Management Of Chronic Periodontitis Research Articles

Lycopene solid lipid microparticles with enhanced effect on gingival crevicular fluid protein carbonyl as a biomarker of oxidative stress in patients with chronic periodontitis

Lycopene (LP), a naturally occurring carotenoid in red-coloured fruits, especially tomatoes, has a pivotal role in counteracting the deleterious effect of oxidative stress on periodontal tissues. The aim of this study is to prepare solid lipid microparticles (SLMs) encapsulating LP and to assess their biochemical and clinical effects in the management of chronic periodontitis. Optimization of SLMs was performed by assessing particle size and LP entrapment efficiency. Clinical study included 16 chronic periodontitis patients allocated into two groups, Group I was managed by scaling and root planing (SRP) and local delivery of LP loaded SLMs, while Group II was managed by SRP only. Protein carbonyl (PC) levels as a biomarker of oxidative stress and drug concentration in gingival crevicular fluid (GCF) were assessed at different time intervals. Results revealed that optimum formula of SLMs had a particle size of 77.28 µm and entrapped 98.03% of LP. SLMs recorded 30 d of drug release with no burst effect. Patients treated with LP SLMs showed significantly lower levels of PC after SRP compared to those treated with SRP only, in addition to improvement in the measured clinical parameters. In conclusion, locally delivered LP SLMs along with SRP could have a protective effect over periodontal tissues and it has the ability to decrease oxidative damage of proteins in diseased periodontium.

Utilisation of antimicrobial photodynamic therapy as an adjunctive tool for open flap debridement in the management of chronic periodontitis: A randomized controlled clinical trial

Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature. This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis. Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 μm fibre, to provide a fluence (energy density) value of 0.0125 J/cm² per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively. Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05). Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis.

A double-blind, placebo controlled study to assess the clinical and microbiological effects of a probiotic lozenge as an adjunctive therapy in the management of chronic periodontitis

Background: The study was conducted to determine the effect of a probiotic lozenge as an adjunct to scaling and root planing in patients having chronic generalized periodontitis in a double blinded, placebo-controlled design. Materials and Methods: A total of 30 chronic generalized periodontitis patients, in the age group of 25–60 years were recruited for the study. Clinical parameters of plaque index (PI), bleeding index (BI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and microbiological levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia were assessed at baseline, 3, 6, and 12 weeks. All patients underwent scaling and root planing (SRP) at baseline and were recalled after 3 weeks. At 3 weeks, the patients were prescribed either probiotic or placebo lozenges for a 3-week period. Statistical analysis was conducted for clinical and microbiological parameters. Results: The PI, PPD, and CAL significantly reduced in both the groups from baseline to 12 weeks. GI and BI reduced significantly at 3 and 6 weeks in the probiotic group and at 3, 6, and 12 weeks in the placebo group. There was a significant decrease in the assayed periopathogens in both the probiotic and placebo groups at all-time intervals. Conclusions: The present study did not show a significant difference of using probiotic over SRP. As the duration of the study was limited to a period of 3 months, the need to conduct large multicenter studies is warranted to substantially validate the use of probiotics in the management of chronic periodontitis.

Efficacy of Ozonised Water and 0.2% Chlorhexidine Gluconate in the Management of Chronic Periodontitis when Used as an Irrigant in Conjugation with Phase I Therapy

To evaluate the efficacy of irrigation of periodontal pockets by using ozonated water and 0.2% chlorhexidine (CHX) gluconate as adjuncts to scaling and root planing in the management of chronic periodontitis. For the present study, 20 patients in the age group of 30-60 years, suffering from chronic periodontitis presenting with at least one site with an almost similar pocket depth of 4-6 mm in both the quadrants of maxillary arch was taken. Irrigation was done after 2 weeks of scaling and root planning on the same day with ozonated water and 0.2% chlorhexidine gluconate for two and half minutes. The clinical parameters like gingival index, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded for both the groups at the baseline visit.They were subsequently recalled after 4 weeks and 3 months interval from the baseline visit. Data thus collected was compiled and put to statistical analysis. The present study showed significant results in both the groups with regards to the improvement in the clinical parameters. When comparison was made between the two groups, ozonated water showed slightly better improvement than the chlorhexidine group. However, a statistically significant difference was seen only with Plaque score. Subgingival irrigation with ozonized water is beneficial than present conventional therapeutic modalities. Ozonated water restricts the formation of dental plaque and reduces the number of subgingival pathogens thereby treating periodontal diseases. Ozone therapy is proving to be a new useful treatment modality which offers great benefits to the patients. The strong antimicrobial power of ozone, along with its ability to stimulate the circulatory system and modulate the immune response, makes it a remedial agent of choice in the treatment of various infectious oral diseases. The study was conducted to justify the routine use of ozone as a treatment modality in effective management of periodontal diseases.

