Non-surgical Periodontal Therapy In Patients Research Articles

Growth of the Omega 3 industry applied in non-surgical periodontal therapies in dental practitioners

The aim of this systematic review is to recognise the effects of dietary supplementation of Omega 3 (fatty acids) as an adjuvant in non-surgical periodontal therapy in patients with periodontitis. In the present research work, a Systematic Review of Randomised Clinical Trials on the supplementary use of Omega 3 in the diet of patients with periodontitis was carried out. The guidelines of the CONSORT 2010 statement were followed using different search equations and previously selected articles. The results show the synthesis of 12 articles selected for this study, providing information such as author, year, journal and quartile classification, among other parameters such as blood biomarkers present and periodontal clinical parameters. In conclusion, the analysis of the efficacy of Omega-3 as an adjunct to non-surgical periodontal therapy (NSPT) shows that, although improvements in clinical indicators such as calculus index (CIN), periodontal pocket depth and bleeding on probing are observed, the additional impact of Omega-3 has not been shown to be statistically significant. The variability in results may be due to differences in study designs, doses administered, and sample sizes, which limits the ability to establish a clear benefit of Omega-3 on these specific parameters.

Efficacy of different protocols of non-surgical periodontal therapy in patients with type 2 diabetes: A systematic review and meta-analysis.

The aim of the present systematic review of the literature and meta-analysis was to evaluate the efficacy of different protocols of NSPT without any adjunctive therapy in subjects with type 2 diabetes, by considering clinical and patient-centered outcomes. For the purposes of the study randomized controlled clinical trials with more than 3-month follow-up were searched in MEDLINE, EMBASE, and Cochrane Central. Then the articles were screened for inclusion and considered based on the protocols adopted, the outcome measure, follow-up, and the level of glycemic control. A total of 23 articles about 22 studies were included. NSPT was more effective than just oral hygiene measures/no treatment in reducing periodontal probing depth (PPD) and clinical attachment loss (CAL) at 3 months (0.47 mm [0.29-0.65 mm] and 0.50 mm [0.24-0.76 mm], respectively) and 6 months (0.56 mm [0.28-0.84 mm] and 0.45 mm [0.13-0.77 mm], respectively for PPD and CAL) follow-up (very low and low level of evidence). The meta-analysis found no evidence of a difference between full-mouth disinfection versus quadrant protocol clinical outcomes (very low level of evidence). One study found no evidence of a difference in periodontal clinical response between good versus poor glycemic control. Based on the results of the present research NSPT protocols could be considered more efficacious than others in terms of clinical outcomes in subjects with type 2 diabetes. Moreover, NSPT resulted in efficacious improvement of periodontal parameters and HbA1c levels compared to no treatment or oral hygiene instructions alone.

Evaluation of the clinical parameters and volumetric analysis of gingival crevicular fluid for chlohexidine vying silver nanoparticle mouthwash the avant garde for chronic periodontitis

BACKGROUND: Oral cavity ecosystem represents a dynamic pattern. Scaling and root planing (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. Although chlorhexidine is the most effective mouthwash against oral microorganisms, the side effects of long- term use suggest the need for an alternative. Hence, this study has been undertaken to know effectiveness of silver nanoparticle mouthwash with chlorhexidine mouthwash which is effective on common microorganisms of oral cavity. OBJECTIVE: To evaluate and compare the clinical and biochemical outcome of chlorhexidine (CHX) and silver nanoparticle as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. METHODS: Ninety- two patients with generalized moderate to severe chronic periodontitis from the Dept. of Periodontology who fulfilled the inclusion and exclusion criteria were recruited for the study. In the experimental clinical trial, the clinical parameters likewise; Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. The volumetric analysis of gingival crevicular fluid (GCF) levels were assessed at baseline and follow up visits. The IBM SPSS Statistics for Windows software, v. 20.0 (IBM Corp., Armonk, USA), was used. The data was numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics were analyzed to compare the responses between the groups. RESULTS: The statistical analysis was carried out by descriptive as well as inferential statistics and both groups demonstrated significant intragroup reduction in PI, GI, PPD, CAL, GCF from baseline to 3 months follow-up. There were statistically significant intragroup differences between both the groups for all of the parameters. CONCLUSION: Silver nanoparticle mouthwash can be an alternative adjunct for non-surgical periodontal therapy in patients with chronic periodontitis. Results of this study indicated that both the mouth rinse demonstrated an equal range of effectiveness. These conclusions were supported by the clinical parameters and biochemical outcomes.

Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study

ObjectivesThe aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT).Materials and methodsAfter the administration of psychological questionnaires, patients diagnosed with generalized stage III–IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT.ResultsOf the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD.ConclusionPsychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017).Practical implicationsBased on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.

Effects of omega-3 supplementation as an adjunct to non-surgical periodontal therapy on periodontal parameters in periodontitis patients: a randomized clinical trial

ObjectivesThis study aimed to assess the effects of omega-3 fatty acid supplementation as an adjunct to non-surgical periodontal therapy in patients with periodontitis.Materials and methodsThis randomized clinical trial was conducted on 30 patients with periodontitis. All patients received standard non-surgical periodontal therapy, and were randomly divided into two groups of intervention and control by a table of random numbers (n = 15). The intervention group consumed 1000 mg natural fish oil soft-gels daily (300 mg Omega-3 marine triglycerides, 180 mg Eicosapentaenoic acid and 120 mg Docosahexaenoic acid) while the control group used soft-gels contained only some soybean oil for 3 months. Clinical attachment loss (CAL), probing depth (PD), and bleeding index (BI) were recorded at baseline (before the intervention) and after 3 months. The two groups were compared regarding the clinical parameters by t-test (alpha = 0.05).ResultsAll three clinical parameters decreased in both groups at 3 months compared with baseline (P = 0.001). The improvement in PD and CAL in the intervention group was significantly greater than that in the control group (P = 0.001); however, the difference in BI was not significant between the two groups (P = 0.283).ConclusionOmega-3 supplementation as an adjunct to non-surgical periodontal therapy significantly improved the clinical parameters in periodontitis patients compared to soybean oil supplements.

Postoperative Analgesic and Anti-inflammatory Effectiveness of Ginger (Zingiber officinale) and NSAIDs as Adjuncts to Nonsurgical Periodontal Therapy for the Management of Periodontitis.

The authors hypothesize that ginger (Zingiber officinale) tablets and non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing postoperative self-rated pain and periodontal parameters (plaque index [PI], gingival index [GI], and probing depth [PD], clinical attachment loss [AL] and marginal bone loss) following non-surgical periodontal therapy (NSPT) in patients with periodontitis. The aim was to compare the postoperative analgesic and anti-inflammatory effectiveness of ginger tablets and NSAIDs as adjuncts to nonsurgical periodontal therapy for the management of periodontitis. Materials and Methods: Patients with periodontitis were included. All patients underwent NSPT. In groups 1 and 2, patients received postoperative ginger (400 mg) and non-steroidal anti-inflammatory drugs (400 mg), respectively. Demographic data were collected, and full-mouth periodontal parameters (PI, GI, PD and CAL) were evaluated at baseline and at 7, 14 and 21 days. Self-rated pain scores were assessed at baseline, and at 24 h, 3 and 7 days of follow-up. In both groups, self-rated pain was assessed pre- and postoperatively using the numeric rating scale (NRS). Power analysis was performed on data from a pilot investigation and group comparisons were done. Statistical significance was set at p < 0.01. Baseline mean NRS scores in groups 1 and 2 were 4.19 ± 0.12 and 4.13 ± 0.08, respectively. All participants had stage II/grade B periodontitis. At baseline, self-rated pain scores were significantly higher among patients in groups 1 and 2 at 24 h (p < 0.01) and 3 days (p < 0.01) of follow-up. In groups 1 (p < 0.01) and 2 (p < 0.01), self-rated pain scores were significantly higher at 24 h compared with 3 days of follow-up. In both groups, there was a significant reduction in PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) at 7, 14 and 21 days of follow-up compared with baseline. Ginger and traditional NSAIDs are effective in reducing postoperative pain and inflammation following NSPT in patients with moderate periodontitis.

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

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

Two-year outcomes following the adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy in patients with stages III and IV periodontitis.

