Improvement In Periodontal Health Research Articles

Возможности витаминно-минеральных комплексов в адъювантной терапии коморбидных пациентов с заболеваниями пародонта, сахарным диабетом и другими системными заболеваниями организма

Periodontitis is a disease of the dental system, characterized by the development of an acute or chronic inflammatory process, destruction of periodontal tissue and atrophy of the bone tissue of the alveoli. Periodontitis is the sixth most common disease in the world and the leading cause of tooth loss in adults. The attention of internists to the problem of periodontitis and periodontal diseases is associated with the concept of “periodontal medicine,” which was formed at the beginning of the 21st century, and considers the bidirectional connection of periodontal pathology with systemic diseases of the body. Nutritional status is now widely recognized as a possible contributing factor in the development of many inflammatory conditions such as periodontal disease. We searched for publications devoted to the study of the influence of microelements selenium, zinc, vitamins A, E, C on the physiology and pathology of periodontal disease. The search was carried out in the PubMed and Scopus information databases; sources up to March 31, 2024 were included. The data presented in the review indicate a deficiency of the microelements selenium, zinc and vitamins A, C, E in periodontitis and suggest the advisability of their correction as part of the adjuvant therapy of periodontal diseases. A number of studies reviewed noted that increased levels of microelements and vitamins lead to clinical improvement in periodontal health. The most pronounced deficiency of microelements and vitamins is observed in patients with periodontitis in the presence of concomitant diabetes mellitus.

The Effect of a Low-Carbohydrate Diet on Periodontal Health and Inflammation in Patients with Type 2 Diabetes

ABSTRACT Background: The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients. Materials and Methods: This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests. Results: After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05). Conclusion: The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.

Efficacy of Laser-assisted Periodontal Therapy vs. Conventional Scaling and Root Planing.

This study aimed to compare the effectiveness of laser-assisted periodontal therapy (LAPT) with conventional scaling and root planing (CSRP) in the treatment of periodontal disease. The objective was to assess the outcomes of these two treatments on a sample of 30 patients in each group. In this study, a total of 60 patients diagnosed with periodontal disease were divided into two groups: the LAPT group and the CSRP group, with 30 patients in each group. The LAPT group received periodontal treatment using laser therapy, while the SRP group underwent traditional SRP. The patients were evaluated for periodontal parameters, including probing depth and clinical attachment level before and after the treatments. After the treatment interventions, both the LAPT group and the CSRP group showed significant improvements in periodontal health. The mean reduction in probing depth was 2.5 mm in the LAPT group and 2.2 mm in the SRP group. In addition, the clinical attachment level increased by 2.8 mm in the LAPT group and 2.5 mm in the SRP group. Statistical analysis using the paired t-test demonstrated a P-value of less than 0.05, indicating the significance of these improvements in both groups. This study suggests that both LAP and CSRP are effective in improving periodontal health in patients with periodontal disease.

Characteristics of oral microbiota and oral health in the patients treated with clear aligners: a prospective study.

In this prospective clinical study, the effect of clear aligners on periodontal health and oral hygiene was examined. As the same time, microbial changes of the aligner tray and subgingival microbiota community were investigated. The study recruited fifteen patients, and clinical parameters were recorded at three different time points: before the initiation of aligner treatment (T0), 1month after treatment onset (T1), and 3months after treatment onset (T3). Plaque samples were collected from the inner surface of aligners and subgingival sulcus at each of these time points. The microbial composition of the samples was analyzed using 16S rRNA gene sequencing, and changes were evaluated based on the abundance of amplicon sequence variants (ASVs). Reduction in plaque index and improvement in periodontal health were observed. In aligner tray plaque samples, the relative abundance of Streptococcus increased significantly, as well as the richness and diversity of microbiota decreased substantially as the duration of treatment time. In subgingival plaque samples, alpha and beta diversity of microbiota did not change significantly. During the clear aligner treatment, the patients' periodontium remained in a healthy condition, and clear aligner treatment had no significant impact on the composition of subgingival microbiota. The structure of the aligner tray microbiota altered significantly at both phylum and genus levels and attracted a unique and less diverse microbiota community. Clear aligner treatment has no significant impact on periodontal health and subgingival microbiota composition of patients.