Effect of hyaluronan and metronidazole gels in management of chronic periodontitis

Background: Sometimes, a combination of mechanical and chemical treatment provides good recovery such as metronidazole (MTZ) and hyaluronic acid (HA) topically that have recently been recognized as an adjunct therapeutic measure for periodontitis. Aims and Objectives: The objective is to estimate and compare the potential benefits of the effect of MTZ and HA gels on the clinical periodontal parameters. Materials and Methods: Chronic periodontitis patients were volunteered to partake in this research. They classified into three groups; 10 patients received root surface debridement (RSD) and 0.2% HA gel was additionally applied subgingival in test sites as the first group, the second group (10 patients) received RSD and MTZ gel was also added subgingival in test sites, and the last group consisting of 10-patient management with RSD alone. At the first visit, plaque index, gingival index, and periodontal pocket depth (PI, GI, and PPD) were recorded subsequently, and this represents 1st record which was done before periodontal treatment, while the 2nd record for indices was taken after 7 days. Results: Intragroup analysis of all the clinical periodontal parameters showed high significant (HS) results between baseline and 1 week at P < 0.01. In addition, on intergroup analysis, the results were significant at a second visit for GI and HS for PPD and not significant for PI. Conclusion: Local applications of MTZ and (0.2%) HA gels as an auxiliary to conventional periodontal therapy have a useful impact on clinical periodontal parameter during 7 days in chronic periodontitis patient.

A Clinical Evaluation of Dantaraksha (An Ayurvedic Tooth Powder) in the Management of Chronic Periodontitis

Chronic periodontitis is the inflammation of the periodontal tissue caused due to the accumulation of dental plaque. If untreated it will lead to progressive attachment loss, bone loss & ultimately tooth loss. It can be correlated to Dantavestaka in Ayurveda. Acharya Sushruta says it manifests due to Dusta Shonita (Vitiated blood). It has symptoms like bleeding gums, pus discharge & mobility in teeth. Conventional periodontal therapy consists of mechanical debridement that is scaling & root planning. Ayurvedic medication Dantaraksha – Tooth powder has been used as an adjunct in the management of chronic periodontitis to avoid the side effects of chemicals. Objective: To evaluate the efficacy of Dantaraksha – Tooth powder, as an adjunct to scaling & root planning in Chronic Periodontitis patients. Material and methods: 40 patients selected for the study were equally divided in two groups: Group A – Only Scaling and Root planning, Group B – Scaling and root planning followed by application of Dantaraksha tooth powder to the gums & teeth, twice daily, and massaging the same on gums & teeth gently with finger. Plaque index, gingival bleeding index scores and probing pocket depth were evaluated at baseline & after one month of treatment. Results: The results show statistically significant difference between Groups A vs B. By looking at the mean value of Group A & Group B it was found that Group B gingival index, plaque index & probing pocket depth was significant over Group A. Conclusion: Dantaraksha powder is effective as an adjunct in the management of chronic periodontitis patients when compared to conventional scaling & root planning alone.

Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects

Background/purposeThe application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. Materials and methodsEighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. ResultsStatistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. ConclusionWithin the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.

PR399: Comparison of two non‐surgical protocols in management of chronic periodontitis

PR399: Comparison of two non‐surgical protocols in management of chronic periodontitis

Efficacy of Ayurvedic drugs as compared to chlorhexidine in management of chronic periodontitis: A randomized controlled clinical study.

