Mean Clinical Attachment Level Research Articles

Clinical evaluation of sodium hypochlorite/amino acids and cross-linked hyaluronic acid adjunctive to non-surgical periodontal treatment: a randomized controlled clinical trial

ObjectivesTo compare the clinical outcomes obtained with either mechanical subgingival debridement in conjunction with a sodium hypochlorite and amino acids containing gel followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with mechanical debridement alone.Materials and MethodsFourty-eight patients diagnosed with stages II-III (Grades A/B) generalised periodontitis were randomly treated with either scaling and root planing (SRP) (control) or SRP plus adjunctive sodium hypochlorite/amino acid and xHyA gels (test). The primary outcome variable was reduction of probing depth (PD), while changes in clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were secondary outcomes. The outcomes were assessed at baseline, at 3 and 6 months following therapy.ResultsAll patients completed the 6 months evaluation. At 6 months, the test group showed statistically significantly better results in terms of mean PD reduction (2.9 ± 0.4 vs 1.8 ± 0.6 mm, p < 0.001). Similarly, mean CAL gain was statistically higher in the test group compared to the control one (test: 2.6 ± 0.5 vs control: 1.6 ± 0.6 mm, p < 0.001). Mean BOP decreased from 81.8 ± 16.2% to 48.9 ± 14.5% in control (p < 0.001) and from 83.2 ± 15.5% to 17.6 ± 11.5% in test (p < 0.001) groups with a statistically significant difference favouring the test group (p < 0.001). Mean PI scores were reduced statistically significantly in both groups (from 38.8 ± 26% to 26.5 ± 20.5% in control (p = 0.039) and from 60.6 ± 10.9% to 12.7 ± 8.9% in test group (p < 0.001)), with a statistically significant difference between the groups (p < 0.001). The number of moderate pockets (4–6 mm) were reduced from 1518 (41.2%) to 803 (22.6%) in the control and from 1803 (48.6%) to 234 (7.7%) in the test group with a statistically significant difference between the groups (p < 0.001), while the number of deep pockets (≥ 7 mm) changed from 277 (7.6%) to 35 (1.0%) in the control and from 298 (8.7%) to 4 (0.1%) in test group (p = 0.003).ConclusionWithin their limits the present data indicate that: a) both treatments resulted in statistically significant improvements in all evaluated clinical parameters, and b) the adjunctive subgingival application of sodium hypochlorite/amino acid and xHyA to SRP yielded statistically significantly higher improvements compared to SRP alone.Clinical relevanceThe combination of sodium hypochlorite/amino acid and xHyA gels to subgingival mechanical debridement appears to represent a valuable approach to additionally improve the outcomes of non-surgical periodontal treatment.Clinical Trial Registration Number NCT04662216 (ClinicalTrials.gov).

Periodontal Regeneration with Amnion-Chorion Membrane on Root Surface: A Retrospective Case Series.

This retrospective case series investigated the clinical and radiographic outcomes in 19 intrabony defects treated with periodontal regenerative therapy utilizing a combined approach. Placing an amnion-chorion membrane (ACM) as a biologic modifier on the root surface of the periodontally diseased tooth, combined with bone substitutes and an additional ACM as a barrier membrane, the treated sites were examined 8 to 24 months after the therapy. The preoperative (baseline) mean probing pocket depth (PPD) was 7.21 ± 1.08 mm, and the mean clinical attachment level (CAL) was 7.68 ± 1.49 mm. A mean PPD reduction of 4.05 ± 1.22 mm, CAL gain of 3.68 ± 1.34 mm, and 73.91% ± 22.02% of bone fill were recorded postoperatively. Without any adverse events, root-surface application of ACM as a biologic material in periodontal regenerative therapy could be a safe and cost-effective approach.

Clinical Evaluation of a Novel Combination of Sodium Hypochlorite/Amino Acid and Cross-linked Hyaluronic Acid Adjunctive to Non-surgical Periodontal Treatment: A Case Series.

