Non-surgical Periodontal Therapy Research Articles

Evaluation and Comparison of the Root Surface Microtopography Following the Use of Gracey Curettes, Piezo-ceramic Scalers, and Piezo-surgery Scalers: An In vitro Study

Abstract Background: Nonsurgical periodontal therapy plays a pivotal role in comprehensive periodontal treatment by effectively removing plaque and calculus through both supragingival and subgingival scaling and root surface debridement. This therapeutic approach encompasses methods aimed at curbing infection, restoring lost tissue integrity, and preserving a healthy periodontium. The ultimate objective of scaling and root planing (SRP) is realized through manual or power-driven scalers. Objectives: This study aims to assess and contrast the microtopography of root surfaces following in vitro SRP using the Gracey curette, Piezo-ceramic ultrasonic scaler, and Piezo-surgery ultrasonic scaler. Materials and Methods: A randomized in vitro investigation was conducted at Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai. Thirty freshly extracted adult human single-rooted teeth, encompassing incisors, canines, and premolars were procured from the Oral and Maxillofacial Surgery outpatient department. The teeth were categorized into three groups: Group A – Gracey curette 7/8 (n = 10), Group B – Piezo-ceramic ultrasonic scaler (Universal insert) (n = 10), and Group C – Piezo-surgery scaler PS1 (n = 10). The evaluation was conducted using electron scanning microscopy (ESEM) and confocal analysis post-SRP. Each tooth was sectioned longitudinally into mesial and distal halves, resulting in 20 samples per group. A demarcation line was established on the middle third of the root surface, distinguishing the test area (T) (coronal) from the control area (C) (apical). In the electron scanning microscopy (ESEM) analysis subset, a notch was created on the upper right corner below the cementoenamel junction in 10 samples from each group. The remaining samples (n = 10 from each group) were not notched for confocal microscopic analysis. Scanning Electron Microscopy analysis was conducted at the Indian Institute of Technology facility in Powai, Mumbai. Results: The overall findings indicated nonsignificant differences among the three groups in the t-test area when examined at × 500 using confocal microscopy and ESEM. However, at × 1000 using ESEM, Group C (Piezo-surgery scaler) exhibited a significantly greater mean surface roughness compared to Group A (Gracey curette) and Group B (Piezo-ceramic ultrasonic scaler) in the t-test area. Conclusion: The Piezo-surgery PS1 root planning tip yields the smoothest root surface following SRP, as indicated by the study’s outcomes.

Efficacy of Locally Delivered Herbal Chip Containing (8% Mimusops elengi) as an Adjunct to Scaling and Root Planing in Chronic Periodontitis: A Randomised Split-mouth Clinical Study

Introduction: Conventional mechanical debridement does not remove all pathogenic bacteria from the subgingival environment. To overcome these limitations, local drug delivery systems enhance the curative effect by combining with drugs, which promote bone and tissue regeneration. Thus, this study aims to evaluate the efficacy of locally delivered herbal chips containing (8% Mimusops elengi) as an adjunct to scaling and root planing (SRP) and compared to SRP alone for the treatment of chronic periodontitis. Materials and Methods: A randomised split-mouth clinical study was conducted among chronic periodontitis patients undergoing periodontal therapy. Thirty subjects with 60 sites were divided into test and control groups. The control sites were treated with SRP alone, whereas the test sites were treated with SRP followed by placement of an 8% M. elengi herbal chip within the pockets. Patients were recalled on the 21st and 45th day, and clinical parameters were measured. Results: An inter-group comparison of all the clinical parameters between the control and test sides was statistically analysed. At all periods of the study, the mean difference was observed to be highly significant (P < 0.001). Conclusion: The 8% M. elengi chip is effective as an adjunct to non-surgical periodontal therapy in chronic periodontitis probing depth. Further clinical studies are needed to evaluate the long-term efficacy of M. elengi.

Non-Surgical Periodontal Therapy's Influence on Alpha-Synuclein and Inflammatory Marker Levels: A Pilot Study.

