Moderate Chronic Periodontitis Research Articles

Neurotrophins and vascular endothelial growth factor in oral fluid of elderly patients: diagnostic value for chronic periodontitis and oral lichen planus

Objective. To evaluate the vascular endothelial growth factor A and brain-derived neurotrophic factor in the oral fluid of mature and elderly patients with chronic periodontitis and oral lichen planus. Materials and methods. The study involved 56 participants. The control group consisted of healthy volunteers aged 18–44 (n=10). The comparison group included relatively healthy elderly people aged 60–74 (n=12). The distinguished groups of patients with age-associated dental diseases included: moderate chronic periodontitis mature patients of 45–59 years (n=10) and elderly patients (n=14), as well as elderly patients with oral lichen planus (n=10). The patients underwent dental examination. The content of neurotrophins and vascular endothelial growth factor A in saliva (BDNF/ NGF beta/ VEGF-A Human ProcartaPlex Simplex Kit, Invitrogen, USA) was determined by the multiparametric fluorescence analysis with magnetic microspheres (xMAP, Luminex 200, USA) in compliance with the manufacturer protocol. Results. The groups reveal no differences in the level of brain-derived neurotrophic factor and nerve growth factor beta. The elderly patients with oral lichen planus were found to obtain the highest angiogenesis factor, which diagnostic value was assessed by ROC-analysis. The test appears moderately accurate (AUC=0.875). Conclusion. Vascular endothelial growth factor A can be considered for laboratory monitoring of elderly patients with oral lichen planus.

Individualized management of chronic periodontitis in patients with orthodontic abnormalities: a clinical case report

Relevance. Chronic periodontitis is a multifactorial disease influenced by a variety of factors. Beyond periodontal pathogens and systemic conditions, important contributing factors include malocclusion, dental misalignment, and tooth loss. These conditions can compromise the tissue blood flow hemodynamics and precipitate occlusal trauma with signs of functional overload. Subsequently, this may intensify the inflammation and degradation of the alveolar bone, often leading to premature tooth loss.Correction of malocclusion is paramount in the effective management of periodontal diseases, requiring orthodontic treatment to resolve malocclusion and mitigate signs of functional overload. This treatment aims to redistribute occlusal forces uniformly, thus creating a conducive environment for successful prosthodontic rehabilitation and promoting optimal personal oral hygiene.Clinical case description. This article outlines a personalized approach to managing periodontal inflammation in individuals with orthodontic anomalies. Patient Z., born in 2002, was diagnosed with moderate severity chronic periodontitis (K05.31), presenting with a Class I molar and canine relationship on both sides, constricted dental arches, individual tooth macrodontia, and retrusion and torsiversion of the incisors. The assessment of the patient's periodontal status and overall health was conducted using standard clinical, radiographic, and laboratory diagnostics, whereas the orthodontic assessment involved anthropometric analysis of dental casts and lateral cephalometric radiographs. The periodontal intervention included foundational non-surgical treatments such as ultrasonic scaling both supra- and subgingivally, biofilm disruption using the Vector Paro system, and specific pharmacotherapy. The orthodontic treatment aimed to widen both dental arches and correct the inclination of the upper and lower incisors, achieving a normal occlusion with fixed orthodontic appliances (Damon Q brackets) in accordance with the treatment plan. The effectiveness of the treatment was measured by examining the improvement in gingival conditions, periodontal parameters, and radiographic evidence before and after the intervention.Conclusion. The research demonstrated that an individualized treatment protocol integrating periodontal and orthodontic care can substantially improve the overall health of the dentofacial complex, masticatory efficiency, and aesthetic aspects.

To Evaluate the Association Between Serum Concentration of Vitamin D and Chronic Periodontitis in Non-menopausal Females: A Clinico Biochemical Study.