Relationship between Diet Quality and Periodontal Disease in South Korean Adults Aged ≥40 Years.

The purpose of this study was to investigate the relationship between diet quality and periodontal disease, in adults aged ≥40 years, using data from the 7th (2016-2018) Korea National Health and Nutrition Survey (KNHANES), representing South Koreans. The subjects of this study were 7935 people aged ≥40 years, who responded to the items in the Korea Healthy Eating Index (KHEI) and underwent periodontal examination. Complex sample univariate and multivariate logistic regression analyses were conducted, to analyze the relationship between the diet quality and periodontal disease. The group with a low diet quality for energy intake balance, showed a higher risk of periodontal disease than the group with a high diet quality for energy intake balance, and it was confirmed that the diet quality in adults aged ≥40 years was related to periodontal disease. Therefore, regular diet evaluations, and the counseling of gingivitis and periodontitis patients by dental experts, will have a positive effect on the restoration and improvement of periodontal health in adults.

Effect modifiers influencing the periodontal healing of the adjacent second molar following mandibular third molar removal

Studies were selected, using appropriate key words, from the following databases: Cochrane Central Register of Controlled Trials; Medline (via Pubmed); Scopus/Elsevier; and Embase. A manual search was also conducted of five periodontology and oral and maxillofacial surgery journals. It was not clarified what proportion of studies included were derived from which source. Inclusion criteria included prospective studies and randomised controlled trials published in English, with a minimum 6-month follow-up reporting on parameters of periodontal healing distal to the mandibular second molar following removal of M3M in human subjects. These parameters included pocket probing depth (PPD) reduction and final depth (FD), clinical attachment loss (CAL) reduction and FD, alveolar bone defect (ABD) change and FD. Given prognostic indictors and interventions were investigated, the studies were screened using PICO and PECO (Population, Intervention, Exposure, Comparison, Outcome). Cohen's kappa statistic measured the level of agreement between 2 selecting authors (0.96 stage 1 screening, 1.00 stage 2 screening). Disagreements were resolved with a tie-breaker 3rd author. Ultimately, from 918 studies, 17 met the inclusion criteria and 14 were included in the meta-analysis. Studies were excluded on the basis of same patient pools, non-representative outcomes of interest, insufficient follow-up period, and unclear results. The 17 studies meeting the inclusion criteria underwent validity assessment and data extraction, including risk of bias analysis. Meta-analysis was performed to calculate mean difference and standard error for each outcome measure. If these were unavailable, a correlation coefficient was calculated. Meta-regression was used on different subgroups to determine factors affecting periodontal healing. For all analyses, statistical significance was determined as p < 0.05. Statistical variability in outcomes beyond the expected was estimated using I2 analyses, with a value >50% indicating significant heterogeneity. The periodontal parameters investigated yielded the following results after meta-analysis: overall PPD reduction of 1.06 mm at 6 months and 1.67 mm at 12 months; final PPD of 3.81 mm at 6 months; CAL change of 0.69 mm at 6 months; final CAL of 4.28 mm at 6 months and 4.37 mm at 12 months; ABD reduction of 2.62 mm at 6 months; ABD of 3.2 mm at 6 months. The authors found no statistically significant effect on periodontal healing from the following confounding factors: age; M3M angulation (specifically, mesioangular impaction); optimisation of periodontal health prior to surgery; scaling and root planing of the distal second molar at the time of surgery; post-operative antibiotics or chlorhexidine prophylaxis. There were statisticallysignificant correlations between baseline PPD and final PPD. There was improved PPD reduction at 6 months with a three-sided flap compared to others, and regenerative materials and bone grafts improved all periodontal parameters. Although M3M removal results in modest improvement in periodontal health distally of the second mandibular molar, periodontal defects remain onwards of 6 months. There is limited evidence suggesting a three-sided flap is more beneficial than an envelope flap in PPD reduction at 6 months. Regenerative materials and bone grafts result in significant improvements across all periodontal health parameters. The most important predictive factor in final PPD of the distal second mandibular molar is baseline PPD.