Background:In India, Ayurveda is considered to be more effective and cheaper than modern medicine. Ayurvedic literature shows its use in treating oral diseases also. However, their effectiveness, in comparison with the allopathic mode of management, has not been assessed previously. The aim of this randomized controlled clinical trial was to compare the efficacy of ayurvedic drugs over chlorhexidine in treating chronic periodontitis.Materials and Methods:Four hundred and eight participants, in the age group 20–49 years, suffering from mild-to-moderate chronic periodontitis were included in this study. Community periodontal index for treatment needs (CPITN) score was recorded, and oral prophylaxis was done for each patient. They were then randomly divided into 6 groups: control group (I), chlorhexidine (II), Khadiradi vati (III), Dashansanskar churana (IV), Neem (V), and Apamarga (VI); based on the drugs used by patients for the maintenance of oral hygiene after oral prophylaxis. Patients were recalled at 1 week, 1 month, and 3 months after oral prophylaxis. CPITN score was re-recorded for each patient at each follow-up. Reduction in CPITN score indicated improvement in the periodontal health. Observations were statistically analyzed using univariate ANOVA and P value was set at <0.5.Results:Improvement in CPITN scores in 6 groups was as follows: I – 42.0%, II – 76.37%, III – 82.03%, IV – 83.46%, V – 78.8%, and VI – 29.9%. Higher mean percentage improvement was seen when patients used these drugs for 3 months as compared to 1 month.Conclusion:Dashansanskar churana and Khadiradi vati showed better results than chlorhexidine and were found to be superior in managing mild-to-moderate cases of chronic periodontitis.

Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin-1β: A 6-month randomized controlled clinical trial.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E2 (PGE2) and interleukin-1β (IL-1β) in the gingival crevicular fluid (GCF) of individuals with periodontitis. The study protocol was approved by the Ethics Committee (2000/071). Forty-one individuals with chronic periodontitis (33 men, 8 women) were divided into two groups (test and control) after initial periodontal therapy. During this 6-month, randomized, double-blind, placebo-controlled study, test (n = 28) and control (n = 13) groups were administered a cyclic regimen of DP (50 mg, twice daily) or placebo. Clinical measurements and GCF sample collections were made at baseline, 2, 4, and 6 months. GCF levels of PGE2and IL-1β were determined using enzyme immunoassay and enzyme-linked immunoassay kits, respectively. At baseline, no significant differences existed between groups for plaque indices, gingival indices, bleeding on probing, probing depth (PD), or attachment levels (P > 0.05). Compared with the control group, cyclic regimen in the test group suppressed increased levels of PGE2found in GCF at the end of the study (P < 0.05). Significant differences for PD and relative attachment gain were also noted in favor of the test group (P < 0.05). These results suggest that a cyclic regimen of DP may be efficacious in the management of chronic periodontitis in adults.

COMPARISON BETWEEN LOCAL APPLICATION OF DOXYCYCLINE LOADED NANOPARTICLES AND CONVENTIONAL DOXYCYCLINE GEL ON MATRIX METALLOPROTEINASE 1 AND BONE DENSITY IN CHRONIC PERIODONTITIS

Background & Objective: Nanoparticles have received considerable attention in recent years. This study was conducted to compare between doxycycline loaded nanoparticles (DLNs) and conventional doxycycline gel (CDG) in management of chronic periodontitis (CP). Materials and Methods: This randomized, split mouth study was conducted on 40 sites among 20 patients with chronic periodontitis. The sites were randomly allocated into a control group, receiving scaling and root planing (SRP) plus CDG, and an experimental group, receiving SRP plus DLNs. Clinical parameters and levels of matrix metalloproteinase 1 (MMP1) were assessed at baseline, 1, 3 and 6 months post treatment. Bone density was also assessed at baseline and 6 months after treatment. Results: The results, following the use of both treatment gel formulas, showed a statistically significant reduction in all tested clinical parameters and levels of MMP1 at 1, 3 and 6 months post treatment along with significant increase in bone density after 6 months. However, DLNs treatment achieved a significant reduction not only in clinical parameters but also in MMP1 as compared to CDG treated group. In addition, The DLNs showed a significant bone formation as compared to CDG group.Conclusion: DLNs shows promise as adjunctive local therapy for management of patients with chronic periodontitis.Clinical Relevance: Scientific Rationale for Study: Evaluating the effect of doxycycline loaded nanoparticles gel and conventional doxycycline gel on treatment of chronic periodontitis. Principal Findings: Findings from this randomized, split mouth study of 40 sites among 20 patients with chronic periodontitis supported the potential of doxycycline loaded nanoparticles and conventional doxycycline gel for providing an effective therapy for chronic periodontitis, along with improving clinical parameter, bone density and decreasing matrix metalloproteinase 1. Practical Implications: Doxycycline loaded nanoparticles are proved to be more effective than conventional doxycycline gel as an adjunctive treatment of chronic periodontitis.

Efficacy of local drug delivery of Achyranthes aspera gel in the management of chronic periodontitis: A clinical study.