The adjunctive subgingival application of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid gels (high molecular weight) has been recently proposed as a novel modality to enhance the outcomes of non-surgical periodontal therapy. The aim of this prospective case series was to evaluate the clinical outcomes obtained following the subgingival application of a combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) gels in conjunction with non-surgical periodontal therapy. Twenty-one systemically healthy, non-smoking patients diagnosed with stage II-III, grade A/B periodontitis underwent full-mouth subgingival debridement (SD) performed with ultrasonic and hand instruments. All sites with probing depths (PD) ≥ 4 mm were treated with additional repeated (i.e., 2-3 times) instillation of sodium hypochlorite/amino acid gel in the periodontal pockets prior to and during SRP. Following mechanical debridement, a mixture of natural and cross-linked hyaluronic acid (high molecular) gel was applied in the pockets. The primary outcome variable was PD reduction; changes in clinical attachment level (CAL) and bleeding on probing (BOP) were the secondary outcomes. The clinical parameters were assessed at baseline, 3 and 6 months after therapy. Compared to baseline, a statistically significant mean reduction of PD values was obtained after 3 and 6 months, amounting to 2.6 ± 0.4 mm, and 2.9 ± 0.4 mm, respectively (p < 0.001). Mean CAL gain measured 2.3 ± 0.5 mm at 3 months and 2.6 ± 0.5 mm at 6 months in comparison to baseline (p < 0.001). Mean reduction of BOP values was 54.9 ± 16.9 % at 3 months and 65.6 ± 16.4 % at 6 months (p < 0.001). The number of moderate pockets (4-5 mm) decreased from 1808 at baseline to 274 at the 6-month evaluation, and the number of deep (≥ 6 mm) pockets dropped from 319 to 3, respectively. The combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) adjunctive to subgingival debridement may represent a valuable approach to improve the outcomes of non-surgical periodontal treatment.

Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study

IntroductionCarbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). MethodsA single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. ResultsThe postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. ConclusionsThe clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.

Multiplicative effect of stress and poor sleep quality on periodontitis: A university-based cross-sectional study.

The aim of this study was to evaluate the association of perceived stress and poor sleep quality with periodontitis in a university-based cohort of individuals. A total of 235 individuals were included in this cross-sectional study. Perceived stress and sleep quality were evaluated through validated questionnaires, while periodontitis was identified with a full-mouth periodontal examination protocol using both European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) and Centers for Disease Control and Prevention (CDC)/AAP case definitions. Simple and multiple linear and ordinal logistic regression analyses were performed to evaluate the association between perceived stress and sleep quality with periodontitis prevalence and severity. Stage III/IV periodontitis resulted associated with both moderate/high perceived stress (odds ratio [OR]=5.4; 95% confidence interval [CI]: 2.2-13.5; p<0.001) and poor sleep quality (OR=3.0; 95% CI: 1.2-7.4; p<0.05). The interaction between moderate/high perceived stress and poor sleep quality presented a multiplicative association with stage III/IV periodontitis (EFP/AAP; OR=5.8; 95% CI: 1.6-21.3; p<0.001). Multiple linear regression analyses indicated a similar trend of association also with linear periodontal parameters, that is, mean clinical attachment level (CAL) and mean probing pocket depth (PPD). The findings from the present study suggest that stress and poor sleep quality may exert a multiplicative effect on periodontitis prevalence and severity.

The effect of scaling and root planning on the periodontal condition in hemodialysis patients: A clinical trial study.

Periodontitis is very common in kidney patients undergoing hemodialysis. The two diseases interact with each other so that kidney failure exacerbates periodontal disease and periodontal disease increases the severity of the renal failure. This study aimed to compare the effect of scaling and root planning on the periodontal status of hemodialysis patients and the healthy control group. A clinical trial study of 60 subjects, 30 subjects in the dialysis group with chronic periodontitis, and 30 with chronic periodontitis who were systemically healthy was conducted. After a health education session, gingival pocket depth (PD) measurement, and clinical attachment level (CAL), scaling was performed for both groups. Then, the mentioned indices were measured consequently, at 4 and 8 weeks of treatment. Improvement in both groups was analyzed by Mann-Whitney and paired sample t-test at the significance level of 0.05 by SPSS software. In both groups, the decrease in PD and CAL was steadily observed from the first to the third time and the changes from the first to the second and the first to the third time were significant however it was not significant between the second and third time. Mean PD and CAL in the dialysis group were higher than in the nondialysis group, which was significant (p < 0.001) for the mean PD. The mean improvement of PD and CAL in dialysis patients was 14.31 ± 10.48 and 17.60 ± 7.83%, respectively, and the mean improvement of PD in the nondialysis group was significantly higher than in the dialysis group (p = 0.008). Periodontal treatment (scaling) causes more improvement in periodontal clinical parameters in healthy people with periodontitis than in dialysis patients.

