enrolled 50 patients. All patients were given oral health instructions, oral prophylaxis, root planning, and relief of trauma from occlusion. The sites for therapy with PRF and PRF plus bisphosphonate were chosen randomly by the coin toss method. After they had received 6 weeks of presurgical therapy, patients underwent further clinical assessments by using different indices and assessment of level of attachment Radiographic outcomes were bone defect height, defect width, and defect depth; these were used to determine the bone defect volume. Results: This study revealed with positive results in all clinical assessments in the PRF plus bisphosphonate, as compared to PRF alone group with significant p value of less than 0.05. All radiographic parameters showed greater degrees of reduction in the parameters of platelet-rich fibrin plus bisphosphonate group, compared to the platelet-rich fibrin alone group; however, only the defect width of bone and defect volume were statistically significantly reduced in the platelet-rich fibrin plus bisphosphonate group, in comparison to the platelet-rich fibrin. Conclusion: Platelet-rich fibrin plus bisphosphonate therapy was beneficial in regeneration of periodontal ligament and improvement of periodontal status.

The Local Effect of Chlorhexidine Agents in The Treatment of Chronic Periodontitis Patients

ABSTRACT Background: Periodontitis is an immuno-inflammatory disease of the tissues surrounding the teeth. Various treatment modalities like mechanical debridement and use of antimicrobials have been followed in the treatment of such conditions. Introduction of local drug delivery system in the periodontal pocket is a promising therapeutic modality for achieving better clinical outcomes when used as an adjunct to conventional non-surgical periodontal therapy. objectives: To evaluate clinical effect of different local delivery chlorhexidine Periochips and solution agents as adjuncts to SRP as combined therapy in patients with chronic periodontitis. Materials and methods: A Clinical comparative study was conducted on 45 patients of both gender (male and female) with an age of 30-50 years and with chronic moderate to severe periodontist, all patients are being undergone full-mouth mechanical debridement by using ultrasonic scaler and universal and Gracey curettes. Periodondontal pockets are to be irrigated by distillate water. Then the subjects were divided into two main group; first group consist of 15 patients with chronic periodontitis treated by chlorhexidine periochips, second group consist of 15 patients with chronic periodontitis treated by chlorhexidine Solution In addition to control group consist of 15 patients which were treated by SPR only. The criteria for chronic periodontitis was defined by the presences of PPD≥5mm and CAL≥3, in two or more different sites for each patient of at least two teeth in each quadrant, and then the results were analyzed statistically. Results: The most significant improvements were found concerning CAL, PI and GI in the group treated with CHX solution over CHX periochips (P 0. 05). Conclusion: Results of this study favor combination therapy using CHX solution as an adjunct to SRP due to greater improvement in periodontal condition of patients with chronic periodontitis, compared to those obtained by SRP alone or with SRP and CHX periochips.

Systemic doxycycline as an adjunct to scaling and root planing in diabetic patients with periodontitis: a systematic review and meta-analysis

BackgroundTo compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis.MethodsTwo independent reviewers (KY and SJ) screened two electronic databases, PubMed and Scopus, for randomized clinical trials on the use of systemic doxycycline as an adjunct to scaling and root planing in improving periodontal status and glycemic control in diabetic patients with periodontitis using predetermined selection criteria within a 3-month period. The reviewers independently did data screening, data selection, data extraction and risk of bias. Quality of studies involved was analysed using the revised Cochrane Risk of Bias 2.0. Weighted standard mean differences (SMD) and 95% confidence intervals were calculated using a random effects meta-analysis model. Publication bias was evaluated using funnel plot. Quality of evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsElectronic searches provided 1358 records and six studies were selected. The meta-analyses indicated that there was no statistically significant difference in the improvement of periodontal status with the use of systemic doxycycline as an adjunct for scaling and root planing (SRP). SMD of clinical attachment levels (− 0.22 [− 0.52, 0.08]) and HbA1c levels (− 0.13 [− 0.41, 0.15]) were calculated. Overall risk of bias is high in 2 out of 6 studies involved.ConclusionSystemic doxycycline when used in addition to scaling and root planing yields no significant improvement of clinical attachment levels for periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group.