Effect of Non surgical Periodontal Therapy on Gingival Parameters of Diabetic and Non Diabetic Periodontitis Patients: A Prospective Clinical Study

Introduction: Non Surgical Periodontal Therapy (NSPT) has been an effective treatment for suppression of gingival inflammation and improvement of periodontal health in patients. Periodontitis and diabetes have an inter-relationship with each other. Surgical intervention is not always advisable for periodontitis with patients with diabetes. Hence, assessing the response of non surgical periodontal treatment in diabetic patients can lead to better and non invasive treatment options. Aim: To evaluate the effect of NSPT by observing changes in Gingival Index (GI), Plaque Index (PI), Clinical Attachment Loss (CAL), and volume of Gingival Crevicular Fluid (GCF) in diabetic and systemically healthy periodontitis patients. Materials and Methods: This was a prospective clinical study conducted in the Department of Periodontology, Rural Dental College, Loni, Maharashtra from January 2021 until June 2022. Total of 90 patients were assessed and were divided into three groups. Group A (n=30) included the patients with healthy periodontium and without any systemic disease. Group B (n=30) included the patients with controlled diabetes, with CAL in ranges of 3-4 mm (stage II periodontitis). Group C (n=30) included the patients who are systemically healthy, with CAL in ranges of 3-4 mm (Stage II periodontitis). Clinical parameters including GI, PI, Periodontal Probing Depth (PPD), CAL and volume of GCF were evaluated at baseline. NSPT was performed and parameters were evaluated after three months and then compared with baseline. Statistical analysis was done by descriptive statistics as mean, SD, percentage etc. Results: Total of 90 patients were included, among which 44 were male patients and 46 were females, within the age range of 18- 60 years. Patients were grouped 30 each in all three groups A, B and C with mean age 39.60±7.89, 45.70±10.02 and 43.90±9.64 respectively. The sites of group B showed statistically significant improvement in PPD at three months (1.80±0.76) compared to group C. Sites of group B also showed significant improvement in GI (1.46±0.45). There was no significant difference in the improvements of PI, Volume of GCF and CAL between group B and C at three months. Conclusion: The present study demonstrated marked improvements in the clinical parameters and their outcomes when the systemically healthy periodontitis patients and diabetic patients are treated with NSPT.

Use of TNF Inhibitors in Rheumatoid Arthritis and Implications for the Periodontal Status: For the Benefit of Both?

The inflammatory diseases rheumatoid arthritis (RA) and periodontitis show similarities in misbalances of cytokine levels, such as tumor necrosis factor-α (TNF-α). RA has been treated for two decades with TNF inhibitors which are effective by blocking TNF’s destructive action. Since RA and periodontitis show similarities in high levels of TNF, the periodontal status of RA patients may improve with the use of anti-TNF therapy. To assess this, a systematic review with special emphasis on duration of therapy was performed to evaluate the effect of anti-TNF-α treatment on the periodontal status of RA patients. Overall, studies showed an improvement in periodontal health with anti-TNF therapy. When analyzed over time (6 weeks to 9 months), it became apparent that initial improvements concerned bleeding on probing (BOP) and gingival index (GI) after therapy duration of 6 weeks. Periodontitis parameters that improved after prolonged treatment were: probing pocket depth (PPD) after 3 months and clinical attachment level (CAL) after 6 months. In conclusion, this systematic review reveals that anti-TNF treatment is therefore not only beneficial for rheumatic joints but also for the gums of rheumatoid arthritis patients. We propose that the sequential tissue recovery due to anti-TNF therapy progresses as follows: 1. block of diapedesis by lowering vessel permeability, 2 fewer leukocytes in the inflamed tissue, and 3. reduced proteolytic activity and subsequent repair of collagen fiber functionality and normalization of osteoclast activity. Clinically, this could lead to a decrease in bleeding on probing and ultimately in an improved clinical attachment level.