Clinical Effects of Subgingivally Delivered Achyranthes Aspera Gel in Chronic Periodontitis: A Clinical and Microbiological Study.

Periodontitis is an inflammatory disease of microbial origin. Local drug delivery agents help reduce subgingival microflora. Achyranthes aspera is a medicinal herb with antimicrobial, antioxidant, anti-inflammatory, and wound-healing properties. A split-mouth study was conducted, in which 60 sites were included. Clinical parameters included measurements of probing depth (PD), gingival index, and clinical attachment level (CAL). Gingival crevicular fluid (GCF) samples were collected, followed by microbiological analysis of Porphyromonas Gingivalis. Clinical and microbiological parameters were recorded at baseline and after 3 months. Statistical analysis was done using the Statistical Package of Social Science (SPSS Version 22; Chicago Inc., USA). At 3 months, Group A resulted in greater mean reductions in clinical parameters: PD (3.77) as compared to Group B (5.23), and also greater mean CAL gain (3.18) in group A as compared to Group B (5.16). Group A also showed a significant reduction in the number of sites harboring periodontopathogens as compared to Group B. A. aspera gel can be used as a nonsurgical local drug delivery agent in patients with chronic periodontitis as an effective adjunct to SRP.

The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

IntroductionPeriodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases. ObjectiveTo evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals. Material and MethodA total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups. ResultThere was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001). ConclusionThe present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.

Evaluating Salivary Apelin Level among Chronic Periodontitis Patients, with and without Type 2 Diabetes Mellitus utilizing Enzyme‑Linked Immunosorbent Assay: A Comparative Study

Background: Periodontitis is a chronic inflammatory disorder mainly due to a decrease in the immune system caused by periodontal pathogens. The relationship of apelin among chronic generalized periodontitis (CGP) and type 2 diabetes mellitus (T2DM) has been reported. This study intends to assess the level of apelin in saliva from patients of healthy individuals, individuals with CGP, and CGP + T2DM, and evaluate the role of apelin adipokine in inflammation and insulin resistance. New treatment modalities can be invented using apelin in host modulation therapies. Methods: The study comprised 300 patients that were enrolled according to their clinical findings and were divided into three groups chronic periodontitis (n=100), chronic periodontitis with T2DM (n=100), and healthy controls (n=100). Probing pocket depth (PPD), clinical attachment level (CAL), and salivary Apelin (AP) were obtained. With the help of the enzyme-linked immunosorbent assay (ELISA) kit, the salivary apelin level was measured. A statistical software package was used for the surveying of collected data. Results: Group three[CGP+DM] shows the highest salivary apelin level compared to CGP patients without DM. It was 15.43±2.05ng/dl in CGP and 24.08 ± 3.60ng/dl in CGP with DM. All three groups found a statistically significant difference in mean Apelin Level, PPD, and CAL. Conclusion: This study indicated a possible role of adipokines in inflammation and glucose level regulation in patients with T2DM and CGP. In the coming era, apelin levels in saliva can be used for screening objectives in large populations to assure the risk of destructive periodontal disease. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 305-315

Longitudinal association between periodontal condition and glycaemic status in middle-aged adults: A cross-lagged panel analysis.

To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status. This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003-2004 and 2008-2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c). The cross-lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow-up (β = 0.044, p = .039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p = .059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow-up was identified. This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis.

Vertical soft tissue augmentation to treat implant esthetic complications: A prospective clinical and volumetric case series.

