Outcomes Of Non-surgical Periodontal Therapy Research Articles

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.

Ability of gingival crevicular fluid volume, E-cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients.

To determine the potential of gingival crevicular fluid (GCF) volume, E-cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients. NSPT is the gold-standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis-associated tissue destruction is evidenced by the increased level of soluble E-cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of NSPT. Patients with periodontitis (n = 24) were included in this clinical trial and full-mouth periodontal charting was recorded for each patient. GCF samples from periodontal pockets with probing pocket depth (PPD) 4-6 mm from the interproximal surfaces of anterior and premolar teeth were obtained. These sites subsequently received NSPT and were clinically re-evaluated after 1 and 3 months. Levels of GCF E-cadherin and TAC levels were assayed using ELISA. All clinical periodontal parameters were significantly improved 3 months after completion of NSPT. These outcomes were associated with a significant decrease in E-cadherin levels and GCF volume, while TAC levels were significantly increased in samples obtained in follow-up appointments. Binary regression model analysis showed that PPD, GCF volume, E-cadherin, and TAC levels could significantly (p < .05) predict the outcomes of NSPT. The cut-off points for PPD, GCF volume, E-cadherin and TAC were 5 mm, 4 × 10-3, 1267.97 pg/mL and 0.09 μmol/g, respectively. NSPT improved clinical parameters along with increased antioxidants capacity and epithelial pocket lining integrity. Discrimination of favorable/unfavorable responsiveness of periodontally diseased sites to NSPT could be possible by using GCF volume, PPD, E-cadherin and TAC level assessments.

CLINICAL APPLICATIONS OF INJECTABLE PLATELET RICH FIBRIN (IPRF) IN ADJUVANT THERAPY FOR PERIODONTITIS: A CASE SERIES

The purpose of this study is to evaluate the clinical outcomes of non-surgical periodontal therapy using injectable Platelet Rich Fibrin (iPRF). Materials and Methods: In the present study, analyzed the results of treatment in 82(43 men and 39 women, aged 36 to 63 years) patients in the period from 2018 to 2023 years with periodontitis stages I–II were included. The following clinical parameters were recorded at the beginning of the study (before and treatment), after 1 month (after iPRF therapy), at the end of the 3-month (after iPRF therapy). The diagnosis of periodontitis was established taking radiological signs of bone loss and indicators of bleeding on probing (BOP), probing depth (PD), Clinical attachment level (CAL). All patients subjected to the complex periodontal treatment included supragingival and subgingival scaling and root debridement with an ultrasonic device, antibacterial therapy. After 4 weeks, only those patients underwent I-PRF therapy who maintained optimal oral hygiene. I PRF was injected into the gum area. The number of plasma-based sessions is strictly individual and depends on the severity of the inflammatory process (4-6 sessions break between sessions 1 week). Results: The postoperative periods in all patients passed without complications, there were no serious intraoperative or immediate postoperative complications. After a course of I-PRF therapy, patients noted elimination of pain, bleeding and swelling of the gums, tooth mobility became less bad breath disappeared, loss of bone tissue stopped. The first changes in the gums are noticeable on the 7th-10th day. The clinical picture and diagnostic parameters were comparable at baseline and after treatment. The clinical periodontal parameters (BOP, PPD, CAL) were shown a reduction in their mean values after 3 months from the treatment with the PRP, with a highly significant difference no complications had been observed. The mean value BOP before treatment was 2.6 ± 0.32, after 1month treatment the mean BOP 1.8 ± 0.2, after 3 months treatment the mean BOP 1.4 ± 0.15. The mean value PPD before treatment was 5.41 ± 0.77 mm, 1 month after therapy it was 4,27 ±0.38 mm and 3 month after therapy it was 2.46 ± 0.42 mm. The mean value CAL before treatment was 5.84 ± 0.79 mm, 1 month after therapy it was was 4.92 ± 0.71 mm. and 3 months after therapy it was 3,4 ± 0,7 mm. Conclusion: This study confirmed that iPRF periodontal therapy can be successfully used in patients diagnosed with I-II periodontitis who have received individualization supportive periodontal therapy and regular periodontal maintenance. The use of iPRF in periodontal therapy represents a valuable minimally invasive adjunct to complex conservative therapy.