Periodontal treatment and vascular inflammation in patients with advanced peripheral arterial disease: A randomized controlled trial

Background and aimsObservational studies support an association between periodontitis and cardiovascular diseases. The study objective was to assess vascular inflammation after periodontal treatment in patients with peripheral arterial disease. MethodsNinety patients with peripheral arterial disease (PAD) and severe periodontitis were enrolled in a randomized, controlled trial. Thirty patients underwent non-surgical periodontal therapy and received additional systemic antibiotics (PT1 group), while 30 patients received the same therapy without antibiotics (PT2 group). The remaining thirty patients did not receive periodontal therapy (CG, control group). The primary outcome of this treatment was a reduction in vascular inflammation three months after periodontal treatment as determined by 18F-FDG PET/CT values. Secondary outcomes were changes in the inflamed periodontal surface area (PISA) and other periodontal parameters, changes in vascular biomarkers, and adverse cardiovascular events. ResultsAfter three months of treatment, a significant improvement in periodontal health was observed in the treatment groups. However, no difference in the primary outcome in the aorta was observed in the three study groups (median target to background ratio follow-up/baseline, PT1 1.00; 95% CI 0.97–1.10, PT2 1.00; 95% CI 0.98–1.1, CG 1.1; 95% CI 0.99–1.1, p = 0.75). No significant differences were detected in most diseased segments and active segments. In addition, no differences were observed in 18F-FDG uptake in the carotid, iliac, femoral, and popliteal arteries.No differences with regard to relative changes in vascular biomarkers were noted, and no serious cardiovascular adverse events occurred. ConclusionsPeriodontal treatment was effective and safe but did not reduce vascular inflammation in patients with PAD.

Efficacy of non-surgical treatment accompanied by professional toothbrushing in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

PurposeThe present study aimed to evaluate the clinical benefit of additional toothbrushing accompanying non-surgical periodontal treatment on oral and general health in patients with type 2 diabetes mellitus (T2DM).MethodsWe conducted a doubled-blind randomized controlled trial in 60 T2DM patients between June 2013 and June 2014. The patients were randomly assigned to the scaling and root planing (SRP) group; the scaling and root planing with additional toothbrushing (SRPAT) group, in which additional toothbrushing was performed by toothpick methods; or the control group. Microbiological and oral examinations were performed for up to 12 weeks following treatment. Non-surgical treatment was conducted in the experimental groups. The SRP group received scaling and root planing and the SRPAT group received additional toothbrushing with the Watanabe method once a week from the first visit through the fifth visit. The primary outcomes were changes in haemoglobin A1c (or glycated haemoglobin; HbA1c) levels, serum endotoxin levels, and interleukin-1 beta levels. Periodontal health status was measured by periodontal pocket depth, the calculus index, and bleeding on probing (BOP).ResultsBoth the SRP and SRPAT groups showed improvements in periodontal health and HbA1c, but the SRPAT group showed significantly less BOP than the SRP group. Furthermore, only the SRPAT group showed a statistically significant decrease in serum endotoxin levels.ConclusionsNon-surgical periodontal treatment was effective in improving HbA1c and serum endotoxin levels in T2DM patients. Furthermore, non-surgical treatment with additional tooth brushing had a more favourable effect on gingival bleeding management.Trial RegistrationClinical Research Information Service Identifier: KCT000416

METRONIDAZOLE (1%) AND CHLORHEXIDINE (0.25%) GEL AS AN ADJUNCT TO SCALING AND ROOT PLANING IN THE TREATMENT OF MODERATE TO SEVERE CHRONIC PERIODONTITIS—A CLINICAL STUDY.