Effect of Aloe Vera mouthwash on moderate gingivitis: Clinical and microbiological study

Background and objectives: Gingivitis is an inflammatory process confined to the gingiva with no attachment or bone loss, Aloe Vera (AV) is an ancient medicinal plant that is widely known for its medicinal uses. This study was planned to assess the effect of AV as a mouthwash on clinical periodontal parameters; plaque index (PI), gingival index (GI) and bleeding index (BI) and to evaluate its antibacterial effect on bacterial plaque Staphylococcus Aureus and Streptococcus Viridans, comparing it with chlorhexidine (CHX) mouthwash. Subjects and methods: Sixty patients with moderate gingivitis were randomly assigned to three groups. The subjects in the first group (A) used 0.12% CHX mouthwash, the second group (B) used 80% AV mouthwash and the third group (C) used 0.9% normal saline as placebo for 14 days. Clinical examinations to assess PI, GI and BI were done at days 0, 14 and 21 post treatment. The antibacterial activity of AV mouthwash was tested using Agar Well Diffusion method. Statistical Analysis: SPSS version 25. Mean ± (SD), normality test, ANOVA and T test. Results: Significant reduction in the mean of PI, GI and BI at day 14 and 21 by using AV and CHX mouthwashes and statistically non-significant difference was observed between them. Means of the inhibition zone diameter against Streptococcus Viridans for CHX and AV were (15.64 ± 0.71 and 13.52 ± 1.02) respectively and against Staphylococcus Aureus were (23.33 ± 1.52) for CHX and (20 ±1) for AV. Conclusions: The use of AV mouthwash results in improvement of periodontal status. It was also found that it has significant anti-bacterial and anti-inflammatory activity. Thus, it may be used as a treatment for plaque-induced gingivitis.

Simple platelet markers: Mean platelet volume and congestive heart failure coexistent with periodontal disease. Pilot studies.

Conducted pilot study concerning mean platelet volume (MPV) parameter among patients suffering from congestive heart failure and periodontal disease. Examination of dynamic changes of platelet and periodontal markers in group of 50 patients before and an average of 6 months subsequent to professional periodontal treatment. Both platelet and periodontal parameters decreased after periodontal treatment, what is more, the decrease of MPV value due to periodontal disease/mm improvement was shown to be statistically significant (p = 0.05). Improvement of periodontal status may influence decrease of MPV value and increase of congestive heart failure treatment efficacy and effect patient comfort. It is a new, not frequently used pattern of chronic disease treatment optimalization.

Glycyrrhiza glabra: An efficient medicinal plant for control of periodontitis – A randomized clinical trial

Background: Periodontitis is a common oral problem that everyone faces at least once in lifetime. According to the WHO, among all oral diseases, prevalence rate of periodontitis is very high. As definition given by the American Dental Association, periodontitis is a chronic inflammation of the tooth and its supporting structure which leads to loosening of the teeth in their socket and lastly loss of teeth. From ancient times, peoples are using traditional medicines to prevent or cure the disease. Glycyrrhiza glabra is one of the medicinal plants that show the effectiveness for sore throat and other respiratory infections in researches. Thus, the present study is an attempt to check the efficacy of G. glabra in the prevention and cure of periodontitis. Methodology: A randomized clinical control trial was conducted on 104 patients divided into two groups – experimental group and control group. G. glabra gum paint in 10% concentration was given to patients of experimental group for 4 weeks. All patients were instructed to strictly follow good oral hygiene habits. Parameters used for checking the effectiveness of G. glabra were gingival bleeding, loss of attachment, and depth of periodontal pockets. Results: Preintervention and postintervention scores were analyzed by means of mean, standard deviation, and t-test. There is a significant improvement in periodontal status of patients in the experimental group. Conclusions: Results of the present study revealed that G. glabra was effective in preventing periodontal diseases. The present study also motivates to conduct more Medicinal plant-based clinical trial in the prevention of periodontitis so that effective treatment can be provided with a minimal side effect.

Probing Pocket Depth and Clinical Attachment Level between Non-Surgical and Surgical Periodontal Therapy in Chronic Periodontitis Patients: A Randomised Controlled Clinical Trial

Background: : Chronic periodontitis is one of the most common form of periodontal diseases which either require non-surgical periodontal therapy or open flap debridement-surgical therapy or both. To date, it is unclear as of how much changes occur after NSPT or OFD and which therapy provides the best outcome in chronic periodontitis having probing pocket depth ≥ 5-7 mm.
 Aim: The aim of this randomized controlled clinical trial was to evaluate the Probing Pocket Depth and Clinical Attachment Level between NSPT and OFD in chronic periodontitis patients.
 Materials and Methods: A total of 52 healthy patients with PPD ≥ 5-7 mm were included in the present study. Half of the patients assigned for the NSPT and half in the OFD group. The PPD and CAL were measured at baseline, three and six months. Independent sample t-test was used to compare the change in mean PPD and CAL between NSPT and OFD group at three and six months, respectively.
 Results: The difference in the mean decrease of PPD between NSPT and OFD group at three and six months were 0.15 mm (P<0.05) and 0.19 mm (P<0.05), respectively. The difference in the mean gain of CAL between NSPT and OFD group at three and six months were 0.03 mm (p>0.05) and 0.12 mm (P<0.05), respectively.
 Conclusion: Substantial improvement in periodontal status occurred with both the therapies, however, significantly higher decrease in PPD and gain in CAL were seen with surgical therapy.