Background: Microbial dysbiosis may contribute to alpha-synuclein (α-Syn) homeostasis disruption, yet the burden of inflammatory periodontal infection and its treatment have never been studied in this regard. We aimed to compare the cytokine and α-Syn levels in the saliva and blood of patients with periodontitis who underwent non-surgical periodontal therapy (NSPT) and those of their healthy counterparts. Methods: Periodontal examination and saliva and blood sample collection were carried out in incoming patients at a university clinic. The periodontitis group (PG) received NSPT. The sample collection and periodontal observation were repeated 30 days after. IL-6, IL1-β and total α-Syn were quantified using immunoassay methods. The periodontal inflamed surface area (PISA) was calculated as a proxy for periodontal inflammation. Results: Eleven participants formed the PG, and there were fifteen healthy controls (HC). At baseline, no correlation between salivary and plasma α-Syn was found. The salivary α-Syn levels revealed a tendency to decrease 30 days after, particularly in the PD cases. The variation in PISA and α-Syn showed significant correlation. Salivary α-Syn correlated negatively with salivary IL-6 levels at both timepoints in the total sample (rho = -0.394 and rho = -0.451) and in the HC (rho = -0.632 and rho = -0.561). Variations in plasma IL-6 and α-Syn were negatively correlated (rho = -0.518) in the healthy participants. Baseline plasma IL1-β negatively correlated with plasmatic α-Syn at 30 days in the HC (rho = -0.581). Conclusions: Salivary and plasma α-Syn bioavailability operate independently, and periodontal diagnosis was not a confounding factor. Salivary α-Syn levels were significantly affected by NSPT, contrary to plasma levels. These results should be confirmed in future larger and prospective studies.

A randomized clinical trial on the effect of vitamin D supplementation prior to non-surgical periodontal therapy: a feasibility trial

A randomized clinical trial on the effect of vitamin D supplementation prior to non-surgical periodontal therapy: a feasibility trial

Periodontal conditions of teeth adjacent to dental implants with or without peri-implantitis after non-surgical therapy in patients treated for periodontitis: A retrospective study.

To retrospectively assess the periodontal conditions of teeth adjacent to and contralateral to implants presenting with or without peri-implantitis, following non-surgical periodontal and peri-implant mechanical therapy. One hundred and one patients with existing dental implants and chronic periodontitis, who underwent non-surgical periodontal and peri-implant mechanical therapy, were included. The periodontal clinical probing depth (PPD), gingival recession (GR), and bleeding on probing (BOP) were recorded at six sites around the adjacent (Adj-) teeth and the contralateral (CL-) teeth relative to the implant. The potential factors influencing the periodontal conditions of 316 teeth were analyzed by multivariate linear regression models with generalized estimating equation methods and α = .05. The PPD of Adj-teeth was significantly different from that of CL-teeth before and after non-surgical therapy when the implant was diagnosed with peri-implantitis (PI) (p < .05). The PPD of teeth was shown to be affected by neighboring implants diagnosed with peri-implantitis (β = .825 mm, p < .001), teeth adjacent to implants (β = .245 mm, p = .004), a molar tooth type (β = .435 mm, p = .019), and non-surgical therapy (β = -.522 mm, p < .001). Relatively compromised periodontal conditions at Adj-teeth after non-surgical PI therapy were detected. Therefore, clinicians should be aware that non-surgical therapy may be less successful at teeth adjacent to implants with PI.

Evaluation of Antimicrobial Efficacy of 5% Myristica Fragrans Mouthwash in Gingivitis Subjects - A Clinico Microbiological Study

Gingivitis is the inflammation or infection of gingiva that support the teeth. The prevailing belief regarding the cause for gingivitis is the toxins produced by the bacteria in the mouth, particularly the bacteria that causes the formation of plaque. Myristica fragrans commonly known as nutmeg possesses anti-carcinogenic, anti-inflammatory activities, antioxidant effect, anti-diabetic, and antibacterial properties. The seeds of nutmeg have the ability to inhibit the growth of Gram Negative and Positive bacteria. Objective: 1. To evaluate clinical parameters at baseline and 21 days post scaling after the use of Myristica fragrans mouthwash. 2. To evaluate the colony count of Porphyromonas gingivalis in plaque samples at baseline and 21 days after the use of Myristica fragrans mouthwash. Methodology: A total of 40 gingivitis subjects were selected and divided randomly into Group A and B. Group A, Non-surgical periodontal therapy followed by Myristica fragrans mouthwash (20) and Group B, Non-surgical periodontal therapy alone (20). The supragingival plaque samples were collected at baseline and 21 days after non surgical periodontal therapy. Results: Significant reduction in clinical parameters and colony count of Porphyromonas gingivalis after the use of 5% Myristica fragrans mouthwash.