Metronidazole and Chlorhexidine are commonly employed antimicrobial agents in the antinfective stage of periodontal therapy, used with the aim to achieve complete eradication of the pathogenic flora from the subgingival niches, in conjunction with professional debridement. This study was aimed to determine the adjunctive effect of a novel combination of metronidazole (1%) and chlorhexidine (0.25%) in a gel form for management of moderate to severe chronic periodontitis. Twenty subjects were included for a split mouth prospective study. Gingival index, Plaque Index, Bleeding scores and Probing depth were noted at baseline, 2 weeks and 1 month after scaling and root planing with or without an additional subgingival delivery of the antimicrobial gel. An improvement of periodontal health was seen after therapy, and the difference between the test and control sites was significant for sites with an initial probing depth of 6-8mm. However, for deeper pockets (&gt;8mm) the difference was statistically non-significant. The reduction in bleeding score was sustained at the test sites throughout the study period. It was concluded that the adjunctive use of metronidazole (1%) and chlorhexidine (0.25%) gel could provide clinical benefit for the management of deep pockets uptil 8mm of initial probing depth.

Does periodontally accelerated osteogenic orthodontics improve orthodontic treatment outcome? A systematic review and meta-analysis

Periodontally accelerated osteogenic orthodontics (PAOO) can be used to improve periodontal conditions and accelerate tooth movement. The aim of this systematic review and meta-analysis was to compare periodontal outcome and treatment duration of patients undergoing PAOO to accelerate orthodontic treatment. An electronic search was performed in four electronic databases including Pubmed, EBSCO Cochrane library, CINAHL Complete for randomized clinical trials till November 2017. A hand search was performed on clinicaltrials.gov and Google scholar. Randomized controlled trials reporting periodontal outcomes and treatment duration of PAOO in adult patients by evaluating treatment duration, root resorption, bone density and pocket depths were included. Two authors conducted searches, data extraction and bias assessment with conflict resolution with a third author. Cochrane's tool for risk of bias assessment was used for evaluation. A manual search was conducted for additional studies. A quantitative synthesis of the pooled results was conducted. Five studies were included in the qualitative synthesis and two in the quantitative synthesis. A total of 56 patients underwent the PAOO technique; the effects of this therapy were compared with 21 patients who underwent corticotomy, 9 underwent non-extraction comprehensive orthodontic treatment and 15 underwent fixed mechanotherapy with extractions of first premolars. A random effect model was used for pocket depths and showed a non-significant difference between bioactive glass augmented corticotomy and corticotomy alone (weighted mean difference, -0.03; 95% CI, -0.16, 0.09). Bone density elucidated a non-significant difference between bioactive glass augmented corticotomy and corticotomy alone (weighted mean difference, 27.69; 95% CI, -2.29, 57.67). Fixed effect model was used for root length which revealed a non-significant difference between bioactive glass augmented corticotomy and corticotomy alone (weighted mean difference, 0.01; 95% CI, -0.00, 0.02). Studies showed significant improvements in periodontal health. Treatment duration was reduced in patients who underwent PAOO. Root resorption was not sufficiently evaluated by current literature.