Challenging implant esthetic complications are often characterized by implant malpositioning and interproximal attachment loss of the adjacent teeth. However, limited evidence is available on the treatment of these conditions. The aim of this study was to evaluate the clinical, volumetric, and patient-reported outcome following treatment of peri-implant soft tissue dehiscences (PSTDs) exhibiting interproximal attachment loss on adjacent teeth, performed through vertical soft tissue augmentation with implant submersion. Ten subjects with isolated PSTD in the anterior maxilla characterized by adjacent dentition exhibiting interproximal attachment loss were consecutively enrolled and treated with horizontal and vertical soft tissue augmentation, involving crown and abutment removal, two connective tissue grafts, and submerge healing. Clinical outcomes of interest included mean PSTD coverage, mean PSTD reduction, clinical attachment level (CAL) gain at the implant and adjacent sites and soft tissue phenotype modifications at 1 year. Optical scanning was used for assessing volumetric changes. Professional assessment of esthetic outcomes was performed using the Implant Dehiscence coverage Esthetic Score (IDES), while patient-reported esthetic assessment involved a 0-10 visual analogue scale. The mean PSTD depth reduction and mean PSTD coverage at 1 year were 2.25 mm, and 85.14%, respectively. A mean keratinized tissue width (KTW) gain of 1.15 mm was observed, while the mean gain in mucosal thickness (MT) was 1.58 mm. A mean CAL gain of 1.45 mm was obtained at the interproximal aspect of the adjacent dentition at 1 year. Greater linear dimensional (LD) changes were observed at the midfacial aspect of the implant compared to the interproximal sites. The mean final IDES was 6.90 points, while patient-reported esthetic evaluation was 8.83 points. The present study demonstrated that vertical soft tissue augmentation with a submerged healing is an effective treatment approach for the treatment of challenging PSTDs with adjacent dentition exhibiting interproximal attachment loss. This technique can be effective in resolution of esthetic complications in most cases, providing a substantial gain in interproximal attachment levels at the adjacent dentition.

Salivary cytokine expression after non-surgical periodontal therapy in smokers: 12-month follow-up.

Diverse smoking trajectories may influence cytokine expression after non-surgical periodontal therapy and supportive periodontal care. Thus, we aimed to describe cytokine profiles in periodontal healing after periodontal therapy in smokers. A smoking cessation program and non-surgical periodontal therapy were offered to 80 smokers with periodontitis. Smoking trajectories (quitters/light, moderate, heavy) were observed. The association of salivary interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) with smoking trajectories and periodontal outcomes was determined using mixed-effects linear regression. Among quitters/light smokers, IL-1β was associated with an increase in mean periodontal pocket depth (PPD) and mean clinical attachment level (CAL). IL-6 was associated with a decrease in mean PPD and CAL in heavy smokers, whereas IL-8 was associated with a decrease in PPD among moderate smokers. TNFα was associated with a reduction in mean PPD and CAL among quitters/light smokers, while among moderate smokers, TNFα was associated with an increase in mean PPD and CAL. IL-12 and IL-13 were associated with a decrease in mean PPD in moderate smokers. Our findings suggest that distinctive smoking exposures induce differential cytokine expression, which, in turn, seems to influence periodontal repair.

Powered tooth brushes are beneficial for long-term oral health: Results from the Study of Health in Pomerania (SHIP-TREND).

To determine the long-term effects of the use of powered tooth brush (PTB) in comparison to manual tooth brush (MTB) on periodontitis severity, coronal caries experience, and the number of missing teeth using in a population-based cohort study. Using 7-year follow-up data of 2214 participants of the Study of Health in Pomerania (SHIP-TREND), comprehensively adjusted linear models using generalized least squares and ordinal regression models estimated the effects of PTB usage on dental outcomes in complete case and imputed data. At follow-up, PTB users had lower medians for mean probing depth (PD; 2.21 mm) and mean clinical attachment levels (1.73 mm) than MTB users (2.30 and 1.96 mm, respectively). Adjusted models revealed the beneficial effects of PTB usage on follow-up levels of plaque, bleeding on probing, mean PD, percentage of sites with PDs ≥4 mm, mean clinical attachment levels (all, interdental, and non-interdental sites, respectively), and the number of missing teeth. For the number of missing teeth, the effects were more pronounced in participants aged ≥50 years. No significant effects of PTB usage on the number of decayed or filled surfaces (all and interdental sites) were found. A recommendation of PTB usage in dental practice could contribute to the long-term promotion of oral health.