In-silico assessment of bioactive compounds from chewing stick (Salvadora persica) against N-acetylneuraminate lyase (5ZKA) of Fusobacterium nucleatum involved in salicyclic acid metabolism

BackgroundFusobacterium nucleatum is implicated in the formation of subgingival dental plaques. The main therapy of choice is the use of non-surgical periodontal therapy; however, this has been shown to be unable to remove Fusobacterium nucleatum completely informing the need for an alternative therapy. The aim of this study was to evaluate in-silico, the mechanism with which bioactive compounds from Chewing stick (Salvadora persica) mediate their action against F. nucleatum. MethodThe bioactive compounds 5-Hydroxymethylfurfural (PubChem CID: 237332), furan-2-carboxylic acid, 3-methyl-, trimethylsilyl ester (PubChem CID: 587050), and d-Erythro-Pentofuranose, 2-deoxy-1,3,5-tris-O-(trimethylsilyl) (PubChem CID: 525316) from S. persica and target protein N-acetylneuraminate lyase (5ZKA) were retrieved from literature and protein database, prepared and utilised for docking and molecular simulations using standard protocols with metronidazole and co-crystal as controls. In addition, the pharmacokinetic (ADMET) properties and density functional theory (DFT) were also evaluated ResultThe docking scores were -6.7 for the control co-crystal, -5.6 for metronidazole, -5.5 for 5-Hydroxymethylfurfural, -5.2 for d-Erythro-Pentofuranose, 2-deoxy-1,3,5-tris-O-(trimethylsilyl)- and -5.9 for furan-2-carboxylic acid, 3-methyl-, trimethylsilyl ester. Molecular simulation indicate RMSD and RMSF values suggestive of stable complexes during most of the simulation runs, especially so for 5-Hydroxymethylfurfural and Furan-2-carboxylic acid-3-methyl- trimethylsilyl ester that returned RMSD values less than 1.8 Å and RMSF values that were generally less than 2.0. Our ADMET prediction indicates that the test ligands had better pharmacokinetic than the standard drug except for furan-2-carboxylic acid and d-Erythro-Pentofuranose, 2-deoxy-1,3,5-tris-O- that showed hepatotoxicity. In addition, our DFT result indicated that the reactivity of the ligands were slightly less than that of metronidazole ConclusionThe ligands show promising drug-like potential that can be exploited further towards an alternative medication for managing F. nucleatum subgingival dental oral diseases.

Decision-making on systemic antibiotics in the management of periodontitis: A retrospective comparison of two concepts.

To retrospectively compare two approaches for the adjunctive use of systemic antibiotics in non-surgical periodontal therapy: one based on the detection of Aggregatibacter actinomycetemcomitans (Aa) and the other on age and severity of periodontitis (Age & PPD). We also assessed the additional benefit of antibiotics in reducing the need for further surgical therapy in each group. Patients of the Department of Periodontology, Goethe University Frankfurt, Germany, were screened for microbiological testing between 2008 and 2018. Patients were categorized by their microbiological result (Aa+/-) and demographic/clinical data (Age & PPD+/-). Agreement on antibiotic indication was tested. The clinical evaluation focussed on teeth with probing pocket depths (PPDs) ≥ 6 mm. Analysis of 425 patients revealed 30% categorized as Age & PPD+ and 34% as Aa+. Sixty-three percent had consistent antibiotic recommendations (phi coefficient 0.14, p = .004). Patients in the Age & PPD+ group receiving antibiotics showed the most substantial reduction in the number of teeth with PPD ≥ 6 mm after non-surgical periodontal therapy. Both strategies resulted in a significant clinical improvement compared with those without antibiotic treatment and restricted antibiotic use similarly, but targeted different patient groups. Younger individuals with severe periodontitis benefited most from antibiotics, reducing the need for additional surgeries. The study was registered in an international trial register (German Clinical Trial Register number DRKS00028768, registration date 27 April 2022, https://drks.de/search/en/trial/DRKS00028768).