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

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

GCF Levels of Osteoclastogenesis-Related Cytokines in Periodontitis in Relation to Smoking During Non-Surgical Periodontal Therapy

Objective: Interleukins (IL) -1β, -34, receptor activator of nuclear factor-kB ligand (RANKL), and osteoprotegerin (OPG) play a crucial role in osteoclastogenesis and bone resorption through modulating inflammatory processes and osteoclastogenesis. Smoking is the major risk factor in the initiation and progression of the periodontitis, and adversely affects the outcomes of non-surgical periodontal therapy. To date, there is no study investigating both gingival crevicular fluid (GCF) IL-1β, IL-34, RANKL, and OPG levels before and after non-surgical periodontal therapy in smoking and non-smoking patients with periodontitis stage 3, grade B and C. The aim of current research was to examine the GCF levels of some osteoclastogenesis-related cytokines in periodontitis in relation to smoking before and after periodontal therapy. Methods: At baseline, full-mouth periodontal status together with GCF samples were collected from 116 individuals, including 60 periodontitis patients (30 smokers and 30 nonsmokers) and 56 periodontally healthy controls (28 smokers and 28 nonsmokers). Non-surgical periodontal therapy, consisting of instruction for daily plaque control and scaling and root planing (SRP), was performed. GCF sampling and full-mouth periodontal measurements were repeated 6 weeks after completion of SRP. The GCF levels of biomarkers were measured by enzyme-linked immunosorbent assay. Results: The periodontitis groups exhibited significant improvement in clinical parameters. At baseline, the GCF IL-1β levels in periodontitis groups were significantly higher than periodontally healthy controls (p&amp;lt;0.05) and it was significantly decreased in periodontitis groups after non-surgical periodontal therapy. At baseline, the GCF IL-34 levels in periodontitis groups were significantly higher than periodontal healthy controls(p&amp;lt;0.05) and the GCF IL-34 level was significantly decreased in non-smoking periodontitis patients. At baseline and after periodontal therapy, the GCF RANKL levels were similar in all groups. The GCF OPG level was significantly lowest in non-smoking periodontitis patients at baseline and the GCF OPG level was significantly increased in smoking and non-smoking periodontitis patients after non-surgical periodontal therapy. Conclusion: In the periodontal inflammation process, GCF IL-34 level followed a similar pathway to GCF IL-1β, suggesting that IL-34 may be a marker in the pathogenesis of periodontal disease. The significant decrease in GCF IL-34 and a significant increase in GCF OPG level in the non-smoker periodontitis group after periodontal therapy suggest the negative effect of smoking on the response to periodontal therapy. More comprehensive studies are needed by increasing the number of samples included in the study groups in order to better understand the pathogenesis of periodontitis.

Effects of Some Types of Smoking on the Outcome of Non-Surgical Periodontal Therapy of Periodontitis Patients.

Effects of Some Types of Smoking on the Outcome of Non-Surgical Periodontal Therapy of Periodontitis Patients.

Estimation of Salivary Neopterin Levels in Aggressive and Chronic Periodontitis After Nonsurgical Periodontal Therapy: A Cohort Study