To evaluate the clinical outcomes 2 years after the adjunctive use of an InGaAsP diode and Er,Cr:YSGG laser for nonsurgical treatment of severe periodontitis. Forty-two patients (45.31 ± 9.78 years old, n = 22 females, n = 23 smokers) with stage III or IV grade B periodontitis were randomly treated either with laser (InGaAsP + Er,Cr:YSGG) adjunctive to subgingival debridement (test group, n = 21) or with subgingival debridement alone (control group, n = 21). Subjects in the test group received a second laser treatment in residual sites 2 months after the initial laser therapy. At baseline, and at 12 and 24 months after therapy, periodontal clinical parameters were evaluated. The primary outcome variable was the number of residual deep sites at 12 months (probing depth [PD] ≥ 6 mm). One and two years after nonsurgical periodontal treatment, both groups yielded statistically significant clinical improvements. The adjunctive use of InGaAsP and Er,Cr:YSGG laser to mechanical debridement resulted in statistically significantly higher clinical (PD, clinical attachment level, bleeding on probing, number of sites with PD ≥ 5 mm, PD ≥ 6 mm, PD ≥ 7 mm) improvements (P < .05) compared to subgingival debridement alone both at 12 and 24 months after therapy. In patients with stage III or IV grade B periodontitis, InGaAsP and Er,Cr:YSGG used adjunctively to subgingival debridement may additionally improve the clinical outcomes compared to mechanical debridement alone over a period of 24 months.

Use and Effectiveness of Propolis on Chronic Periodontitis: a Systematic Review

The aim of this study was to determine the effect of propolis on non-surgical periodontal therapy in patients with chronic periodontitis (CP) as it appears in the recent literature. Propolis is a natural and biocompatible resinous substance that has shown, by means of several scientific studies, to possess medicinal properties such as antimicrobial, healing, anesthetic, anti-inflammatory, and analgesic, among others. There are several studies that have reported the use of propolis as a non-surgical treatment of CP, its comparison with other antimicrobials, and the improvement of clinical and microbiological parameters with scaling and root planing (SRP). A bibliographic search was conducted in the PubMed, Google Scholar, Web of Science, and Science Direct databases up to 2021. The results showed that there are very few reports focused on clinical studies; however, according to the analyzed data, propolis could be a good adjuvant for the treatment of patients with chronic periodontitis compared to the conventional treatment (SRP).

Changes in Salivary Melatonin Levels by Scaling and Root Planing in Patients with Chronic Periodontitis

Background: Periodontitis is a chronic inflammatory disease that causes tissue destruction due to the imbalance in the oxidant-antioxidant system. Melatonin has anti-inflammatory, antioxidant, and immune-modulatory properties and is considered to be a biomarker and diagnostic/therapeutic agent in the pathogenesis of periodontitis. Objectives: The present study aimed to evaluate the salivary melatonin level and its changes following non-surgical periodontal therapy in patients with periodontitis. Methods: In total, 90 salivary samples were collected from 60 patients, including 30 from patients with moderate chronic periodontitis (before periodontal treatment), and 30 from the same patients one month after the non-surgical periodontal therapy, and 30 from periodontally healthy subjects (control). Salivary melatonin levels were measured using the competitive immunoassay of the human melatonin ELISA kit. Results: The highest melatonin concentration was observed in the control group (79.55 ± 59.22; P &lt; 0.05), while the lowest concentration was observed in the pre-treatment group (P &lt; 0.05). In addition, salivary melatonin concentration in the post-treatment group (56.58 ± 46.48) was significantly higher compared to the pre-treatment group (17.25 ± 5.79; P &lt; 0.05). Conclusions: According to the results, salivary melatonin levels improved after non-surgical periodontal therapy, which suggests the involvement of melatonin in the pathogenesis of periodontitis. However, the exact role of melatonin requires further investigation.

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study.

Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results.Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis.Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed.Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05).Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

Impact of stress on clinical outcomes of non-surgical periodontal therapy in patients with severe generalized periodontitis

Relevance.Aim – to assess the impact of psychosocial stress on the clinical outcomes in severe periodontitis patients treated with Nonsurgical Periodontal Therapy (NPT).Materials and methods.Patients received 2 psychological questionnaires to score their stress levels, while clinical data were obtained 1 week before and six weeks after the completion of NPT.Results.A total of 55 patients were consecutively included in the study and subsequently categorized into different stress levels (low stress level n = 22 and moderate/high stress level n = 33). All clinical parameters were found to be comparable at baseline between groups. While reduction in full-mouth bleeding scores was found to be statistically significantly lower in group with higher stress levels, a similar improvement in the other clinical parameters was observed at the completion of NPT.Conclusion.Psychosocial stress seems to influence negatively the results of NPT and highly stressed patients may represent a risk category for disease progression.

Role of probiotics in adjunct to non-surgical periodontal therapy in patients with chronic periodontitis: a systematic review and meta-analysis.

The objective of this study was to establish the significance of probiotic usage, both as a preventive as well as a therapeutic strategy for the management of periodontal disease. It also substantiates the existing studies of single/combined bacterial strain for exhibiting variable ecological impact on oral bacteria. Data sources included literature searches of PubMed (MEDLINE), Scopus, Embase, CENTRAL and Web of science databases for placebo controlled randomized clinical trials of SRP with orally administered probiotics in any form as an adjunct. Data extraction was conducted and information from the included studies was tabulated according to the study designs, form of drug delivery, main outcomes, and clinical parameters. Data collected were based on the focused question outlined for the present systematic review. The reviewers cross-checked all extracted data. CAL and PD were assessed as the primary outcome to compare the effectiveness of adjunctive probiotic therapy in addition to SRP. Fourteen clinical studies were included and demonstrated efficacy in reducing periodontal probing depth (PPD) and gaining clinical attachment level (CAL), between probiotics and SRP/placebo. Adjunctive probiotic therapy in addition to SRP leads to decrease in probing depth and clinical attachment gain in chronic periodontitis patients. However, further high-quality randomized clinical trials with microbiological outcomes are required to fortify the conclusion.

Effect of Nigella Sattiva (Kalonji) Oil Based Mouth Wash on Salivary Matrix Metalloproteinase-8 Level in Patients with Chronic Periodonititis- A Randomized controlled Trial

&lt;p&gt;&lt;strong&gt;Background and Objective&lt;/strong&gt;: Salivary level of Matrix metalloproteinase-8 (MMP-8), a collagen degradation enzyme, is known to increase during chronic periodontitis. Nigella sativa is one of the potent anti[1]inflammatory compounds that has a promising role in oral inflammatory conditions. Present study aims to explore the salivary MMP-8 levels after Nigella sativa oil-based mouth wash as compared to placebo(normal saline) after non-surgical periodontal therapy in patients with chronic periodontitis.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This parallel arm randomized controlled trial was conducted at FMH College of Medicine &amp;amp; Dentistry, Lahore Pakistan from January 2018 to June 2019. Fifty patients suffering from chronic periodontitis were recruited and randomized into the treatment group that received Nigella sativa oil and the control group that received simple normal saline. Salivary samples for MMP-8 levels were collected , once before non-surgical periodontal therapy and secondly after two weeks of&amp;nbsp;rinsing with Nigella sativa oil-based mouthwash in one group and normal saline in the second. Salivary MMP-8 levels were determined through ELISA. The comparison within groups was done through paired t test and between groups through independent sample t-test.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean pre-treatment concentration of salivary MMP-8 of the Nigella Sativa group and normal saline group were 199.37 &amp;plusmn; 300.75 ng/l and 195.29 &amp;plusmn; 175.89 ng/l that decreased post-treatment to 147.35 &amp;plusmn; 144.9ng/l and 114.17 &amp;plusmn; 129.21ng/l respectively. Statistical analysis revealed no difference in the salivary MMP-8 levels between the chronic periodontitis patients using Nigella sativa or normal saline mouth wash twice daily for two weeks.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The salivary levels of MMP-8 reduced in patients with chronic periodontitis after scaling and root planning with the use of Nigella sativa oil-based mouthwash as well as placebo (normal saline). However, this reduction was statistically non-significant both within and between the study groups.&lt;/p&gt;

Effects of smoking on non-surgical periodontal therapy in patients with periodontitis Stage III or IV, and Grade C.