Context:Periodontitis is an inflammatory disease of microbial origin. Locally delivered antimicrobials reduce subgingival flora. Achyranthes aspera gel has antimicrobial, antioxidant, anti-inflammatory, and immunostimulant effects.Aims:To evaluate the efficacy of local drug delivery of A. aspera gel in the management of chronic periodontitis.Materials and Methods:Thirty patients with chronic periodontitis were considered in the study and categorized into two equal groups (Group A: scaling and root planing (SRP) with A. aspera gel, Group B: SRP with placebo gel). Patients were enlisted from the Department of Periodontics, Mamata Dental College and Hospital. The clinical parameters (gingival index, bleeding on probing, probing pocket depth, and clinical attachment level) were recorded at baseline and 3 months.Statistical Analysis Used:All the obtained data were sent for statistical analyses using SPSS version 18.Results:The periodontitis and the Achyranthes were statistically analyzed. A comparison of clinical parameters for test group and control group from baseline to 3 months was done using paired t-test. Intergroup comparison for both the groups was done using independent sample t-test.Conclusions:A. aspera gel when delivered locally along with SRP showed a beneficial effect. A. aspera gel as a non-surgical local drug delivery system proved to be without any side effects in the management of periodontitis. A. aspera gel has strong anti-inflammatory effects in addition to its antioxidant activity.

Management of Chronic Periodontitis with two Locally Delivery Antiseptics (Povidine-Iodine Versus Hexetidine): Clinical and Microbiological Study.

Management of Chronic Periodontitis with two Locally Delivery Antiseptics (Povidine-Iodine Versus Hexetidine): Clinical and Microbiological Study.

Role of sea buckthorn oil in management of chronic periodontitis: follow-up study

Periodontitis is an inflammatory condition resulting in loss of periodontal ligament and alveolar bone. Nonsurgical therapy remains the cornerstone of periodontal treatment. For sustained plaque control it plays an important role in achieving successful long-term results for the care of Chronic Periodontitis subjects. Proper maintenance and patient hygiene plays a vital role in suppression of re-colonization of micro-organism. Many adjunctive treatment modalities along with mechanical debridement have been clinically used and investigated for their efficacy. Systemic antioxidants in conjunction with scaling and root planing can offer additional effects and can be used as an adjunctive treatment. Patients with periodontal disease display increased PMN number and activity, resulting in high degree of free radical release culminating in heightened oxidative damage to gingival tissues, periodontal ligament and alveolar bone. Damage mediated by free radicals can be mitigated by "antioxidant defense system ".Sea buckthorn oil is an omega-7 fatty acid antioxidant which has unique botanical and nutritional properties thereby benefiting mucous membrane by reducing inflammation, improving wound healing and showing excellent antibacterial property. In this research patients were prescribed systemic antioxidant after the phase 1 therapy ie scaling and root planing to observe its effects on the various clinical parameters.

Efficacy of non-surgical periodontal therapy in the management of chronic periodontitis among obese and non-obese patients: a systematic review and meta-analysis.

There is a controversy over the influence of obesity on the periodontal treatment outcome in patients with chronic periodontitis (CP). The aim of the present systematic review was to evaluate the efficacy of non-surgical periodontal therapy (NSPT) in the management of CP among obese and non-obese patients. The addressed focused question was "What is the efficacy, of NSPT with respect to clinical, radiographic, biochemical, microbiological, and patient-centered outcomes in obese as compared to non-obese chronic periodontitis patients?" Databases were searched from 1977 up to and including December 2014 using relevant key indexing terms. Unpublished data, experimental studies, letters to the editor, review articles, case reports, and commentaries were excluded. Meta-analysis of three studies was performed. Five clinical studies were included. The total number of patients ranged between 30 and 260 individuals. The mean age of patients was between 42.5 and 48.8years. In three studies, the clinical periodontal parameters (plaque index (PI), gingival bleeding index (GBI), periodontal pocket depth (PPD), and clinical attachment loss (CAL)) in obese and non-obese patients following NSPT was comparable. Meta-analysis of PPD and CAL among obese and non-obese subjects showed comparable outcomes (PPD P=0.91, I (2) 67.36%; CAL P=0.87, I (2) 77.16%). However, in three studies, NSPT resulted in a significantly better clinical periodontal outcome among non-obese subjects than obese subjects. The difference in the levels of serum pro-inflammatory cytokine levels (IL-1β, IL-6, TNF-α, IFN-γ, leptin, adiponectin, and CRP) among obese and non-obese patients following treatment for CP was inconsistent. It remains unclear whether NSPT has a significantly higher impact on the clinical periodontal outcomes in obese patients than in non-obese patients with chronic periodontitis, given that the number of selected studies was relatively low and the reported findings were inconsistent. Although the effect of obesity on the outcome of NSPT still remains unclear, nevertheless clinicians are prompted to manage obesity prior to and during periodontal treatment.