Periodontal disease's initiation and propagation is through a dysbiosis of the commensal oral microbiota. But recently, through the extraordinary progress, the interrelationship that exists between periodontal disease and systemic health has been unveiled. Through various studies, it has been revealed that vitamin D deficiency may be associated with a greater risk of developing chronic periodontitis and vitamin D supplementation may help to preserve periodontal health. To find a co-relation between 25-hydroxy vitamin D status and the severity of periodontal diseases. To evaluate and compare the effect of non-surgical periodontal therapy alone and in combination with vitamin D supplementation in reducing the severity of periodontal diseases. The present study was conducted on 90 non-menopausal female subjects who divided into 3 groups. Group I comprised of healthy controls. Group II comprised of patients with moderate chronic periodontitis who were assigned to receive only Scaling and root planing (SRP). While group III included patients with moderate chronic periodontitis who were assigned to receive SRP along with Vitamin D supplementation. The periodontal parameters and serum levels of 25- hydroxy vitamin D were recorded for all the participants at baseline. Group II and group III participants were reassessed at an interval of 3 months post-treatment. The results indicated that vitamin D deficiency affected periodontal health negatively. Statistically highly significant improvement was observed in Group III as compared to group II, signifying the efficacy of vitamin D supplementation adjunctive to SRP. Regular evaluation of Vitamin D levels and supplementation to treat the deficiency may have potential periodontal health benefits.

Comparative evaluation of propolis mouthwash with 0.2% chlorhexidine mouthwash as an adjunct to mechanical therapy in improving the periodontitis among perimenopausal women: a randomized controlled trial

ObjectiveTo evaluate the efficacy of Propolis mouthwash compared to chlorhexidine mouthwash as an adjunct to mechanical therapy in improving clinical parameters in perimenopausal women with chronic periodontitis.MethodologyA double-blind, randomized, controlled clinical trial was conducted by recruiting 144 subjects with mild to moderate chronic periodontitis. After scaling and root planning, subjects were allocated to two treatment groups: 0.2% chlorhexidine mouthwash and 20% propolis mouthwash twice daily for six weeks. Clinical parameters such as pocket probing depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP) were analysed at baseline, six weeks, and 12 weeks.ResultThe mean value of PPD in the propolis group was 4.67 at baseline, reduced to 4.01 at six weeks and 3.59 at 12 weeks. While in the chlorhexidine group, the baseline value of 4.65 reduced to 4.44 and 4.25 at six weeks and 12 weeks, respectively. The baseline value of the mean CAL in the propolis group was 4.45. This value was reduced to 4.15 at six weeks and 3.77 at 12 weeks. For the chlorhexidine group, the baseline value of CAL was 4.80, which was reduced to 4.50 and 4.19 at six weeks and 12 weeks. The mean value of bleeding on probing in the propolis group was 77.20, which decreased to 46.30 at six weeks and 14.60 at the final visit. In the chlorhexidine group, the mean value of 77.30 was reduced to 49.60 and 22.80 at subsequent visits.ConclusionThis study concludes that both propolis and chlorhexidine mouthwash positively improve clinical parameters; however, propolis is significantly more effective in improving BOP.Trial registrationID: NCT05870059, Date of Registration: 02/02/2022. (https://beta.clinicaltrials.gov/study/NCT05870059).

Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases

To study the effectiveness of the drug Cholisal as part of the conservative treatment of chronic periodontitis. We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute stage with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of periodontitis, patients were divided into two groups of 50 people. In the main group, Cholisal dental gel was used as part of complex conservative treatment, and in the control group, Metrogil-denta gel was used. To assess the effectiveness of treatment, a dental examination of patients was carried out with an index assessment of the condition of periodontal tissues and a biochemical analysis of the content of arachidonic acid and prostaglandin E2 in gingival blood, comparing the indicators before treatment and 14 days after the start of treatment. When the drug Cholisal was included in complex treatment, 14 days from the start of treatment, patients experienced a statistically significant decrease in the depth of periodontal pockets from 4.7±0.32 mm to 3.6±0.19, and the Green-Vermillion hygiene index by 60.7%, Silness-Loe plaque index by 73.1%, PMA index by 68.8%, Muhlemann-Cowell bleeding index by 68.0% (p<0.001 compared to baseline). When Metrogil-denta gel was used in complex therapy, the effectiveness of treatment was lower: the depth of periodontal pockets did not change significantly (from 4.5±0.22 mm to 4.2±0.17 mm, p>0.05), reduction in the hygiene index Green-Vermillion was 51.9%, Silness-Loe plaque index - 64.0%, PMA index - 43.7%, Muhlemann-Cowell bleeding index - 45.8% (p<0.001 compared to baseline, p<0.001 compared to the main group). A laboratory study showed that in patients of the main group, after completing a course of conservative treatment, the content of biomarkers of inflammation significantly decreased compared to the initial level (p<0.05), while in patients of the control group the content of arachidonic acid and prostaglandin E2 in the gingival blood during the study period did not change significantly (p>0.05 compared to the initial level). The use of the drug Cholisal in the conservative treatment of chronic periodontitis has demonstrated more pronounced positive dynamics of clinical and biochemical parameters compared to traditional therapy, which suggests its high effectiveness.