To evaluate possible effects of smoking on clinical, biochemical, and microbiological outcomes of non-surgical periodontal treatment in patients with periodontitis Stage III or IV and Grade C. Conventional quadrant-wise non-surgical periodontal treatment was performed and whole-mouth periodontal measurements were recorded at baseline, 1, 3, and 6 months after completion of treatment. Saliva, gingival crevicular fluid, subgingival plaque, and blood samples were obtained at the same time points. Inflammatory cytokine levels, presence, and quantities of 11 different bacterial species were determined. Smoking status was validated by cotinine assay. Fourteen smoker and 13 non-smoker patients completed the study protocol and revealed similar clinical findings except for the higher plaque scores in the non-smokers at 6 months (P <0.01). Significant differences were found between the study groups in biofluid cytokine levels at 1 and 3 months (P <0.01). Gram-negative bacteria were more abundant in the smokers at baseline and so were Gram-positive bacteria in the non-smokers (P<0.01). Gram-negative bacteria repopulated in the smokers faster than in the non-smokers (P<0.01). The present findings suggest that smoker patients with periodontitis Stage III and IV, Grade C respond well to the non-surgical periodontal treatment during the 6-month follow-up. However, smokers exhibit faster repopulation of Gram-negative bacteria.

Melatonin as host modulating agent supporting nonsurgical periodontal therapy in patients affected by untreated severe periodontitis: A preliminary randomized, triple-blind, placebo-controlled study.

The aim of the current clinical trial was to evaluate if the oral supplementation of melatonin after nonsurgical periodontal therapy (NSPT) determined a better periodontal healing than NSPT alone, in patients affected by untreated severe periodontitis. Melatonin's anti-inflammatory, antioxidant and immunomodulatory capacities, together with its pharmacokinetic and pharmacodynamic profiles are key characteristics that justify the therapeutic use for the treatment of periodontitis. This is a randomized, triple-blind, placebo-controlled study. Twenty patients were blindly randomized either to melatonin or placebo group. The melatonin group received NSPT and melatonin capsules 1mg per day for 1month, while the placebo, NSPT, and placebo capsules for 1month. The patients were evaluated at baseline and 6months after. Mean change from baseline probing depth (PD) was the primary outcome; site of probing was used as unit of analysis; FMBS (%) and FMPS (%) were also calculated. Mann-Whitney test was used to evaluate statistical significance (α=0.05). Melatonin was well tolerated by all patients. Both treatments were effective in reducing PD, but no statistical difference was found when comparing posttreatment PD (probing all sites), P=.62. When considering the primary outcome, melatonin administration resulted in greater mean PD change at 6months if compared to control group: for 4-5mm sites 1.86 (0.81) vs 1.04 (0.69), P=.00001 and for sites >5mm 3.33 (1.43) vs 2.11 (0.96), P=.00012. No difference was found for FMBS and FMPS. Current study, within its limitations, concluded that oral administration of melatonin (1mg per dayfor 30days) after one-stage full mouth NSPT determined a greater change from baseline PD if compared to NSPT alone, in untreated stage III periodontitis. This could provide a non-pharmacological support to improve periodontal healing of periodontal sites after NSPT.

Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis.