Exploring changes in oral hygiene behaviour in patients with diabetes and periodontal disease: A feasibility study.

ObjectiveExploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment.MethodsPatients with type 1/2 diabetes and chronic periodontitis (n = 8) received standard non‐surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD ≥ 5 mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre‐ and post‐treatment. At 3 months post‐treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients.ResultsData from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3 months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self‐efficacy element.ConclusionThe novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine.

C-Reactive Protein Levels and Periodontal Diseases During Pregnancy in Malaysian Women.

To investigate the association between plasma CRP levels and periodontal disease during pregnancy. Fifty-six pregnant women attending the Antenatal Clinic, UMMC for their first antenatal check-up consented and were recruited for this study: 28 subjects with diseased periodontium (test group) and 28 subjects with healthy periodontium (control). The test group underwent nonsurgical periodontal therapy and the control group was given oral hygiene education. Periodontal parameters and CRP levels were evaluated at baseline and 6 weeks. Pregnancy outcome data were recorded from the Antenatal Clinic, UMMC. Plasma CRP levels in the test group were statistically significantly elevated compared to the control group (8.55 ± 5.28 mg/l vs 5.66 ± 2.91 mg/l). After nonsurgical periodontal therapy, a statistically significant reduction in the CRP level in the test group (2.06 mg/l) along with statistically significant improvement in periodontal status in both groups was observed. The mean birth weight for infants of both groups showed no statistically significant difference. Plasma CRP levels in pregnant women with diseased periodontium were statistically significantly reduced after nonsurgical periodontal therapy. However, no association between CRP levels and adverse pregnancy outcome was observed.

Periodontal Disease in Patients with Ankylosing Spondylitis: myth or reality?

Although the relation between periodontitis (PD) and systemic disorders (e.g. cardiovascular diseases, diabetes and rheumatoid arthritis) is widely accepted, the association with ankylosing spondylitis (AS) is inconsistently mentioned. We prospectively examined the relationship between periodontal disease and AS, focusing on the rate and course of PD, factors associated with severity and the impact of anti-TNF-a treatment on inflammatory status. Standard assessments performed twice (week 0, week 24) included an extensive dental evaluation (plaque index, gingival index, bleeding on probing, periodontal pocket depth, clinical attachment loss), inflammatory parameters and AS activity scores (BASDAI, ASDAS-CRP). More than half of AS presented with impaired periodontal health at baseline (mild to moderate PD) meaning increased sites with dental plaque, abnormal bleeding, increased periodontal pocket depth and clinical attachment loss. Significant positive correlation between presence and severity of PD, AS activity and systemic inflammation (CRP) was reported at baseline (p[0.05). A final analysis performed at 24 weeks revealed significant improvement in periodontal status, inflammatory parameters and AS activity, suggesting efficacy of TNF inhibitors directed not only against systemic, but also on local (articular, periodontal) inflammation (p[0.05). Patients with AS are at risk to develop periodontal disease, particularly those with high levels of systemic inflammation. Benefits of anti-TNFa therapy in the particular settings of AS patient and concomitant periodontal disease should be validated through further studies in larger cohorts.

Influence of periodontal treatment on rheumatoid arthritis: a systematic review and meta-analysis

ObjectiveTo evaluate the influence of periodontal treatment on rheumatoid arthritis activity. MethodsMEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5. ResultsFour articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: −1.18; 95% CI: −1.43, −0.93; p<0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend toward reduction (not statistically significant). ConclusionsThe reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.