Chlorhexidine and doxycycline gel versus chip as adjuncts in oral hygiene among Indians.

The effectiveness of newly released medications such as Chlorhexidine (CHX) chip, Doxycycline hyclate (DH) chip, CHX gel, DH chip as adjunct to scaling and root planing in the treatment of chronic periodontitis is important. 90 adult Indian patients with moderate chronic periodontitis were enlisted. It was observed that reduction in periodontal pocket depth (PPD) and increase in clinical attachment level (CAL) was seen in patients in CHX group as compared to DH treated study participants. It was observed that CHX and DH in gel form were more effective in improving periodontal health as compared to CHX and DH in chip form in this group of subjects.

Long-Term Stability of Er:YAG Laser Non-Surgical Periodontal Treatment

Background: Nonsurgical periodontal therapy is the first step of periodontal diseases treatment. It could be performed with various instruments and in recent years lasers have been tested too. The aim of the present study is to evaluate the long-term clinical effectiveness of Er:YAG laser monotherapy in the treatment of moderate chronic periodontitis. Methods: 451 teeth (1099 periodontal pockets) from 30 patients with moderate chronic periodontitis are allocated for subgingival scaling and root planing into two groups—hand instrumentation (control) and Er:YAG laser instrumentation with 100 mJ/15 Hz (test). Patients are examined for probing pocket depth, gingival recession, clinical attachment level, bleeding on probing, plaque presence at baseline, 1, 3, 6 and 12 months after instrumentation. Results: One year after therapy significant reduction of all clinical parameters examined is observed. The pocket depth decreases with 1.55 mm for the control group and 1.70 mm in the test group. The attachment level gain reveals 1.09 mm for hand instrumentation and 0.59 for laser instrumentation. The bleeding on probing reduces more significantly in the test group, where one year after treatment the index is 19.1%, whereas in the control group, it is 33.8%. Conclusions: The Er:YAG laser demonstrates similar clinical effectiveness to hand instrumentation in the non-surgical periodontal treatment. Better long-term stability is observed in the test group.

ЦИТОКИНОВЫЙ СТАТУС ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ПАРОДОНТИТОМ, АССОЦИАЦИИ И КОРРЕЛЯЦИИ

Subject. The subject of this research is the immunological parameters of the blood serum and the oral fluid.&#x0D; Objectives. The objective of this research is to study the levels of serum and oral cytokines TNF-α, IFN-γ, IL-4, MCP-1 in women with secondary amenorrhea for at least one year.&#x0D; Methodology. There were 109 women under the supervision of the Ural State Medical University Department of Preventive Dentistry and Propedeutics of Dental Disease. The main group consisted of 76 women with generalized moderate chronic periodontitis (K05.31)and secondary amenorrhea for at least one year. The control group consisted of 33 post-menopausal women with generalized slight chronic periodontitis in remission. The patients of the both groups underwent laboratory serum and oral fluid testing using enzyme-linked immunosorbent assay. The levels of cytokines TNF-α, IFN-γ, IL-4, MCP-1 were measured in samples using Vector-Best’s tests systems (Vector-Best, Koltsovo, Novosibirsk Region, Russia). The systemic bone mineral density was measured using dual energy X-ray absorptiometry (DXA) with Discovery W QDR Series X-Ray Bone Densitometer (Hologic Inc., USA).&#x0D; Conclusion. The levels of interleikins TNF-α, IFN-γ and chemokine MCP-1 were found to be elevated in the blood serum and the oral fluid of women generalized moderate chronic periodontitis against the background of secondary amenorrhea for at least one year. In contrast, the serum values of IL-4 revealed statistically lower levels in comparison with the same values of IL-4 in the patients from the control group. We defined the statistically significant (at 0.05) correlation between parameters of salivary IL-4 levels and spine bone mineral density, and also the statistically significant (at 0.05) weak negative correlation between parameters of blood IFN-γ levels and right-hip bone mineral density.