Patients’ perceptions of antimicrobial photodynamic therapy in the management of chronic periodontitis

The aim of this study is to evaluate patients’ perception of antimicrobial photodynamic therapy (aPDT) in the management of chronic periodontitis. 90 patients (51 females and 39 males) with untreated localized chronic periodontitis were randomly assigned to receive SRP with aPDT (test group) or SRP alone (control group) in a single-centered double-blinded randomized and controlled clinical trial. Patients’ perception in terms of changes in bleeding gums, pain in gums while chewing, bad breath and sensitive gums along with pain during the procedure and patient acceptance were recorded for 6 months after treatment by a periodontist who was blinded to the procedure. Inter-group and intra-group statistical analyses were performed. Significant difference between the frequencies of two groups with respect to each variable was assessed using non-parametric test. Patients’ report of bleeding gums and pain in the gums while chewing showed statistically significant reduction in the test group at 2 weeks and 1 month (p<0.05). Also, a significant difference was detected at 1 month between SRP and SRP+aPDT in terms of halitosis (p<0.05). No statistically significant change was observed between two groups in terms of sensitive gums, pain during procedure and patient acceptance. Patients perceived short-term benefits of single session of aPDT therapy due to the reduction in bleeding gums, halitosis and pain while chewing following treatment. Further studies are required to assess the effectiveness of aPDT for a longer-term and following multiple sessions.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study.

The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis.

口腔前庭拡張手術としてEdlan-Mejchar改良法を適用した長期経過症例から

口腔前庭拡張手術としてEdlan-Mejchar改良法を適用した長期経過症例から

Effect of adjunctive use of green tea dentifrice in periodontitis patients - A Randomized Controlled Pilot Study.

Green tea is known to possess anti-inflammatory, antibacterial and antioxidant activities. This study evaluated the effect of a locally prepared green tea dentifrice on specific parameters assessing gingival inflammation and severity of periodontal disease, when used as an adjunct to scaling and root planing (SRP) in the management of chronic periodontitis by comparing with a fluoride-triclosan-containing control dentifrice. Thirty patients, with mild to moderate chronic periodontitis, were randomly allocated into two treatment groups, 'test' and 'control' after initial SRP. The test group was given green tea dentifrice with instructions on method of brushing, while the control group received a commercially available fluoride and triclosan containing dentifrice. Clinical parameters of Gingival Index (GI), Plaque Index (PI), percentage of sites with bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) along with biochemical parameters of total antioxidant capacity (TAOC) and glutathione-S-transferase (GST) activity in gingival crevicular fluid (GCF) were recorded at baseline line and 4weeks post-SRP. Intragroup analysis at 4weeks showed statistically significant improvements of GI, PI, BOP, PD, CAL and TAOC in both groups. GST activity however, was increased only in the test group. At the end of the study period, the test group showed statistically significant improvements in GI, BOP, CAL, TAOC and GST levels compared to the control group. On comparison with fluoride-triclosan dentifrice, green tea showed greater reduction of gingival inflammation and improved periodontal parameters. Green tea dentifrice may serve as a beneficial adjunct to non-surgical periodontal therapy.

Comparison of Periochip (chlorhexidine gluconate 2.5 mg) and Arestin (Minocycline hydrochloride 1 mg) in the management of chronic periodontitis.

Background:The aim of the study was to compare the efficacy of chlorhexidine gluconate 2.5 mg (Periochip) and Minocycline hydrochloride 1 mg (Arestin) as local drug delivery agents in the management of chronic periodontitis.Materials and Methods:Twenty patients in the age group of 30–50 years suffering from chronic periodontitis (12 males and 8 females), with almost identical probing depth bilaterally (5–8 mm), and exhibiting bleeding on probing were selected and divided into two groups: Group I consisted of periodontal pockets on the left side and received Periochip and group II consisted of periodontal pockets on the right side and received Arestin. Patients were recalled after 6 weeks and 3 months intervals from the baseline visit to record plaque index, gingival index, and probing depth.Results:There was reduction in all the parameters in both the groups at 6 weeks and 3 months as compared to baseline.Conclusion:From the results of the present study, it was concluded that both the drugs were equally effective in reduction of plaque scores as well as gingival scores. It was further observed that Arestin resulted in better results at 6 weeks while Periochip showed better results at 3 months with respect to probing depth reduction.