Aim: Neopterin is a marker associated with cell-mediated immunity produced by interferon-Ɣ-stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies, and allograft rejections. Recently, it was shown to be associated with the initiation and progression of periodontal disease. This investigation was designed to explore the use of salivary neopterin in predicting the outcome of nonsurgical periodontal therapy (NSPT) in aggressive and chronic periodontitis patients. Materials and Methods: This case-control study with stratified sampling comprised 45 subjects divided into three groups: a control group of 15 periodontally healthy participants, a test Group A of 15 participants with chronic periodontitis, and a test Group B of 15 participants with aggressive periodontitis. Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL), were recorded at baseline and three months after scaling and root planing (SRP). An enzyme-linked immunosorbent assay (ELISA) analysis was performed to measure neopterin levels in saliva in study groups before and after SRP. Kruskal–Wallis analysis of variance and Mann–Whitney U tests were done for intra- and intergroup comparisons. The correlation between salivary neopterin levels with clinical parameters was done by Karl Pearson’s correlation coefficient. Results: Baseline salivary neopterin levels were least in the control group (5 62 nmol/L), higher in test Group A (9.30 nmol/L), and highest in test Group B (9.76 nmol/L). Three months after SRP, there was a significant reduction in all the clinical parameters, and the reduction in mean salivary neopterin levels were 2.79 and 2.57 in test Group A and test Group B, respectively; the difference was not statistically significant. Conclusion: Salivary neopterin levels have the potential to be utilized as a diagnostic tool for detecting the presence, activity of the disease, and the course of the lesions. It cannot, however, be utilized to distinguish between chronic and aggressive periodontitis.

The Effect of Adiposity on the Outcome of Non-Surgical Periodontal Therapy

Background: Non-surgical periodontal therapy constitutes the first step in controlling periodontal infections, and its outcome is affected by the presence of other systemic diseases and conditions. Obesity is a modifiable risk factor for periodontitis and its effect on the outcome of non-surgical periodontal therapy has not been clearly determined. Aim: To determine the impact of central adiposity on the outcome of non-surgical periodontal treatment in patients with periodontitis. Methodology: This prospective interventional study included 39 obese patients with periodontitis (Group A) and 39 normal?weight patients with periodontitis (Group B). The waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR), Simplified oral hygiene index (OHIS), bleeding on probing (BOP), probing pocket depth (PPD), number of sites with PPD ≥ 4 mm, and clinical attachment loss (CAL) were measured at baseline and 3 months after non-surgical periodontal treatment. Chi-square test was used to compare categorical variables between the groups. Independent samples t-tests and paired t-test were used to analyse the numerical intergroup and intragroup data, respectively. Pearson’s correlation coefficients and multiple regression analyses were used to assess the strength and impact of central adiposity on periodontal treatment outcomes. Data were analysed using the IBM Statistical Package for Social Sciences version 20.0 and statistical significance was set at P &lt; 0.05. Results: At baseline, the mean PPD and CAL were comparable in both Groups A and B; while the mean percentage of sites with gingival BOP and percentage of sites with periodontitis were significantly higher in Group A. All periodontal parameters significantly improved after treatment in Groups A and B. However, participants in Group B had a better improvement in sites with gingival BOP and percentage of sites with periodontitis after treatment compared to Group A. Multiple regression analysis showed that central adiposity had a significant (P &lt; 0.05) negative impact on the treatment outcome of gingival BOP, PPD and percentage of sites with periodontitis (PPD ≥ 4 mm) after adjusting for age, sex and socio-economic status. Conclusions: The findings indicated that central adiposity has a negative impact on gingival bleeding on probing, probing pocket depth and percentage of sites with periodontitis.

Adjunctive Er:YAG laser in non-surgical periodontal therapy of patients with inadequately controlled type 2 diabetes mellitus: A split-mouth randomized controlled study.