Quantitative Association of Platelet-Rich Fibrin (PRF) and Hyperacute Serum (HAS) with Glycemic Control (HbA1c) in Chronic Periodontitis Patients: An Ex vivo Study.

To evaluate correlation of PRF and HAS with glycemic control (HbA1c) and other systemic parameters amongst the chronic periodontitis patients. Twenty-seven non-smoker, non-tobacco users, non-alcoholic moderate chronic periodontitis volunteers (Stage II, Grade A or B), aging between 40 and 50 years of both genders with type 2 diabetes mellitus (T2DM, HbA1c >6.5%) or without T2DM (HbA1c <6.5%), were recruited. After recording vitals and demographic parameters, 20 ml of intravenous fasting blood was collected, of which 11 ml blood was used for investigating complete blood count, lipid profile, glycated hemoglobin (HbA1c), C-reactive protein, and fasting insulin level. As per the standard protocol, PRF and HAS was prepared from the 9-ml blood sample of the patients. PRF obtained was quantified using Wensar's analytical balance with a readability of 0.0001 g. Prepared HAS from the fibrin clot was quantified using a micropipette and stored in 2 ml Eppendorf vials. Mean values of PRF and HAS obtained in the study were 2.0089 ± 0.844 g (ranged between 0.0 g and 3.968 g) and 1.540 ± 0.552 ml (ranged between 0.00 and 3.500 ml), respectively. The amount of PRF and HAS obtained were significantly higher in non-diabetic patients (mean 2.3093 g and 1.743 ml, respectively) as compared to diabetic patients (mean 1.5762 g and 1.266 ml, respectively). Results suggested a significant correlation between HbA1c level and quantification of PRF (P=0.007) and HAS (P=0.037), whereas no correlation was observed between HbA1c levels and hematologic, lipid, and demographic parameters. Within the limitation of the present study, it can be concluded that a significant correlation exists between the HbA1c level and quantification of PRF and HAS.

Effect of self-reported clinician experience level on perceptions of the relative rankings of risk factors for biological complications with dental implant therapy

Statement of problemThe effect of clinician experience on the perception of risks for biological complications associated with dental implant therapy is unknown. PurposeThe purpose of this study was to determine whether clinician experience levels, as assessed by the number of implants placed and/or restored, as well as by type of clinical experience (restorative/prosthodontic and/or surgical), influence the perception of risk for biological complications with dental implant therapy. Material and methodsA 10-item survey instrument was developed that asked participants from a convenience sample to rank different risk factors for peri-implant complications in the areas of patient history, clinical findings, and clinician choices and postimplant placement findings. Information about participant experience (number of implants placed and restored and type of experience) was also captured. The Kruskal-Wallis and Mann-Whitney U test statistical analyses were performed to determine the degree, if any, to which the level of clinician experience influenced risk factor rankings (α=.05). ResultsClinicians with more experience viewed the use of selective serotonin reuptake inhibitor (SSRI) medications and clinician inexperience as more important risk factors than did less experienced clinicians. Clinicians with less experience viewed treated moderate or severe chronic periodontitis and thin tissue biotype as more important risk factors than did more experienced clinicians. Clinicians with predominantly surgical experience viewed a heavy plaque index as a more important risk factor than clinicians with predominantly restorative experience. ConclusionsThe data indicate that the level of clinical experience influences how risk factors associated with biological complications of dental implant therapy are viewed by clinicians.

