Probing Pocket Research Articles

To Evaluate the Clinical Efficacy of 940 nm Diode Laser and Propolis Gel (A Natural Product) in Adjunct to Scaling and Root Planing in Treatment of Chronic Periodontitis.

Recently, various adjunctive treatment options along with Scaling and root planing (SRP) such as local drug delivery, medications, and lasers have been introduced for the treatment Chronic periodontitis (CP) but literature is limited. To evaluate the clinical efficacy of 940 nm diode laser and propolis gel in adjunct to Scaling and root planing (SRP) in the treatment of CP. Randomized clinical trial was conducted among 30 CP patients with a probing depth of ≥5 mm was allocated randomly into Group 1 (SRP), Group 2 (SRP + diode laser), and Group 3 (SRP + propolis gel). Plaque index, gingival index, pocket probing depth, and clinical attachment level were assessed at baseline, one and three months. Data analysis was performed using SPSS version 17 for windows, and statistical techniques employed were repeated measures by using One-way ANOVA, Tukey's HSD, independent t-test, and paired t-test. Post-treatment sites among all the three groups showed statistically significant reduction in Periodontal index (PI), Probing pocket depth (PPD), and Clinical attachment level (CAL), whereas gingival inflammation was significantly reduced in groups 2 and 3 from baseline to one and three months. On comparison, at baseline, all clinical parameters were statistically insignificant. At one month, the mean difference of PI, Gingival index (GI) was statistically significant between group 1 and 2 whereas the mean difference of CAL and PPD were statistically significant from group 1 to groups 2 and 3. Lasers with SRP were greatly effective in reducing gingival inflammation, PPD, and CAL. Propolis gel also offered encouraging and promising clinical results but still needs further long-term studies to establish its precise role in the treatment of CP.

Periodontal status following orthodontic mini-screw insertion: A prospective clinical split-mouth study.

Anchorage control is one of the most important determinants of orthodontic treatments. Mini-screws are used to achieve the desired anchorage. Despite all their advantages, there is a possibility that treatment will not be successful due to conditions related to their interaction with the periodontal tissue. To evaluate the status of the periodontal tissue at the sites adjacent to the orthodontic mini-implants. A total of 34 teeth (17 case and 17 control) in 17 orthodontic patients requiring a mini-screw in the buccal area to proceed with their treatment were included in the study. Oral health instruction was provided to the patients prior to the intervention. In addition, scaling and root planing of the root surface were done using manual instruments and ultrasonic instruments if needed. For tooth anchorage, a mini-screw with Elastic Chain or Coil Spring was used. The following periodontal indices were examined in the mini-screw receiving tooth and the contralateral tooth: plaque index, pocket probing depth, attached gingiva level (AG), and gingival index. Measurements were made before the placement of the mini-screws and 1, 2, and 3 months following that. The results revealed a significant difference only in the amount of AG between the tooth with mini-screw and the control tooth (p = 0.028); for other periodontal indices, there were no significant differences between the two groups. This study showed that periodontal indices in adjacent teeth of the mini-screws do not change significantly compared to other teeth and mini-screws can be used as a suitable anchorage without posing a threat to the periodontal health. Using mini-screws is a safe intervention for orthodontic treatments.

Association between preterm birth and low birth weight and maternal chronic periodontitis: A hospital-based case-control study.