Comparison of Serum Lipid and Thyroid Profiles Before and After Scaling and Root Planning in Periodontitis Subjects

Background: Hyperlipidemia and Thyroid disorders are considered to be related with systemic inflammation. Periodontitis has been found to release inflammatory cytokines to systemic circulation. So, it could be related with these two systemic conditions. Aim: Determination of effect of changes in periodontal status obtained by scaling and root planing on serum lipid and thyroid profiles. Materials and Methods: The study was conducted on 30 subjects with chronic periodontitis. Subjects with history of periodontal treatment in the past six months, diabetes and on anti hyperlipidemic/thyroid drugs or active tobacco smoking were excluded. Periodontal parameters (gingival index, plaque index, bleeding on probing, probing pocket depth) and metabolic parameters, like, fasting serum lipid profile and thyroid profiles were taken at baseline and 90 days. At baseline, conventional periodontal therapy i.e., full mouth scaling and root planing was performed without any prescription of antibiotics or mouthwashes. Results: There were significant improvement (p<0.05) in all periodontal parameters. Correspondingly, there were significant (p<0.05) decrease in the levels of very low density lipoprotein (VLDL), Triglycerides and thyroid stimulating hormone (TSH). There was significant (p<0.05) increase in HDL levels, but no significant changes in cholesterol, VLDL and triiodothyronine (T3) and thyroxine (T4) levels. Conclusion: The improvement in periodontal status is reflected in improvement of serum lipid profile. This effect is not very obvious on thyroid status.

Aggressive periodontitis associated with Kindler syndrome in a large Kindler syndrome pedigree.

Talo-Yıldırım T, Acun-Kaya F, Taşkesen M, Dündar S, Bozoğlan A, Tekin GG, Akdeniz S. Aggressive periodontitis associated with Kindler syndrome in a large Kindler syndrome pedigree. Turk J Pediatr 2017; 59: 56-61. Kindler syndrome (KS) is a rare genetic disorder. The clinical features include aggressive periodontal disease and severe desquamative gingivitis. Five individuals with KS were assessed by oral examination, radiographic analysis and periodontal measurements. All the patients' indexes were recorded prior to periodontal treatment and at the end of the 1th, 3th , 6th, 9th and 12th month respectively. All the patients had improvement of periodontal status and enhancement in index scores. The affected individuals were previously screened for FERMT1 mutations. KS patients' periodontal disease activity could be taken under control with regular follow-up.

Influência do tratamento periodontal na artrite reumatoide: revisão sistemática e metanálise

ObjectiveTo evaluate the influence of periodontal treatment on rheumatoid arthritis activity. MethodsMEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non‐surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta‐analysis using Review Manager 5. ResultsFour articles were included. Non‐surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: −1.18; 95% CI: −1.43, −0.93; p <0.00001). Erythrocyte sedimentation rate, C‐reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend towards reduction (not statistically significant). ConclusionsThe reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.

Anti-B lymphocyte immunotherapy is associated with improvement of periodontal status in subjects with rheumatoid arthritis.

Rheumatoid arthritis (RA) and periodontitis present many similar features. The benefits of anti-B lymphocyte therapy (rituximab) on reducing tissue resorption in RA prompted us to assess its potential efficacy on the periodontal status of patients with RA treated with rituximab. Periodontal status was assessed in 21 subjects with RA, divided into two groups: Group I consisted in 11 subjects assessed before their first infusion of rituximab and again 6 months later. Five of them were also assessed for up to 4 years after their first rituximab infusion. The 10 subjects in group II had received more than two courses of two rituximab infusions at the time of periodontal assessment. Pocket depth and attachment loss were significantly decreased 6 months after treatment with rituximab in group I. The periodontal status of the five subjects from group I followed for up to 48 months after rituximab treatment was improved irrespective of the clinical parameter observed. Patients from group II had a better periodontal status than patients from group I before treatment with rituximab. Anti-B lymphocyte therapy could be beneficial to improve periodontitis suggesting a major role of B cells in this disease.

Is alveolar cleft reconstruction still controversial? (Review of literature).

Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA1c.

We evaluated the effects of nonsurgical periodontal therapy in 100 patients with type 2 diabetes and chronic periodontitis. The participants were classified as having good (n = 48) or poor (n = 52) glycemic control and were further randomly allocated to receive either scaling and root planning treatment group or no treatment (n = 50 each). The effect of nonsurgical periodontal therapy was compared among diabetic patients with good glycemic control, those with poor glycemic control, and 25 nondiabetic individuals. Periodontal and metabolic status was recorded at baseline, 3 months, and 6 months. In patients receiving treatment, periodontal parameters significantly improved and HbA1c decreased by 10.8%. Improvements in gingival index and bleeding on probing were greater in the nondiabetic participants and the treated patients with good glycemic control than in the treated patients with poor glycemic control (P < 0.05). Regression analysis showed that improvement in periodontal status was independently associated with glycemic improvement. Nonsurgical periodontal therapy improved glycemic control and periodontal health in patients with type 2 diabetes. However, patients with poor baseline glycemic control had less clinical improvement than did those without diabetes and those with good glycemic control.