Improvement In Gingival Inflammation Research Articles

Low-level laser periodontal therapy in diabetic patients: a randomized controlled clinical trial - pilot study

Objectives We aimed to evaluate the effects of low-level laser therapy as an adjunct to non-surgical periodontal therapy in patients with periodontitis and compare the effect on periodontal healing in diabetes mellitus and non-diabetes mellitus patients. Methodology Ten patients with periodontitis stage II grade B were divided into two groups; Group 1 included 5 non-diabetes mellitus patients with periodontitis, and Group 2 included 5 type2 diabetes mellitus patients with periodontitis. A 13 mW low-level laser was used in a continuous wave and non-contact mode as an adjunct to scaling and root planning (SRP) in a split-mouth study design “OPTODAN” (Scientific Development and Production Center, Saratov, Russia). The clinical parameters; plaque and gingival index, probing depth, and relative clinical attachment level of the test and control sides of both groups were analyzed at baseline and 1-month post-therapy. Visual analogue scale was used to determine patient discomfort intraoperatively and after 1 week. Results Statistically, significant improvement was evident in the gingival index, probing depth, and relative clinical attachment level when comparing test and control sides in all patients 1-month post-therapy. There was improvement in gingival index amongst type 2 diabetes mellitus patients in the test group. However, non-diabetes mellitus patients demonstrated superior results especially in probing depth and relative clinical attachment level. Conclusion The use of low-level laser therapy as an adjunct in periodontal therapy showed overall improvement in gingival inflammation, probing depth, and clinical attachment level. In comparison to non-diabetes mellitus patients, type 2 diabetes mellitus patients demonstrated significant improvement in gingival inflammation with low-level laser therapy.

Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis

BackgroundThe aim of this meta-analysis was to evaluate the difference in treatment outcomes between sub-gingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis.MethodsWe searched the MEDLINE (PubMed), SCOPUS and CENTRAL databases and identified 15 randomized clinical trials published within the last decade (2007–2019): 9 with split-mouth design and 6 with parallel study design. We extracted data and performed both qualitative and quantitative syntheses. The primary outcomes assessed were gain in clinical attachment level (CAL), reduction in probing pocket depth (PPD), improvement in gingival inflammation, and results of microbiological assays.ResultsWe used meta-analysis plots to assess all the clinical outcomes. The mean differences in PPD reductions at 1 month (MD 0.63), 3 months (MD 0.69), and 6 months (MD 0.75); and the CAL gains at 1 month (MD 0.54), 3 months (MD 0.64), and 6 months (MD 0.68) showed more favorable responses in sites treated with the CHX chip as an adjuvant to SRP, than in sites treated with SRP alone.ConclusionSRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.

Anti-Inflammatory Effects of Prepared Punica Granatum Mouthwash on Patients with Moderate Gingivitis

Objective: Punica granatum is a herbal product used in the field of dentistry which has many potential effects including bactericidal, antifungal, antiviral, and immune modulation. This study aimed to evaluate the effect of prepared Punica granatum as an antiplaque and anti-inflammatory agent in the treatment of gingival inflammation. 
 Methods: Sixty patients were enrolled in this study. Fourty five patients with moderate gingivitis were divided randomly into 3 groups; chlorhexidine group included 15 patients received once-daily dose of chlorhexidine mouthwash for 1 day, Punica I group included 15 patients received once-daily dose of Punica mouthwash for 1 day, and Punica II group included 15 patients received once-daily dose of Punica mouthwash for 2 consecutive days. Plaque index, gingival index, and bleeding on probing were assessed before rinsing and after 3 and 7 days of rinsing, also saliva were collected before rinsing and after 1 hour, 2 hrs, 1 and three days of rinsing to estimate the level of interleukine-1β. The rest 15 subjects were with clinically healthy gingiva. 
 Results: Punica II group resulted in significant reduction of plaque index, gingival index, and bleeding on probing after 3 and 7 days of rinsing (p≤0.05) but with non-significant differences with chlorhexidine group (p>0.05). It had significant effect in reduction of interleukine-1β which begin after one day of rinsing and continued into three days (p≤0.05).
 Conclusions: Punica like chlorhexidine has a positive effect on reduction of plaque accumulation and improvement of gingival inflammation so can be used as an anti-plaque and anti-inflammatory agent in the treatment of gingival inflammation.