Identification of Nutritional Factors to Evaluate Periodontal Clinical Parameters in Patients with Systemic Diseases.

Nutritional factors reflect the periodontal parameters accompanying periodontal status. In this study, the associations between nutritional factors, blood biochemical items, and clinical parameters were examined in patients with systemic diseases. The study participants were 94 patients with heart disease, dyslipidemia, kidney disease, or diabetes mellitus. Weak negative correlation coefficients were found between nine clinical parameters and ten nutritional factors. Stage, grade, mean probing depth (PD), rate of PD 4-5 mm, rate of PD ≥ 6 mm, mean clinical attachment level (CAL), and the bleeding on probing (BOP) rate were weakly correlated with various nutritional factors. The clinical parameters with coefficients of determinations (R2) &gt; 0.1 were grade, number of teeth, PD, rate of PD 4-5 mm, CAL, and BOP rate. PD was explained by yogurt and cabbage with statistically significant standardized partial regression coefficients (yogurt: -0.2143; cabbage and napa cabbage: -0.2724). The mean CAL was explained by pork, beef, mutton, and dark green vegetables with statistically significant standardized partial regression coefficients (-0.2237 for pork, beef, and mutton; -0.2667 for dark green vegetables). These results raise the possibility that the frequency of intake of various vegetables can be used to evaluate periodontal stabilization in patients with systemic diseases.

Evaluation of Efficacy of 4% Ocimum sanctum Gel in the Management of Chronic Periodontitis

ABSTRACT Aim: The present experimental study was performed with the aim of assessing the efficacy of Ocimum sanctum (OS) gel as an adjunct to scaling and root planing (SRP) in the management of chronic periodontitis. Materials and Methods: Minimum inhibitory concentrations and minimum bactericidal concentration of OS on Porphyromonas gingivalis, Prevotella intermedia (Pi), Fusobacteria nucleatum, and Aggregatibacter actinomycetemcomitans was carried out as a pilot study. Further, a total of 60 patients (mean age of 34.5 ± 8.3 years) were enrolled in this study (n = 30 in each group). In the control group (A), Phase I periodontal therapy was performed, whereas in the test group (B), 4% OS gel was inserted into the pockets at baseline after the same. The clinical parameters recorded included plaque index (PI), sulcus bleeding index, probing depth, and clinical attachment level were recorded at baseline and after 45 days. Results: The results obtained by in vivo assessment following the placement of 4% OS gel demonstrated that the mean PI score at baseline was 2.29 ± 0.21, which was reduced to 0.97 ± 0.293 at the 45th day (P = 0.001) for Group A, whereas it was 2.18 ± 0.22, which was reduced to 1.46 ± 0.29 at the 45th day (P = 0.001) for Group B. The mean Modified Sulcular Bleeding Index score at baseline was 3.56 ± 0.77, which was reduced to 1.55 ± 0.62 at the 45th day after local drug delivery of OS gel for Group A, whereas it was 3.08 ± 0.69, which was reduced to 1.45 ± 0.51 at the 45th day (P &lt; 0.001). The difference between Group A and Group B was statistically not significant (P &gt; 0.05). The mean probing depth at baseline was 8.07 ± 1.60, which was reduced to 4.83 ± 1.38 for Group A (P &lt; 0.001), whereas it was 7.50 ± 1.63 at baseline and 5.68 ± 1.29 at the 45th day for Group B (P &lt; 0.001). The mean clinical attachment level at baseline was 4.26 ± 1.02, which was reduced to 2.78 ± 0.84 for Group A at the 45th day (P &lt; 0.001), whereas it was 4.05 ± 1.08 at baseline and 3.27 ± 0.97at the 45th day for Group B (P &lt; 0.001). The difference between Group A and Group B was statistically highly significant (P &lt; 0.01). Conclusions: The subgingival delivery of 4% OS gel can be used as an adjunct to SRP for superior clinical outcomes in chronic periodontitis cases as compared to SRP alone. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY This study emphasizes the anti-inflammatory role of Ocimum sanctum in nonsurgical management of periodontal infection which need to be tackled before any other procedures of orthodontics, prosthetic or restorative dentistry.