Limited studies are available comparing the outcomes of non-surgical periodontal therapy (NSPT) with or without adjunctive Er:YAG laser (ERL) in patients with type 2 diabetes mellitus (T2DM). This study evaluated the effects of ERL adjunctive NSPT on single-rooted teeth of inadequately controlled T2DM patients with periodontitis. Twenty-two inadequately controlled T2DM participants with periodontitis were recruited. Adopting a double-blinded split-mouth design and under block randomization, we investigated the effects of ERL in calculus removal then degranulation mode, or a sham treatment, adjunct NSPT, which included two visits of full-mouth root surface debridement delivered within 4-10days, to test or control single-rooted teeth (Wuxi Stomatology Hospital, trial 2017-016). We followed periodontal parameters (plaque %, bleeding on probing [BOP] %, probing pocket depth [PPD], probing attachment level [PAL]) and selected systemic parameters (fasting plasma glucose [FPG], glycosylated hemoglobin [HbA1c%], high sensitivity C-reactive protein) at baseline, one, three, and six months after periodontal treatment. The study was completed as planned. Periodontal parameters, FPG and HbA1c% of the 22 participants appeared significantly improved at six months (p < 0.001). The 44 ERL treated, compared to 44sham treated single-rooted teeth exhibited significant improvement in BOP, mean PPD, and mean PAL at various postoperative follow-up time points (effect size ≥0.44; p < 0.001). No adverse event was reported. Periodontal treatment outcomes in the T2DM patients with inadequate glycemic control were better in the single-rooted teeth received ERL adjunct NSPT. Further studies are warranted to confirm the observations reported in this short-term clinical study.

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.

Outcomes Of Nonsurgical Periodontal Therapy By Undergraduate Dental Students At King Saud University, A Longitudinal Study

This study aimed to assess the outcomes of nonsurgical therapy of chronic periodontitis patients performed by undergraduate dental students at King Saud University. Subjects who were &gt;18 years old and had severe or moderate chronic periodontitis were eligible for the study. 33 patients constituted the study sample and received nonsurgical periodontal therapy by undergraduate students who were supervised by experienced periodontists. At reevaluation and maintenance visits, the mean values of p

The impact of smoking on non-surgical periodontal therapy: A systematic review and meta-analysis.

Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non-surgical periodontal therapy. Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non-smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non-surgical periodontal therapy. Meta-regressions were conducted to evaluate correlations between outcomes and other contributing factors. Seventeen studies were included. The post-treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: -0.33mm, 95% confidence interval (CI): [-0.49, -0.17], p<.01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: -0.20mm, CI: [-0.39, -0.02], p<.01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups. Smoking negatively impacts clinical responses to non-surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non-smokers.

Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No Aggregatibacter actinomycetemcomitans Is Detected-A Randomized Clinical Trial.

Background: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when Aggregatibacter actinomycetemcomitans was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no A. actinomycetemcomitans in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; n = 29) or amoxicillin/metronidazole (AMX/MET; n = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. Results: PD, CAL and BOP improved at 3 and 6 months (each p < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (p < 0.001) with a higher reduction of PD in the AMX/MET group (p < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (p < 0.05). MMP-8 and IL-1β were without significant changes and differences between the groups. Conclusion: When A. actinomycetemcomitans was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled.

The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies.

Considering the role of the inflammatory host response in the pathogenesis of periodontitis, different host modulators have been proposed to enhance the outcomes of non-surgical periodontal therapy (NSPT), but their efficacy has not been fully clarified. This systematic review investigated the efficacy of host modulators combined with NSPT in reducing probing pocket depth (PPD) in periodontitis patients. Placebo-controlled RCTs with ≥6months follow-up were searched. Meta-analysis was conducted when ≥5 studies using the same host modulator were identified. Fifty eight studies met the inclusion criteria. After 6months, local administration of 1.2% statin gels as adjuncts to NSPT significantly improved PPD reduction (1.83mm) in infrabony defects and systemic administration of sub-antimicrobial dose doxycycline (SDD) in addition to NSPT improved PPD reduction of deep pockets. Administration of probiotics conferred limited clinical benefits. Local bisphosphonate and metformin gels showed potential for clinical use in infrabony defects, which needs to be confirmed. Local delivery of statins in infrabony defects and systemic SDD for deep pockets may confer additional clinical benefits to NSPT. Their long-term effectiveness and safetyneed to be confirmed in independent multi-centred studies. Further studies are needed to confirm the benefit of otherhost modulators.