Assessment of the effect of ozonated water irrigation on gingival inflammation in patients undergoing fixed orthodontic treatment.

Background:A split-mouth longitudinal study was designed here to evaluate the effect of ozonated water delivered subgingivally through a jet device (Kent Ozone dental TY 820 jet) in controlling gingival inflammation of patients undergoing fixed orthodontic therapy.Materials and Methods:Twenty-eight patients undergoing fixed orthodontic treatment following thorough oral prophylaxis were recalled after 2 weeks, and baseline gingival inflammation was estimated. This study was conducted as split-mouth technique with the upper left quadrant (Control side) was irrigated by jetting saline into sulcus by air–water syringe with gauge 22 needle tip and upper right quadrant (Test side) irrigated with ozonated water by a jet device using similar delivery tip. The patients were recalled at the end of 1st, 2nd, 3rd, and 4th month and the irrigations as well as gingival inflammation estimation were repeated. A biochemical assessment of gingival inflammation (estimation of aspartate aminotransferase [AST] in gingival crevicular fluid [GCF]) and clinical assessment (gingival index scoring) was done at each visit.Results:At the test side, the AST level in the GCF was found to be maintained almost the same value as baseline till the end of 4th month, indicating not much of change in inflammatory status. Statistically significant difference in GCF-AST and gingival index score between test and control sites were found at the end of 3rd and 4th month with a significance of P < 0.05.Conclusion:The patient undergoing fixed orthodontic treatment showed a consistent improvement in gingival inflammation on frequent irrigation with ozone jet irrigation as compared with saline irrigation delivered with same jetting force.

Evaluation about Antimicrobical Activity of Silver in Orthoshield Safe-T-Tie® Ligatures Used in Orthodontic Patients

Purpose: to value efficacy of anti microbic propriety of silver ligatures Orthoshield Safe-T-Tie® on periodontal tissues in orthodontic patients. Materials and methods: 50 orthodontic patients between 11 and 20 years old with permanent teeth were selected in this study. We evaluated periodontal health of maxillary and mandibular lateral incisors and canines at TO before the substitution of elastomeric ligatures with Orthoshield Safe-T-Tie® ligatures and at T1 (one month after substitution of ligatures). We used PI (Periodontal Index), GI (Gingival Index) and PRC-real-time to analyze periodontal health. Results: there was an improvement of gingival inflammation and a reduction of periodontal pathogens. Conclusions: Orthoshield Safe-T-Tie® ligatures improve periodontal health in orthodontic patients.

Mechanical stimulation of gingiva reduces plasma 8-OHdG level in rat periodontitis

Objective Gingival cells respond to periodontal pathogens by generating reactive oxygen species, and such a condition would increase circulating oxidative stress. Improvement of gingival inflammation by toothbrushing may offer clinical benefits on not only periodontal health but also the circulatory conditions. We examined the effects of mechanical stimulation on the plasma 8-hydroxydeoxyguanosine level in a rat periodontitis model. Design In this experiment, male Wistar rats ( n = 18) were divided into three groups. The control group received topical application of pyrogen-free water to the gingival sulcus for 8 weeks, while the other two groups received topical application of bacterial pathogens (lipopolysaccharide and proteases). After 4 weeks, half of the rats in the experimental groups received daily mechanical stimulation with an electric toothbrush for 4 weeks. Results Rats treated with bacterial pathogens presented periodontal tissue damage and increased plasma levels of 8-hydroxydeoxyguanosine. Mechanical stimulation by toothbrushing decreased gingival inflammation and oxidative DNA damage indicated by a decrease in plasma 8-hydroxydeoxyguanosine. Conclusions Mechanical stimulation of periodontally involved gingiva reduced 8-hydroxydeoxyguanosine in plasma and may contribute to a reduction in circulating oxidative stress associated molecules.