An evaluation of the long-term wear of a distal extension-removable partial denture on abutment teeth that have undergone periodontal therapy

Although the evidence is clear on the long-term effects of removable partial dentures (RPDs) on the periodontal health of abutment and non-abutment teeth, little work has been done on the periodontal outcomes of the remaining teeth previously treated with periodontal therapy. The aim of this study was to evaluate the effect of denture loading on teeth previously exposed to periodontal treatment with additional photo-disinfection. Twelve partially edentulous patients classified as having mandibular Kennedy Class I arches were included. In each quadrant of the mandibular arch, the terminal abutment was diagnosed to have untreated chronic periodontitis. Initially, all the affected abutments received a conservative periodontal treatment in form of scaling and conventional root debridement. Patients were randomly received additional treatment with photodynamic therapy in one of the mandibular quadrants (test group). After the periodontal treatment, a 4-week load-free period was planned. Mandibular distal extension RPDs was fabricated to restore the missing teeth. The clinical periodontal parameters including plaque index (PI), gingival index (GI), gingival recession (GR), probing pocket depth (PD), clinical attachment level (CAL) and tooth mobility (TM) were assessed at baseline, and then for two additional 6-month recall appointments over a period of twelve months after prosthetic treatment. In addition, the mean annual vertical bone loss was also assessed. Except for the PI, GR, and PD, values for the mean GI, CAL, and TM scores at the test group were significantly lower than those in the control group. Better annual vertical bone loss results were observed on the proximal sides of abutments treated with additional photodynamic therapy. The results of this study suggest that RPD abutments affected by chronic periodontitis may perform better as abutments for distal extension RPDs when treated with both conventional root debridement and additional antimicrobial photodynamic therapy.

Investigation of the Association Between Psychological Parameters and Periodontal Disease in a Greek Adult Population: A Case - Control Study

Objective: Epidemiologic studies provide strong evidence that chronic psychosocial stress and depression increase the risk of several systemic diseases and disorders. The current research aimed to investigate the association between stress, and depression with Periodontal Disease indices. Material and Methods: The study counted with 280 individuals, males and females, 40–65 years of age, and were collected through a clinical examination and a modified standardized questionnaire. Case group included 140 individuals suffering from periodontal disease and control group consisted of 140 individuals with no history of periodontal disease. Psychological factors assessment included the following inventories, Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Periodontal disease was assessed based on the following indices, Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), Gingival Index (GI) and Bleeding on Probing (BOP). Univariate and multivariate logistic regression analyses were carried out to compare cases and controls. Results: Mean probing depth and clinical attachment level were 4.60 ± 0.32 mm and 4.72 ± 1.12 mm in cases and 2.10 ± 0.50 mm and 1.86 ± 0.31 mm in controls, respectively (p &lt; 0.05 and p&lt; 0.01, respectively). Multivariate logistic regression model, controlling for confounding factors, demonstrated significant association between BAI and BDI with deeper periodontal pockets [p = 0.028 and p = 0.032, respectively], and moderate/severe CAL [p = 0.018 and p = 0.048, respectively]. The outcomes also revealed no significant associations between the mentioned psychological parameters with gingival inflammation (GI) and BOP. Those associations were confirmed after adjusting for possible confounders such as smoking, educational and socio-economic status. Conclusion: Within the limits, the current research revealed significant associations between BAI and BDI and deeper periodontal pockets and moderate/severe CAL.