Context:Periodontitis and diabetes are universally prevalent diseases which are interlinked with each other. Inflammatory products released both by the microorganisms, and the host plays a pivotal role in causing both the diseases. Pentraxins are acute-phase proteins which are often found to be elevated in inflammatory states. Anti-inflammatory agents have a very important role to play in curbing infection of which, aspirin and omega-3 fatty acids (O3FAs) are being administered often nowadays. Nonsurgical periodontal therapy (NSPT) remains the gold standard of treatment, and other agents have been used as adjuvants only, to increase the efficacy of treatment.Aims:This study compares the effects of low-dose aspirin versus O3FAs when used as adjuvants to NSPT in patients with diabetes and chronic periodontitis.Settings and Design:A total of 42 patients (mean age of 30–65 years) from a diabetic center who were diagnosed with Type II diabetes and chronic periodontitis were included in the study.Materials and Methods:This study was done in the department of periodontics of a tertiary referral care hospital in Hyderabad, in collaboration with a reputed diabetic center.Statistical Analysis Used:Intragroup comparison was done using the paired t-test for continuous data and Wilcoxon signed-rank test for score data. Intergroup comparison was compiled using independent t-test. All P < 0.05 were considered statistically significant.Results:Intragroup comparison at baseline and 3 months after NSPT showed statistically significant results (P < 0.001) in all the three groups pertaining to the clinical (gingival index, probing pocket depth, and clinical attachment level) and biochemical (glycosylated hemoglobin and pentraxin) parameters. However, the intergroup comparison showed a significant improvement in Group II related to pentraxin levels only (P < 0.001).Conclusions:O3FAs proved to be better than low-dose aspirin and placebo after NSPT.

Reduced ADAM8 levels upon non-surgical periodontal therapy in patients with chronic periodontitis

ObjectiveTo determine effect of non-surgical periodontal treatment on a disintegrin and metalloproteinase 8 (ADAM8) levels in gingival crevicular fluid (GCF) of patients with chronic periodontitis (CP) in comparison with those of patients with gingivitis and to find correlations between ADAM8 levels and clinical parameters. DesignTwenty-two and eleven patients with CP and gingivitis, respectively, were examined for four clinical parameters, probing depth, clinical attachment level, gingival and plaque indices. GCF from the selected gingivitis or periodontitis sites with distinct severities was sampled by Periopaper strips. The non-surgical treatments, including scaling and/or root planing and oral hygiene instruction, were provided for all patients. Clinical measurements and GCF sampling were repeated at three months after the treatments. ADAM8 concentrations were analyzed by ELISA and normalized by GCF volumes or total protein amounts. ResultsAll patients exhibited significant improvement of almost every clinical parameter after treatment, whereas the median ADAM8 concentrations were significantly decreased at the moderate and severe periodontitis sites of patients with CP (p < 0.05). Moreover, the significantly positive correlations between ADAM8 concentrations and four clinical parameters were found in both moderate and severe groups (p < 0.05). ConclusionADAM8 concentrations were decreased by non-surgical periodontal therapy in patients with chronic periodontitis at the moderate and severe sites and were correlated with four clinical parameters, implying that GCF ADAM8 levels reflect inflammatory and bone-resorbing activities in the periodontal pocket.

Non-surgical periodontal therapy in patients with periodontitis not suffering from common health disorders

Non-surgical periodontal therapy in patients with periodontitis not suffering from common health disorders

Consumption of cranberry functional beverage reduces gingival index and plaque index in patients with gingivitis

Periodontal disease is highly prevalent worldwide, and consumption of certain foods, such as fruits, seem to improve the effectiveness of periodontal therapy (PT) due to their antiadhesive, immunomodulatory, and antioxidative properties. We hypothesized that the cranberry functional beverage (CFB) consumed for eight weeks improves gingival inflammation indices via inhibition of dental plaque, and alterations in antioxidant status, and systemic inflammation in patients with gingivitis. In this two-arm randomized controlled study, fifty participants were divided into an experimental group (CFB), administered daily with 750 ml CFB, or a control group administered the same amount of water. All patients underwent nonsurgical PT prior to the intervention. Gingival (GI) and bleeding on probing (BoP) indices of inflammation, plaque (PI) and approximal plaque (API) indices of dental plaque deposition, saliva and serum total antioxidant status (TAS), serum malonylodialdehyde level (MDA), and interleukin 1-beta level (IL-1beta) were measured pre- and postintervention. A risk of caries development was determined by Streptococcus mutans (SM) and Lactobacillus spp. (LAB) counts in supragingival dental plaque. Changes in GI and PI but not BoP and API were significantly more pronounced in the CFB group compared to the control group. Serum or saliva TAS, IL-1beta, and MDA did not differ between groups. The number of SM reduced in CFB, but not in the control group. We demonstrated that the consumption of CFB improves gingival and plaque indices without posing a risk of caries development. Thus CFB can be recommended as a safe adjunct for nonsurgical PT in patients with gingivitis.