Influence of non-surgical periodontal therapy on insulin resistance in chronic periodontitis subjects with prediabetes

Prediabetes (PRD) has been closely associated with chronic periodontitis (CP). Lately, studies have proposed the role of glutathione peroxidase (GPx), a ubiquitous antioxidant, in potentiating insulin resistance (IR), a significant factor in PRD. As overexpression of GPx is associated with CP as well as IR, the current study was undertaken to evaluate the influence of nonsurgical periodontal therapy (NSPT) on GPx levels and hence the IR in CP subjects with PRD. Forty-seven subjects were divided into two major groups: healthy controls (n = 11) and CP (n = 36), according to probing depth (PD) and clinical attachment loss (CAL). The CP patients were subdivided into CP only (n = 18) and CP with PRD (n = 18) based on baseline FBS levels. Serum and crevicular GPx and malondialdehyde (MDA) were measured in all the subjects using spectrophotometry. The participants underwent NSPTat baseline and 3 months. At 6 months, all the parameters were re-recorded. At 6 months after NSPT, there was significant improvement in periodontal health (p < 0.05) in all the three groups which was associated with reduced GPx and MDA levels. Besides, a significant reduction in IR was noted in both CP and CP with PRD groups (p < 0.05). NSPT may be a vital tool in reducing IR in CP subjects with PRD. This was clearly evident as there was progressive decline in IR with GPx levels along with improvement in other parameters, specifically in the PRD group.

A Modified Method for Bone Regeneration using Gelatin Sponge with Bone Graft in treating an Osseous Defect after Root Resection

ABSTRACT Introduction Modern advances in all phases of dentistry have provided the opportunity for patients to maintain a functional dentition for longer periods of time. The disciplines of endodontics, periodontics, and prosthodontics fuse when the molars that have furcation involvements are treated by hemisection or root resection. Preserving the socket in these cases after removing the root or tooth segment and regenerating bone around the remaining portion of the root is an important part of the treatment that determines the prognosis of the tooth. Case report To enhance bone regeneration, a modified approach was used while bone grafting, where gelatin sponge was placed along with the synthetic hydroxyapatite and β-tricalcium phosphate in the osseous defect of the lower right first molar tooth following distal root resection. In this case report, the tooth after root resection has shown profound improvement in periodontal health, and the socket was preserved satisfactorily. Conclusion The simple modification showed an uneventful healing and excellent periodontal health clinically and good bone fill contributing to socket preservation as seen radiographically. The tooth has continued to serve well as found in the sixth month follow-up. Clinical significance The future prospect of using bone graft along with an agent that holds the clot and stabilizes it (gelatin sponge) during healing could serve as a useful treatment procedure, as this combination might act together producing synergistic effects. How to cite this article Sunil S, Babu HM. A Modified Method for Bone Regeneration using Gelatin Sponge with Bone Graft in treating an Osseous Defect after Root Resection. J Health Sci Res 2017;8(2):80-83.

Impact of the Daily Use of a Microcrystal Hydroxyapatite Dentifrice on De Novo Plaque Formation and Clinical/Microbiological Parameters of Periodontal Health. A Randomized Trial.

AimThis 12-week prospective, randomized, double-blind, two-center trial evaluated the impact of a microcrystalline zinc hydroxyapatite (mHA) dentifrice on plaque formation rate (PFR) in chronic periodontitis patients. We hypothesized that mHA precipitates cause delayed plaque development when compared to a fluoridated control (AmF/SnF2), and therefore would improve periodontal health.Material & MethodsAt baseline and after 4 and 12 weeks, PFR and other clinical and microbiological parameters were recorded. Seventy periodontitis patients received a mHA or AmF/SnF2 dentifrice as daily oral care without hygiene instructions. Four weeks after baseline, participants received full mouth debridement and continued using the dentifrices for another 8 weeks.ResultsPrimary outcome PFR did not change statistically significantly from baseline to weeks 4 and 12, neither in mHA (n = 33; 51.7±17.2% vs. 48.5±16.65% vs. 48.4±19.9%) nor in AmF/SnF2-group (n = 34; 52.3±17.5% vs. 52.5±21.3% vs. 46.1±21.8%). Secondary clinical parameters such as plaque control record, gingival index, bleeding on probing, and pocket probing depth improved, but between-group differences were not statistically significant. Microbiological analyses showed similar slight decreases in colony-forming units in both groups.ConclusionIn patients with mild-to-moderate periodontitis, periodontal therapy and use of a mHA-or AmF/SnF2 dentifrice without instructions induced comparable improvements in periodontal health but did not significantly reduce the PFR.Trial RegistrationClincalTrials.gov NCT02697539