Effect of non-surgical periodontal therapy on salivary and gingival crevicular fluid concentration of visfatin in periodontal health and disease

Background and objectiveVisfatin, a pleotropic mediator mostly produced by visceral fat, is crucial in controlling the immunological and defensive systems. It serves the roles of a cytokine, an enzyme involved in energy metabolism, and a growth factor. The objective of the present study was to assess the impact of non-surgical periodontal therapy (scaling and root planing) on visfatin concentrations in saliva and gingival crevicular fluid in individuals with Periodontitis (stage-II grade-A) Materials and methods54 individuals were divided into Group A (Periodontally Healthy) and Group B1(Periodontitis baseline) based on periodontal parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and radiographic parameters. After NSPT (SRP), Group B1 patients were recalled after 4 weeks, constituting Group B2 (post NSPT group B1). At baseline and 4 weeks after non-surgical periodontal therapy (SRP), all clinical parameters, salivary and GCF samples were recorded. An ELISA kit was used to measure the levels of visfatin. Using the paired t-test, unpaired t-test, and Pearson's correlation coefficient, data were analysed using SPSS 15. ResultsAfter non-surgical periodontal treatment (SRP), the mean salivary and gingival crevicular fluid concentration of visfatin considerably decreased to a level comparable to periodontal health. In all groups, GCF visfatin concentration was higher than salivary concentration of visfatin. In periodontitis patients, visfatin concentration in GCF was 1.5 times higher than in saliva. ConclusionThe results of this investigation suggest a direct correlation between salivary and gingival crevicular fluid visfatin concentration and periodontal tissue inflammation and disease activity.

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial.

This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.

Platelet-Rich Fibrin in Non-Surgical Periodontal Therapy: A Split-Mouth Randomized Controlled Clinical Trial.

This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test group pockets alongside SRP, while control group pockets received SRP alone. Measurements at baseline and six weeks included probing pocket depths (PPDs), clinical attachment loss (CAL), gingival recession (GR), the plaque index, and the gingivitis index. The wound healing index was assessed at six weeks. The results show statistically significant improvements in the SRP+PRF group compared to SRP alone, demonstrating a better CAL gain (SRP+PRF group: 2.69 ± 0.63; SRP alone group: 4.15 ± 0.69-p-value: 0.001), PPD reduction (SRP+PRF group: 2.62 ± 0.65; SRP alone group: 3.85 ± 0.80-p-value: 0.001), and GR minimization (SRP+PRF group: 0.46 ± 0.62; SRP alone group: 0.81 ± 0.72-p-value: 0.21). The adjunctive use of PRF enhanced healing, reduced pocket depths, decreased tissue morbidity, and minimized gingival recession. This study concludes that PRF placement is effective in 5-6 mm pockets, potentially reducing the number of periodontal treatment sessions needed for pocket closure.

Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III-IV Periodontitis: A Retrospective Analysis.

To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.

Effect of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser-assisted periodontal therapy using radial firing tip during early healing period: a randomized controlled split-mouth clinical trial

BackgroundThis study aimed to demonstrate the efficacy of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser-assisted nonsurgical periodontal therapy in periodontitis patients during 8 weeks of healing.MethodsA split-mouth, single-blinded, randomized controlled clinical trial was conducted on 12 patients diagnosed with stage III/IV periodontitis and had a minimum of two teeth with probing pocket depth (PPD) > 5 mm in at least two quadrants. Upon randomization, each quadrant was assigned for conventional scaling and root planing (SRP) procedure or laser-assisted therapy (SRP + laser) using radial firing tip (RFPT 5, Biolase). Clinical measurements and gingival crevicular fluid collection were performed for statistical analysis.ResultsIn the initial statistical analysis on the whole subject teeth, modified gingival index (MGI) reduction was greater in test group at 1(P = 0.0153), 4 (P = 0.0318), and 8 weeks (P = 0.0047) compared to the control in the same period. PPD reduction at 4 weeks in test group was -1.67 ± 0.59 showing significant difference compared to the control (-1.37 ± 0.63, P = 0.0253). When teeth with mean PPD ≥5 mm were sorted, MGI decrease was significantly greater in test group at 1 (P=0.003) and 8 week (P=0.0102) follow-ups. PPD reduction was also significantly greater in test group at 4 week period (-1.98 ± 0.55 vs -1.58 ± 0.56, test vs control, P=0.0224). ConclusionsEr,Cr:YSGG-assisted periodontal therapy is beneficial in MGI and PPD reductions during early healing period.

Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study.

To assess the potential benefits of minimally invasive non-surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes. A multi-centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months. Eighty-four patients completed the 12-month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty-six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively. Improvements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally%20invasive%20non%20surgical%20therapy&locStr=UK&country=United%20Kingdom&distance=50&rank=2.

Short-term, nonsurgical periodontal therapy boosts interleukin-12 levels and reduces oral cancer risk.

Cytokines, including interleukin-12 (IL-12), are proteins that regulate cell survival, proliferation, differentiation, and function. IL-12 is a heterodimeric proinflammatory cytokine. It possesses tumoricidal properties and promotes M1 macrophage polarization and IFN-γ production by T helper (Th1) cells, which in turn stimulates the antitumor cytotoxic cluster of eight positive (CD8+) and natural killer cells, therefore activating an effector immune response against tumor cells. Herein, the IL-2 levels of 60 patients with generalized chronic periodontitis (GCP) were assessed. Plaque index, gingival index, pocket probing depth, bleeding on probing percentage (BOP %), and clinical attachment loss were the clinical indicators reported. Patients with GCP in the pretreatment group had substantially lower mean IL-12 levels than those in the post-treatment group. Short-term, nonsurgical treatment (NST) considerably improved periodontal indices and increased IL-12 levels, thereby reducing oral cancer risk. NST is a cost-effective and accessible cancer prevention procedure for general dentists.

Step 2 for the treatment of periodontal diseases: adjunctive therapies

Step 2 of periodontal therapy primarily aims at the non-surgical, mechanical disruption of the subgingival biofilm and removal of plaque-retentive factors, allowing a shift from disease to health. Numerous therapeutic agents have been proposed as adjuncts to non-surgical periodontal therapy, generally through either aiding disruption of the dental plaque biofilm, or though alteration of the host immune response. This article reviews the British Society of Periodontology's implementation of the S3-level guidelines in relation to adjunctive therapies. CPD/Clinical Relevance: Recommendation to use adjunctive therapies in the treatment of periodontitis requires careful consideration of the available evidence as well as the wider effects of the proposed therapy.

Effects of minimally invasive non-surgical therapy on C-reactive protein, lipoprotein-associated phospholipase A2, and clinical outcomes in periodontitis patients: A 1-year randomized, controlled clinical trial.

Growing evidence suggests the type of periodontal treatment could differentially influence the reduction of key cardiovascular risk mediators in periodontitis patients. This randomized, controlled clinical trial compared the impact of minimally invasive non-surgical therapy (MINST) with quadrant-wise subgingival instrumentation (Q-SI) on C-reactive protein (CRP) together with lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, and clinical periodontal outcomes in patients with periodontitis. Moreover, it was evaluated if baseline CRP levels impacted the efficacy of non-surgical periodontal therapy protocols. Forty-two periodontitis patients were enrolled and randomly treated by means of MINST (n=21) or Q-SI (n=21). The outcomes assessed were serum CRP and Lp-PLA2, and periodontal parameters (probing depth [PD], clinical attachment level [CAL], full-mouth bleeding score [FMBS]), at baseline and at follow-ups at 1, 3, and 6 months and at 1 year after treatment. At 1 year, MINST significantly reduced, among others, mean PD (p=0.007), mean CAL (p=0.007), the number of pockets>4mm (p=0.011) and ≥6mm (p=0.005), and FMBS (p=0.048) compared to Q-SI. Generalized multivariate analysis evidenced that high baseline CRP (p=0.039) and FMBS (p=0.046) levels, together with MINST treatment (p=0.007) were significant predictors of PD reduction at 1-year follow-up. Moreover, the Jonckheere-Terpstra test showed that patients with high baseline CRP levels gained more benefits from MINST treatment at 1-year follow-up than they did from Q-SI. Patients receiving MINST showed a greater reduction in CRP levels than patients with Q-SI after 1 year of follow-up. Moreover, patients with high baseline levels of CRP and Lp-PLA2 gained more benefits from the MINST approach at 1-year follow-up.

Exploring the bi-directional relationship between periodontitis and dyslipidemia: a comprehensive systematic review and meta-analysis.