Pilot study of dietary fatty acid supplementation in the treatment of adult periodontitis

The anti-inflammatory effects of both n-3 and n-6 polyunsaturated fatty acids (PUFA) have been demonstrated in vitro and in many disease states, in particular in the treatment of rheumatoid arthritis. The benefit of n-3 PUFA supplementation has been documented in animal models of periodontal inflammation and a trend towards reduced inflammation has been seen in human experimental gingivitis. The purpose of this study was to examine the potential anti-inflammatory effects of PUFA supplementation, by administration of fish oil as a source of the n-3 PUFA, eicosapentaenoic acid, and borage oil as a source of the n-6 PUFA, gamma-linolenic acid (GLA), to adults with periodontitis. Thirty adult human subjects with periodontitis were administered either fish oil 3000 mg daily; borage oil 3000 mg daily; fish oil 1500 and borage oil 1500 mg daily, or placebo. The modified gingival index, the plaque index (PI), periodontal probing depths and β-glucuronidase levels in gingival crevicular fluid were measured at baseline and after 12 weeks of treatment. Improvement in gingival inflammation was observed in subjects treated with borage oil ( P<0.016), with a trend apparent in subjects treated with fish oil or a combination of PUFA. There was no statistically significant improvement in PI, although a trend was apparent in those receiving borage oil. Improvement in probing depth was seen in those subjects treated with either fish oil alone or borage oil alone, but statistical significance was only seen for the comparison of borage oil and placebo ( P<0.044). No change was seen in gingival crevicular fluid (GCF) β-glucuronidase levels. The use of borage oil supplementation, a source of the n-6 PUFA, GLA, can have beneficial effects on periodontal inflammation. n-6 PUFA supplementation seemed to offer more impressive results than either n-3 PUFA supplementation or the combination of lower doses of the two supplements. Additional studies will be necessary to more fully assess the potential of these agents to favorably affect periodontal inflammation.

The effect of toothbrushing and scaling in periodontal therapy (author's transl)

The efficacy and limitation of toothbrushing (rolling method) and scaling in the treatment of periodontal disease were examined in 14 patients, who were suffering from gingivitis and mild periodontitis not due to poor restoration and malocclusions. The periodontal status was measured with Gingival Index system (GI), periodontal pocket depth, purulent exudation and bone score. The oral hygiene was expressed as debris index (DI) and calculus index (CI).The results were summarized as follows:1. Brushing and scaling was effective in removing a dental plaque.2. Gingival inflammatory intensity was reduced by removing a dental plaque (DI=0), but gingival inflammation was not improved in about 15% of that group.3. Scaling was effective in the reduction of gingival inflammation. The deposition of a dental plaque was found in 49% of the group in which gingival inflammatory status was not improved by scaling.4. The effect of brushing and scaling on a periodontal pocket:1) The deeper the periodontal pocket, the lower the rate of healing of a periodontal pocket.2) Correlation between a periodontl pocket depth and a degree of a dental plaque deposit was not found.3) It was shown that the improvement of gingival inflammation followed by removing a dentalplaque deposit was necessary in the healing of a periodontal pocket.4) The improvement of gingival inflammation with removing a dental deposit was observed in about 25% of the group in which a periodontal pocket was not still diminished by brushing and scaling. It was assumed that many other factors except a dental deposit played an important role in the pathosis of a periodontal pocket formation.5) The percentage of purulent exudation was higher in the group in which a periodontal pocket was not diminished than in the group in which a pocket was healed. The periodontal pocket with purulent exudation was one of the criteria of the limitation of brushing and scaling.