Hábitos de prescrição de antibióticos de dentistas brasileiros durante tratamentos periodontais

Abstract Introduction Periodontal treatment involves procedures aimed to reduce bacterial load, involving or not the use of local or systemic antibiotics. Objective The purpose of this study was to assess Brazilian dentists’ knowledge about antibiotics prescription during periodontal treatment. Material and method An online questionnaire was available asking for systemic application of local or systemic antibiotics prescription (frequency, and sequence with mechanical periodontal treatment) and in relation to different periodontal diseases. The use of microbial diagnostic services and volunteers’ demographic data were also elucidated. Data were statistically analyzed (Binomial Test, p&lt;0.05). Result Three hundred and ninety-three volunteers answered the questionnaire. Twenty-three percent males and 76.2% females. Average age was 27.7 years. Minority (19.2%) of the volunteers reported to indicate systemic antibiotics to treat gingivitis or periodontitis stages I and II (old slight and moderate chronic periodontitis). Majority of the professionals indicate it to treat periodontal abscess, necrotizing ulcerative gingivitis or periodontitis, periodontitis in severe immunodeficiencies, old aggressive periodontitis, and periodontitis stages III and IV (old severe chronic periodontitis). Rarely (2.5%) the prescription was without the combination with mechanical therapy. Microbiological tests as an auxiliary diagnostic method are rarely (3.1%) requested due to lack of information or cost. Most frequent answers about the number of times professionals reported prescribing systemic antibiotics as part of periodontal treatment per trimester was “at least once”, followed by “2 times”. Conclusion It can be concluded that Brazilian dentists have knowledge about the correct prescription of antibiotics in periodontal therapy.

Significance of salivary poly (ADP-ribose)-polymerase in the assessment of age-dependent pathological processes in the oral cavity.

Age-related changes in the oral cavity are accompanied by the development of age-related pathology, such as chronic periodontitis (CP). Although apoptosis plays a certain role in its pathogenesis, this fact, however, has not been evaluated clinically, and the diagnostic information content of biomarkers of apoptosis and aging has not been determined. The aim of the study was to evaluate the content of cleaved poly-(ADP-ribose)-polymerase (cPARP) and caspase-3 (Casp3) in mixed saliva of elderly patients with age-related dental diseases and in mature patients with mild to moderate CP. The study included 69 people. The control group included 22 healthy young volunteers aged 18 to 44 years. The main group included 22 elderly patients aged 60 to 74 years. They were divided into subgroups according to clinical manifestations: occlusion (comparison group), periodontal, and dystrophic syndromes. Additionally, a group of 25 patients of mature age from 45 to 59 years old with mild to moderate CP was analyzed. The content of salivary Casp3 in patients with occlusion syndrome was lower than in healthy young people (p=0.014). In patients with the periodontal syndrome, the content of cPARP was higher than in the comparison group (p=0.031). The group with dystrophic syndrome had the highest level of Casp3 in comparison with the control group and the comparison group (p=0.012, p=0.004, respectively). There were no statistically significant differences between patients of different age groups with mild to moderate CP. Evaluation of the correlation between cPARP and Casp3 levels revealed a direct relationship in the group of elderly patients and in patients with mild CP (r=0.69, r=0.81, respectively). We assessed the effect of Casp3 levels on changes in the cPARP levels by means of a simple linear regression analysis. The cPARP level correlated with the content of Casp3 (r²=0.555). According to the results of the ROC analysis, it was found that using the cPARP indicator it would be possible to distinguish between groups of elderly patients with periodontal and occlusion syndromes (AUC=0.71), while using Casp3 it would be possible to distinguish patients with the occlusion syndrome and the control group (AUC=0.78). Since the level of Casp3 in young people is significantly higher than in the elderly patients, its decrease can be considered as a potential salivary biomarker of aging. The level of studied cPARP in the elderly has clinical value in periodontal syndrome and low age dependence.