As periodontitis and dyslipidemia are diseases that occur with high incidence, the relationship between them has attracted much attention. Previous studies on these diseases have tended to focus on lipid parameters and periodontitis, we aimed to investigate the relationship between dyslipidemia and periodontitis. A comprehensive search to identify the studies investigating the relationship between dyslipidemia and periodontitis was performed on PubMed, Web of Science and Cochrane Library before the date of August, 2023. Studies were considered eligible if they contained data on abnormal blood lipid parameters and periodontitis. Studies that reported mean differences and 95% confidence intervals or odds ratios were used. A total of 73 publications were included in the meta-analysis. Hyper total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and lower high-density lipoprotein (HDL) levels are risk factors for periodontitis. Periodontal disease is a risk factor for high TG and low HDL levels. Three months after periodontal treatment, the levels of TC, TG and HDL were significantly improved, and statin treatment only improved gingival index (GI) levels compared to that of the dietary control. The findings reported here suggest that the mutual promotion of periodontitis and dyslipidemia can be confirmed. Non-surgical periodontal therapy may improve lipid abnormalities. It can't be demonstrated whether systematic application of statins have a better effect on the improvement in periodontal status in patients with dyslipidemia compared to that of the control.

A retrospective analysis of the role of age and sex in outcomes of non-surgical periodontal therapy at a single academic dental center

The present study examined the role of age and sex in the outcomes of non-surgical periodontal therapy (NSPT). De-identified demographic and periodontal characteristics of patients who presented for baseline periodontal evaluation, NSPT, and periodontal re-evaluation were abstracted from electronic health records. Independent associations of age and sex with severe periodontitis defined as ≥ 5 mm clinical attachment loss (CAL) and ≥ 6 mm probing depth (PD) were determined using multinomial logistic regression. The null hypothesis was rejected at α < 0.05. A total of 2866 eligible subjects were included in the analysis. Significantly lower odds of CAL ≤ 4 mm than CAL ≥ 5 mm (reference) were observed in adults aged 35–64 (odds ratio, OR, 0.19; 95% confidence interval, CI 0.13, 0.29) and ≥ 65 years (OR 0.13; 95% CI 0.07, 0.25) compared to those aged 18–34 years. Odds of PD < 4 mm versus PD ≥ 6 mm (reference) were lower in adults aged 35–64 years than those aged 18–34 years (OR 0.71; 95% CI 0.55, 0.90) and higher in females compared to males (OR 1.67; 95% CI 1.14, 2.44). These results suggest more compromised post-NSPT outcomes in older adults and males compared to the respective populations and highlight the need for personalized therapeutic strategies in these populations.

Probing the salivary proteome for prognostic biomarkers in response to non-surgical periodontal therapy.

This prospective study investigated the salivary proteome before and after periodontal therapy. Ten systemically healthy, non-smoking, stage III, grade C periodontitis patients underwent non-surgical periodontal treatment. Full-mouth periodontal parameters were measured, and saliva (n = 30) collected pre- (T0), and one (T1) and six (T6) months post-treatment. The proteome was investigated by label-free quantitative proteomics. Protein expression changes were modelled over time, with significant protein regulation considered at false discovery rate <0.05. Treatment significantly reduced bleeding scores, percentages of sites with pocket depth ≥5 mm, plaque and gingival indexes. One thousand seven hundred and thirteen proteins were identified and 838 proteins (human = 757, bacterial = 81) quantified (≥2 peptides). At T1, 80 (T1 vs. T0: 60↑:20↓), and at T6, 118 human proteins (T6 vs. T0: 67↑:51↓) were regulated. The salivary proteome at T6 versus T1 remained stable. Highest protein activity post- versus pre-treatment was observed for cellular movement and inflammatory response. The small proline-rich protein 3 (T1 vs. T0: 5.4-fold↑) and lymphocyte-specific protein 1 (T6 vs. T0: 4.6-fold↓) were the top regulated human proteins. Proteins from Neisseria mucosa and Treponema socranskii (T1 vs. T0: 8.0-fold↓, 4.9-fold↓) were down-regulated. Periodontal treatment reduced clinical disease parameters and these changes were reflected in the salivary proteome. This underscores the potential of utilizing saliva biomarkers as prognostic tools for monitoring treatment outcomes.