Statistical Study on Serum CRP levels in Aggressive &amp; Chronic Periodontitis:Pre &amp; Post Non-Surgical Periodontal Therapy

Background: Elevated serum C-reactive protein (CRP) is regarded as a risk predictor for cardiovascular diseases. A positive association between circulating CRP levels and periodontal disease may be responsible. The aim of this study was to determine the effect of non-surgical periodontal therapy on serum CRP, WBC and OHI-S level in patients with aggressive and chronic periodontitis. Methods: Total 57 subjects, divided into 3 groups based on the diagnosis into: Group A- aggressive periodontitis (n=17), Group B- chronic periodontitis (n=20) and Group C- non-periodontitis (n=20). After clinical data were recorded, venous blood was taken at baseline and 1 month after nonsurgical periodontal therapy. Periodontal examination included probing depth at baseline and OHI-S level was recorded at baseline and after 1 month. Blood was analysed to determine serum CRP and white blood cells (WBC) count. Results: Mean WBC level: In group A, at baseline is 1.03E4 ± 1850.85 whereas it is 7976.47 ± 1538.47 after one month and in group B, at baseline is 9464.00 ± 1904.62 whereas it is 8510.00 ± 1778.79 after one month. Mean OHI-S level: In group A, at baseline was 2.8847 ± 0.83 whereas it was 0.7029 ± 0.30 after one month and in group B, at baseline was 3.1480 ± 0.87 whereas it was 0.6465 ± 0.40 after one month. Treatment resulted in reduction of WBC count and oral hygiene index- simplified (OHI-S) score levels (p<0.05). Mean CRP level: In group A, at baseline was 5.091 ± 10.02 whereas it was 3.0153 ± 3.37 after one month and in group B, at baseline was 2.658 ± 1.82 whereas it was 3.0030 ± 2.24 after one month. In group C at baseline was 1.917 ± 0.79. However, there were statistically no significant changes in levels of serum CRP in aggressive and chronic periodontitis (p>0.05). Conclusion: Both forms of periodontitis are associated with increased systemic inflammatory response with aggressiveness of disease progression, but improvement in periodontal health did not influence the levels of serum CRP.

Low power laser efficacy in the therapy of periodontitis

Background. Periodontitis is an inflammatory disease of periodontal tissues and is one of the most widespread diseases. It represents a huge problem with increasing importance. Modern therapy of periodontitis includes the classic treatment methods, surgery and the latest laser technology. Particularly important is that low level laser therapy is completely painless, non-invasive and without harmful effect. The aim of the study was to investigate the efficacy of low level laser therapy as an adjunct to the basic treatment of periodontitis. Material and Method. The study was conducted on 50 patients with periodontitis and clinical symptoms of gingival inflammation. During the first visit, periodontal indices were measured: plaque index (PI), gingival index (GI) periodontal Ramford index (PDI); dental plaque and tartar were removed and periodontal pockets were treated. Consequently, the right side of the jaws (group A) was treated with GaAlAs laser (Mils 94, 670 nm, 5 mW, 14 min). Laser therapy was left out on the left side the jaw of each patient (group B), in order to compare the effect of treatment with and without laser. After the first, third and fifth treatment, GI and PI were measured, and one month after finished therapy GI, Pi and PDI were measured again. Results. Comparing the mean values of indices in relation to the value before the therapy, the reduction was observed and was more pronounced on the lased side of the jaws. Comparing the mean indices values between groups, lower values were noticed on the lased compared to the non-lased side. Conclusion. Low-power lasers are effective in the elimination of gingival inflammation and improvement of periodontal health. They can be recommended as an adjunct to the basic periodontal therapy.