Evaluation of Nd: YAG laser as an appurtenance to scaling and root planning in treating chronic periodontitis

Chronic Periodontitis (CP) causes inflammation of teeth’s supporting tissues and progressive loss of bone and attachment. The purpose of this study was to compare the treatment methodology for CP using Scaling and Root Planning alone and in combination with Nd: YAG Laser.: Sixty patients diagnosed with generalized moderate chronic periodontitis were randomly assigned to two different groups. Group 1: SRP, group 2: SRP and Nd: YAG Laser. A clinical examination of Plague Index PI, Gingival Index GI, and Probing Pocket Depth PPD was performed on each patient. Four follow-ups were conducted: at baseline, at one month, at three months, and six months.A gradual reduction was seen in PI, GI, and PPD in both groups, but significant effects were observed in group 2 patients. In group 2, the PI had a more considerable F value of 291.22 and was more substantial than the control group. It can be concluded that although SRP is a conventional technique for Chronic Periodontitis but when combined with non- surgical laser treatment it provides with prolonged benefits.

Evaluation of P53 protein expression in gingival tissues of patients with chronic periodontitis by immunohistochemistry methods.

Periodontitis is one of the most important periodontal diseases that can be affected by many factors. Although the mechanism of periodontitis development is not yet fully understood, previous studies suggest that apoptosis may be one of the pathological factors that can affect the process of the disease by destroying old and damaged cells. Low expression of P53 protein is one of the reasons for delaying cell death that allows damaged cells to survive longer and gives more time for the chance of mutations and pathogenesis. Because of the important role of P53 in gingival cells of patients with chronic periodontitis, the objective of our study is to evaluate the P53 protein expression in gingival tissues of patients with chronic periodontitis by immunohistochemistry methods. In this cross-sectional study, 35 patients with severe to moderate chronic periodontitis (loss of attachment ≥3 mm, probing depth ≥5 mm) with no treatment and 25 people who were healthy for periodontal problems were examined. Gingival biopsies from marginal and attached gingiva were obtained, prepared, and mounted on slides. Then, the expression of P53 on each slide was evaluated by optic microscopy after using P53 antibodies and staining with hematoxylin-eosin (immunohistochemistry method). Data were analyzed using independent t-test, Mann-Whitney U-test, and Spearman correlation test using SPSS Statistics version 18.0. The mean ages of participants in the case and control groups were 37.58 and 32.09, respectively. Our results showed that the expression of P53 was not significant in periodontitis compared to the control group (p > .05). Also, gender could not affect the expression of P53 in both groups (p > .05), and there was no significant relationship between age and P53 gene incidence. Chronic periodontitis has no significant effect on P53 expression, so changes in apoptosis due to P53 expression in periodontitis are not significant.

Changes in the periodontal microhemocirculation during the treatment of generalized periodontitis using polarized light

BACKGROUND: Chronic generalized periodontitis is one of the main causes of tooth extraction, significant decrease in chewing efficiency, deterioration in the quality of life, and progression of comorbidities. Research in the field of modulating the response of the macroorganism (host therapy) to pathogenic factors is a huge player in solving the problem of effective treatment of chronic generalized periodontitis, along with an active study of methods influencing the periodontal microbiome.&#x0D; AIM: To examine changes in microhemocirculation in the periodontium in the treatment of chronic generalized periodontitis of moderate severity using polarized, incoherent, polychromatic radiation.&#x0D; MATERIAL AND METHODS: Microhemocirculation parameters in periodontal tissues were obtained and analyzed in the treatment of moderate periodontitis in 90 patients using polarized, incoherent, polychromatic radiation (piler-light therapy) and a nonsteroidal anti-inflammatory drug (lysine salt of ketoprofen) as modulators of the regional host response. Analyses were conducted within 1 year using clinical and radiological methods and laser Doppler flowmetry.&#x0D; RESULTS: In the treatment of moderate chronic periodontitis, single-component pharmacotherapy using an antimicrobial gel containing metronidazole and chlorhexidine has a positive effect on clinical symptoms and microhemodynamics in periodontal tissues only for 3 months.&#x0D; CONCLUSIONS: The combined use of the gel and lysine salt of ketoprofen increases the duration of positive changes in the microhemodynamics of periodontal tissues for up to 6 months. By its inclusion in the algorithm for the treatment of chronic periodontitis of moderate severity, along with antimicrobial and anti-inflammatory drugs, piler-light therapy allows for maintaining the improvement in hemodynamic parameters in the periodontium within 1 year and makes the disease in remission.