Evaluation of the Correlation between Systemic Osteoporosis and Periodontal Status in Menopausal Women

Introduction: Periodontitis is one of the most common periodontal diseases, characterized by destruction of connective tissue and supporting structure of the tooth. Osteoporosis is a systemic disease of skeletal tissue characterized by a decrease in bone mass and leads to the destruction of bone structure. The aim of this study was to evaluate the correlation between systemic osteoporosis and periodontal status in menopausal women referred to the bone density measurement center in Gorgan.&#x0D; Materials &amp; Methods: In this case-control study, 56 menopausal women aged 45-65 years participated. Among the participants, 28 individuals had osteoporosis and 28 women were healthy. Periodontal pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and gingivitis index (GI) were measured for each patient. Finally, the data were analyzed using 95% confidence level.&#x0D; Results: A total of 56 menopausal women were included in the study. The mean GI in the osteoporotic group was 0.74 ± 1.43 and in the non-osteoporotic group was 0.77 ± 1.32 (p value = 0.280). The mean periodontal pocket depth in the osteoporotic group (0.63 ± 3.73) was more than the non- osteoporotic group 0.57 ± 3.66 (p value = 0.363). PI mean in the osteoporotic and non-osteoporotic groups were 37.11 ± 15 and 37.39 ± 15, respectively (p value = 0.363).&#x0D; Conclusion: The mean clinical attachment level in menopausal women with osteoporosis was significantly higher than normal menopausal women. On the other hand, there was no significant difference in other indices of periodontal disease such as PPD, PI, GI.

Nonsurgical Treatment of Peri-implantitis Using a Chitosan Brush with Adjunctive Chemical Decontaminants- A Retrospective Case Series.

To evaluate the effect of a simple nonsurgical procedure for the treatment of peri-implantitis. A total of 30 implants across 24 patients diagnosed with moderate to advanced peri-implantitis were treated using a chitosan brush with adjunctive chemicals, ie, 3% hydrogen peroxide and a tetracycline slurry. The treatment was performed a total of three times, with intervals of approximately 3 weeks. Results showed improvement in both the clinical attachment level (CAL) and bleeding on probing score between the baseline and the re-examinations between 9 months and up to 43 months (mean 26.8 months) after treatment. The mean CAL at baseline was 3.4 mm (range: 1 to 8 mm), while the mean CAL during the final examination was 1.4 mm (range: 0 to 5 mm), demonstrating a mean reduction of CAL of 2 mm (range: 1 to 7 mm; P < .001). Of the analyzed implant sites, 72% demonstrated radiographic signs of osseous defect fill varying between 0.1 and 2.2 mm (mean: 1.0 mm). The results show that this novel treatment strategy may serve as a nonsurgical alternative to reduce parameters of inflammation around implants with moderate to advanced peri-implantitis.

Berry as an adjunct to nonsurgical periodontal therapy: A clinical trial.

Periodontal disease, a persistent inflammatory condition affecting the tissues around the teeth, is brought on by an imbalance between dental biofilm and the host's reaction, with the potential for tooth loss. Periodontal disease has been linked to an excess of free radicals induced by oxidative stress or antioxidant deficiency. There is a notable oxidative process early in the course of periodontal disease, especially in periodontitis. The objective of the study is to assess if berry supplements can be used as a supplement to nonsurgical periodontal therapy. Forty individuals with chronic periodontitis in total were divided into two groups for this study. Group A received scaling and root planing (SRP), whereas Group B received SRP plus berry supplements. At baseline and on the 28th day, both groups had their probing pocket depth (PPD) and clinical attachment level (CAL) assessed. After then, the data from both time periods were compared. The SPSS software was used to examine the data (Version 23.0). Using an unpaired t-test, the mean PPD and CAL values were compared between the groups. The mean PPD in Group A decreased on day 28 from 4.18 ± 0.12 to 3.06 ± 0.02 while in Group B reduced from 4.21 ± 0.13 to 2.05 ± 0.08. The CAL in Group A improved from 5.05 ± 0.09 to 3.04 ± 0.11 and in Group B from 4.52 ± 0.17 to 2.02 ± 0.08. There was evidence of a statistically significant difference between two groups in terms of mean pocket depth and clinical attachment degree (P < 0.05). Therefore, berries may be an effective treatment for chronic periodontitis when used in conjunction with SRP.