Influence of CYP1A1 rs1048943 on Short- and Long-term Outcomes of Non-surgical Periodontal Therapy for Generalised Aggressive Periodontitis.

<p>Objective: To investigate the influence of CYP1A1 rs1048943 on short- and long-term outcomes of nonsurgical periodontal therapy (NSPT) for generalised aggressive periodon- titis (GAgP).<br /> Methods: The CYP1A1 rs1048943 polymorphisms of 224 GAgP patients were genotyped by time-of-flight mass spectrometry. A total of 125 patients received NSPT and subsequent followup for 3 months. Of the 125 patients, 81 were followed for at least 3 years. Clinical periodontal parameters were collected at baseline and at the follow-up visits. Negative binomial regression was used to analyse the association between the number of teeth lost during the 3-year observation period and CYP1A1 rs1048943 genotypes.<br /> Results: The mean probing depth (PD) and percentage of sites with Bleeding Index (BI) ≥ 3 were all significantly greater in CYP1A1 rs1048943 G allele carriers than non-carriers at 3 months and 3 years after treatment (P &lt; 0.05). In the PD ≥ 7 mm subgroup, the mean PD was significantly higher in G allele carriers than non-carriers at the 3-year follow-up (P &lt; 0.05). The other clinical parameters did not show a similar trend (P &gt; 0.05). Furthermore, the changes of percentage of sites with BI ≥ 3 were significantly smaller in G allele carriers than non-carriers at 3 months and 3 years after treatment (P &lt; 0.05). GAgP patients with the GG genotype had lost more over the 3-year follow-up period compared with patients with the AA genotype (P &lt; 0.05).<br /> Conclusion: These data indicated that the CYP1A1 rs1048943 AG/GG genotypes may influence the short- and long-term outcomes of NSPT in GAgP patients.</p>.

The outcomes of nonsurgical periodontal therapy: A retrospective study

Aim: In this study, patients with chronic periodontitis (CP) were evaluated to determine the clinical outcomes following nonsurgical periodontal therapy. Materials and Methods: A retrospective assessment of clinical outcomes following nonsurgical periodontal therapy was provided by International Islamic University Malaysia (IIUM) dental undergraduates. This secondary data analysis of 110 patients with chronic periodontitis were reviewed and clinical data abstracted. Data were analyzed to observe the treatment outcomes of all patients and then were grouped into “responders” or “nonresponders” to assess the correlation between clinical prognostic indicators and the treatment outcome. Results: Significant improvements with all clinical parameters such as plaque score, bleeding on probing (BOP), periodontal probing depth (PPD) >4 mm and >6 mm, and clinical attachment loss were noted on all patients. Deep sites (PPD >4 mm) were significantly higher in smokers and it continued to be in large proportions during the posttreatment period. A great number of smokers and all diabetic patients fall into the nonresponder group. However, this study fails to statistically prove better outcomes in terms of all clinical parameters on the responder group as compared to the nonresponder group as all P values > 0.05. Conclusion: The CP treatments were positively associated with the benefits of nonsurgical therapy by IIUM undergraduates. It is displayed by the improvement in all clinical parameters. In addition, poorer outcomes were portrayed by smokers as reduction of BOP and PPD was not significantly achieved compared to their counterparts. However, patient-specific outcomes were not positively reported due to lack of data.

Clinical efficacy of amino bisphosphonate on periodontal disease status in postmenopausal women: Randomized double-blind placebo-controlled trial.

Objectives:Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women.Materials and Methods:Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months.Results:A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179).Conclusion:Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy.