Comparative analysis of subgingival microbiota in patients with mild, moderate, and severe chronic periodontitis.

In this study, we explored the suspected pathogens of chronic periodontitis at different stages of occurrence and development. We collected 100 gingival crevicular fluid samples, 27, 27, and 26 from patients with mild, moderate, and severe chronic periodontitis, respectively, and 20 from healthy individuals. Pathogens were detected using a 16S rRNA metagenomic approach. Quantitative Insights in Microbial Ecology, Mothur, and other software were used to analyze the original data, draw relative abundance histograms and heat maps, and calculate flora abundance and diversity indexes. We identified 429 operational taxonomic units, covering 13 phyla, 20 classes, 32 orders, 66 families, and 123 genera from the four groups of samples. Each group showed microbial diversity, and the number of new species of bacterial flora in the gingival crevicular fluid samples gradually increased from the healthy to the severe chronic periodontitis group. There was a significant difference in the relative abundance of the core flora at the phylum, class, order, family, and genus classification levels. Our data indicated a certain correlation between the changes in the subgingival microbial structure and the occurrence and development of chronic periodontitis, which might be able to provide a reference for the diagnosis, treatment and prevention of chronic periodontitis.

EFFICACY OF 980NM DIODE LASER AS AN ADJUNCT TO NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS: A 9-MONTH CLINICAL STUDY.

BACKGROUND: Subgingival plaque is the initiating factor for Chronic Periodontitis (CP). Therefore initial measures consist of Non-Surgical Periodontal Therapy (NSPT). The use of lasers as adjuvants to NSPT has gained preference for many years now. However it has not been completely validated. So, we studied the efcacy of diode laser (DL), as adjunct to NSPT. MATERIALS AND METHODS: In 50 subjects, aged 35-65 years with moderate CP (5-8 mm pocket depth), based on inclusion and exclusion criteria, 25 patients were selected and randomly allocated to two groups; the rst group, control group (CG), treated by NSPT; and 25 in the second test group, (TG), received NSPT followed by DL irradiation. Assessment was conducted for gingival index (GI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD) at baseline (B/L), 1, 3, 6, and 9 months. RESULTS: There was improvement of all clinical parameters in both the groups, but was more statistically signicant in the TG. CONCLUSIONS: The application of adjunctive 980nm DL improves clinical parameters including GI, CAL, PPD and most markedly, BOP.

THE USE OF 980NM DIODE LASER AS AN ADJUNCT TO NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS: A CLINICAL STUDY

BACKGROUND: Chronic Periodontitis (CP) is a major cause of tooth loss. Management usually consists of Non-Surgical Periodontal Therapy (NSPT) and surgical treatment. Lately advances in periodontics include the use of lasers, known for their benecial effects, as efcient adjuvants to NSPT. This study evaluated and compared clinically, the efcacy of 980 nm Diode Laser (DL) used as adjunct to conventional NSPT for treating CP. MATERIALS AND METHODS: The study included 50 subjects, aged 35-65 years with moderate CP (5-8mm pocket depth). According to inclusion and exclusion criteria, 25 patients were selected and randomly allocated to two groups; the rst group, the control group (CG), treated by NSPT; and 25 in the second test group, (TG), received NSPT followed by DL irradiation. Assessment was conducted for gingival index (GI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD) at baseline (B/L), 4th and 12th weeks. RESULTS: There was statistically signicant improvement in all clinical parameters. GI reduced from 2.35 at B/L to 1.07 and 0.93 in CG; and from 2.39 to 0.96 and 0.85 in TG at 4 and 12 weeks (P &lt; 0.00001). At B/L all 50 patients had BOP, which decreased to 7 in the CG and to 0 in the TG at both 4 and 12 weeks, (P &lt; 0.003). PPD at B/L was 7.8mm for CG; 7.92 mm for TG and reduced to 4.8mm and 5.1mm in CG; 3.64 mm and 3.36mm in TG at 4 and 12 weeks (P &lt; 0.00001). CAL at B/L was 7.24 mm for CG and 7.28mm for TG, and improved to 4.6mm and 4.72mm and in TG to 3.28mm at 4 and 12 weeks (P &lt; 0.00001). CONCLUSIONS: The application of adjunctive980 nm DL improves clinical parameters including GI, CAL, PPD and most markedly, BOP