Treatment of anterior crossbite and its influence on gingival recession

Several etiological factors for gingival recession have been discussed in the literature, and the vestibular region of the mandibular incisors is a critical anatomical area for the emergence of this condition. Anterior crossbite is an important factor, because the trauma from occlusion between the incisors generates an imbalance in the distribution of forces, causing changes in the periodontium and making the area more susceptible to mechanical trauma during brushing and to plaque formation. In view of these aspects, the objective of this paper was to demonstrate the influence of early treatment of anterior crossbite on the gingival margin level and risk of gingival recession in the region of the incisors. A case of anterior crossbite treated during the mixed dentition phase was used as an example. After orthodontic therapy with the use of a removable appliance with a finger spring, we noticed improvement in periodontal health and esthetics as the tooth was reattached at its base bone.

The adjunct effectiveness of diode laser gingivectomy in maintaining periodontal health during orthodontic treatment

To evaluate the effectiveness of diode laser gingivectomy as an adjunct to nonsurgical periodontal treatment in the management of periodontal health among patients receiving fixed orthodontic appliance therapy (FOAT). Thirty patients undergoing FOAT with gingival enlargement were block randomized into two treatment groups. The test group received diode laser gingivectomy (940-nm diode laser, ezlase, Biolase Technology Inc) as an adjunct to nonsurgical periodontal treatment. The control group received nonsurgical periodontal treatment only. For both groups, five periodontal parameters were assessed at baseline, 1 month, 3 months, and 6 months: Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, and Gingival Overgrowth Index. Intra- and intergroup variations in the periodontal parameters were determined over time. Both groups showed statistically significant improvements in periodontal health over the study period (P < .05). However, significant improvements in periodontal health were evident earlier among the test group subjects (P < .05). The magnitude of improvement in periodontal health compared to baseline was greater in the test group than in the control group for Gingival Overgrowth Index at 1 month (P < .001) and 3 months (P < .05), Gingival Index at 3 months (P < .05) and 6 months (P < .05), and probing pocket depth at 1 month (P < .05). Nonsurgical periodontal management with or without the adjunct use of lasers can be effective in the management of gingival health problems among patients receiving FOAT. The adjunctive use of lasers can produce an earlier and greater improvement in gingival health.

Periodontal status and post‐transplantation complications following intensive periodontal treatment in patients underwent allogenic hematopoietic stem cell transplantation conditioned with myeloablative regimen

Evaluation of the periodontal status is necessary prior to management with high-dose chemotherapy before hematopoietic stem cell therapy (HSCT). During medical therapy, pre-existing periodontal conditions may exacerbate and cause local and systemic complications. When possible, maximal oral health should be achieved prior to engraftment. In this study, we aimed to determine the alterations occurred in the periodontal status of the patients after periodontal treatment and allogenic HSCT and evaluate the effect of intensive periodontal approach on the short-term complications of HSCT. The alterations occurred in the periodontal tissues 3-4 weeks after periodontal treatment and after HSCT periods of 3 months for 29 patients treated with full-mouth periodontal treatment completed in 24 h in addition to eradication of dental foci, and oral hygiene status were evaluated using pocket depth measurements, presence of bleeding on probing and plaque and gingival indices. The incidence and severity of acute graft-versus-host disease (GVHD) and oral mucositis (OM) were recorded. Duration of engraftment period and the episode of febrile neutropenia were also evaluated. There were significant improvements in periodontal status after periodontal treatment (P<0.001). There were 14 (48.3%) patients without acute GVHD and 17 (58.6%) patients with no sign of OM. The majority of OM was at grade II level. There was a negative relation that exists between the percentage of BOP (+) sites and presence of OM (r=-0.518, P<0.05). Together with a significant reduction in gingival inflammation and maintenance of the improvement in periodontal health, remarkable decrease in the incidence and severity of OM were observed.