Baseline probing depth and interproximal sites predict treatment outcomes of non-surgical periodontal therapy

Background/purposeThe efficacy of non-surgical periodontal therapy (NSPT) has been well discussed. The aim of this study was to investigate whether the baseline clinical periodontal parameters, radiographic defect angle, and interproximal site predict the treatment outcome of NSPT. Materials and methodsA total of 39 patients who were diagnosed with generalized chronic periodontitis and met the inclusion criteria were enrolled in this study. All patients received full-mouth periodontal examination by two well-trained periodontists. Clinical periodontal parameters, including probing depth (PD), recession (Rec), and clinical attachment level (CAL), were recorded, and vertical bitewing radiographs were taken as baseline data. Revaluation was performed after 4 weeks of non-surgical periodontal treatment. Pearson's correlation coefficient and multivariate logistic regression were performed to examine the association between favorable treatment outcome (PD reduction ≥ 3 mm) and various clinical parameters. ResultsA significant improvement was observed in PD reduction and CAL gain after NSPT. The radiographic defect angle was strongly correlated with baseline Rec, baseline CAL, and interproximal sites in teeth with a deeper PD. Baseline PD and interproximal sites emerged as significant prediction factors for favorable treatment outcome with a PD reduction of ≥3 mm. ConclusionOur study is the first to report that distal sites show wider radiographic angles with shallow infrabony defects and that pocket reduction is more obvious at distal sites than at mesial sites. These data provide evidence that baseline PD and interproximal sites may predict the treatment outcome of NSPT.

Influence of Adjacent Teeth Absence or Extraction on the Outcome of Non-Surgical Periodontal Therapy.

Background: Extraction of periodontally compromised or strategically non-important teeth is often an integral part of non-surgical periodontal treatment (NSPT). This study evaluated the association between the status of adjacent teeth and the outcome of NSPT on molars. Methods: Charting data of patients with generalized chronic periodontitis receiving NSPT in 2012–2014 were included. The association between initial clinical parameters and significant clinical improvement, including the reductions of probing pocket depth (PPD) and clinical attachment loss (CAL), in molar teeth with severe periodontitis after NSPT was assessed by a generalized linear model and logistic regression. Results: ≥7 mm PPD and <2 mm gingival recession (REC) at the tooth level, and ≥7 mm PPD, ≥7 mm CAL and <2 mm REC at the site level, were associated with significant clinical improvement. Absence or extraction of an adjacent tooth achieved an additional 0.22–0.23 mm and 0.60–0.83 mm clinical improvement. Among the interproximal sites, ≥7 mm PPD, <2 mm REC, ≥7 mm CAL, <Degree II furcation involvement, and absence of an adjacent tooth were associated with significant clinical improvement. Conclusion: Absence or extraction of teeth during NSPT significantly improves the PPD and CAL of the adjacent periodontal sites of molars.

Stress reduction intervention and the initial periodontal therapy outcome in chronic periodontitis patients. a randomized controlled pilot study

Background: Psychosocial stress, have been implicated as risk indicators for periodontal disease. Minimal evidence in literature exists to assess the effect of stress reduction therapy (SRT) in the outcome of non-surgical periodontal therapy (NSPT).Objective: Hence, we aimed to explore the possibility of employing SRT in stressed patients as an adjunctive intervention in the management NSPT.Materials and Methods: Sixty male patients divided into Group 1 comprised of 20 unstressed chronic periodontitis patients receiving non-surgical periodontal therapy alone, Group 2a (20 stressed chronic periodontitis patients) received intervention focused on SPT with NSPT and Group 2b (20 stressed chronic periodontitis patients) received only NSPT without SPT. Their stress level was evaluated using a standard questionnaire method and salivary cortisol levels, at baseline and 3 months along with periodontal parameters.Results: There was significant reduction in stress parameters for Group 2a patients. The reduction of total periodontitis affected sites was highest in Group I patients (55.4%), followed by Group 2a patients (53.2%) and Group 2b patients (38%).Conclusion: SRT may result in comparable treatment outcome to unstressed chronic periodontitis patients. This study opens new avenues to investigate the effects of stress management as an adjunctive to conventional NSPT, which should be explored further.Â