Comparative Evaluation of Azadirachta indica (Neem) Chip and Soft Tissue Diode Lasers as a Supplement to Phase I Periodontal Therapy in Localized Chronic Moderate Periodontitis: A Randomized Controlled Clinical Trial.

Introduction The current trial aimed to assess and compare the efficacy of neem chip and diode laser as a local drug delivery (LDD) agent as a supplement to phase I periodontal therapy in treatment of localized chronic moderate periodontitis. Materials and Methodology. Fourteen systemically healthy participants with 4–6 mm deep periodontal pockets at least in three quadrants (with no alveolar bony defect amenable to respective or regenerative osseous surgery, as seen in orthopantomograph) were selected for the trial. One week after phase I therapy, 10% absorbable chip of neem (commercially prepared by staff of a pharmacy college, Sheriguda, India) was placed in the periodontal pocket on one site, and soft tissue diode laser pocket sterilization was performed on the other site of the arch. Remaining one site was considered as a control. Parameters recorded clinically were plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and relative attachment level (RAL) measured at baseline, 21st day, and one month postoperatively. Results Statistically significant improvements were observed in all clinical parameters at one month as compared to baseline for both treatment groups. Conclusion Neem chip supplemented with phase I therapy showed best improvement in clinical parameters followed by laser supplemented with phase I therapy in comparison to phase I therapy alone at one month follow-up. Clinical Significance. Neem chips are nature's products, affordable without side effects, with a potential to be used as a local drug delivery agent in treating moderate chronic periodontitis.

Cross-sectional analysis of the association of periodontitis with carotid intima media thickness and atherosclerotic plaque in the Hamburg City health study.

Previous epidemiological studies regarding the association between chronic periodontitis (CP) and carotid intima-media thickness (cIMT) and subclinical atherosclerosis have been inconclusive. The aim of this study was to determine whether CP is associated with subclinical atherosclerosis in a large population-based cohort study conducted in northern Germany (the Hamburg City Health study). Baseline data from 5781 participants of the Hamburg City Health Study with complete oral health and carotid ultrasound data (50.7% female, mean age: 62.1± 8.4 years) were evaluated. A standardized duplex sonography of the carotid artery was performed with measurement of carotid intima-media thickness (cIMT) and atherosclerotic plaques. Oral health was assessed by recording the decayed, missing, and filled teeth (DMFT) index, clinical attachment loss (CAL), bleeding on probing (BOP), and the dental plaque index (PI). Correlations were tested for statistical significance by means of descriptive statistics and multivariate regression analyses. Moderate and severe CP were associated with the prevalence of cIMT ≥ 1 mm (none or mild CP: 5.1%, moderate CP: 6.1%, severe CP: 10%) and mean cIMT (none or mild CP: 0.72 mm, moderate CP: 0.75 mm, severe CP: 0.78 mm) in bivariate analyses (p< .001). Additionally, severe and moderate CP were associated with higher prevalence of carotid atherosclerotic plaques (plaque=yes: none or mild CP: 23.9%, moderate CP: 29%, severe CP: 40.2%,). After adjustment for age, sex, smoking, diabetes, hypertension, educational level, hypercholesterolemia, and hsCRP, severe CP still correlated significantly with cIMT and the prevalence of cIMT ≥1 mm and/or presence of carotid atherosclerotic plaques. In this study, severe CP was associated with increased cIMT and higher prevalence of carotid plaques independent of common risk factors.