Periodontal diseases (PDs) are one of the most common chronic diseases affecting overall oral functions, and their association with adverse pregnancy outcomes (APOs) has been an area of interest since the late 90s. The present hospital-based case-control study aimed to find any association between maternal chronic periodontitis (CP) and preterm birth (PTB) and low birth weight (LBW) by comparing the periodontal parameters in patients with normal birth, PTB and LBW. The participants of the study were females that had delivered a live baby (n = 1,200). They were classified as either cases or controls. The cases were defined as PTB if the delivery was before 37 weeks of gestation, and as LBW if the infant weighed <2,500 g. The others were controls. The intraoral examination, which included recording the periodontal status, was conducted within 3 days of delivery. Detailed medical history and demographic data were recorded for the determination of the confounding factors. The multivariable dependence of PTB and LBW on both the categorical and continuous data was analyzed using a multivariate logistic regression analysis. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) for the risk of PTB and LBW were calculated. A strong association with PTB was found for a high plaque index (PI) score (AOR = 1.61; p < 0.001; 95% CI: 1.26-2.07) and a mean pocket probing depth (PPD) ≥4 mm (AOR: 4.32; p < 0.001; 95% CI: 3.09-6.02). A strong association with LBW was found for a high PI score (AOR = 2.02; p < 0.001; 95% CI: 1.43-2.83) and a mean PPD ≥4 mm (AOR: 8.70; p < 0.001; 95% CI: 6.01-12.59). A high PI score and a mean PPD ≥4 mm were independent risk factors for PTB and LBW. The presence of deep pockets and inadequate plaque control in pregnant females increased the risk of APOs.

Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment – a randomized clinical trial

PurposeThis study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined with scaling and root planing (SRP) in untreated periodontitis stage III and IV.MethodsForty patients were randomly assigned to the test group receiving SRP plus omega-3 PUFAs (n = 20) or control group receiving SRP alone (n = 20). Clinical changes of pocket probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP) and rates of closed pockets (PPD ≤ 4 mm without BOP) were evaluated at baseline and after 3 and 6 months. Phorphyromonas gingivalis, Tanarella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans counts were analysed at baseline and at 6 months. Serum was subjected to lipid gas chromatography/mass spectrometry analysis at baseline and at 6 months.ResultsSignificant improvement of all clinical parameters at 3 and 6 months was observed in both groups. For the primary outcome “change of mean PD,” no significant difference was detected between the groups. Patients treated with omega-3 PUFAs demonstrated significantly lower rates of BOP, higher gain of CAL and higher number of closed pockets at 3 months in comparison to the control group. After 6 months, no clinical differences between the groups were found, with the exception of lower BOP rates. Moreover, in the test group, the number of key periodontal bacteria was significantly lower than in the control group at 6 months. Increased proportions of serum n-3 PUFAs and decreased proportions of n-6 PUFAs were detected at 6 months in the patients from the test group.ConclusionHigh-dose omega-3 PUFA intake during non-surgical treatment of periodontitis results in short-term clinical and microbiological benefits.The study protocol was approved by the ethical committee of Medical University of Lodz (reference number RNN/251/17/KE) and registered at clinicaltrials.gov (NCT04477395) on 20/07/2020.

The effect of bromelain in periodontal surgery: a double-blind randomized placebo-controlled trial

BackgroundPeriodontitis is a persistent inflammatory condition. Eliminating the infection and reducing its risk factors are the first steps in treating periodontitis. When the anti-infective therapy is complete, there may still be deep periodontal pockets and prolonged inflammation. Surgical pocket reduction or elimination is indicated under these circumstances. We aimed to evaluate the effect of bromelain on bleeding on probing (BOP), gingival index (GI), and plaque index (PI) after pocket elimination surgery.MethodsThis double-blind randomized placebo-controlled trial included 28 candidates for pocket elimination surgery referred to the private office of a periodontist in Bandar Abbas, Iran, from April 18 to August 18, 2021. Patients’ general characteristics, such as age and sex, were recorded. Additionally, periodontal indices including BOP, PI, GI, and pocket probing depth (PPD) were evaluated in all subjects. All patients underwent pocket elimination surgery. Afterwards, they were randomized into two groups. The first group received 500 mg Anaheal (bromelain) capsules twice a day before meal for one week. The second group received placebo, prepared in similar shape and color by the same pharmaceutical company. BOP, PI, GI, and PPD were assessed four weeks after completion of the treatment course (five weeks after surgery).ResultsFour weeks after intervention, BOP was significantly lower with Anaheal compared to placebo (0% vs. 35.7%, P = 0.014). However, there was no significant difference in GI between groups (P = 0.120). Mean PI was lower (17.71 ± 2.12 vs. 18.28 ± 2.49) and mean PPD higher (3.10 ± 0.71 vs. 2.64 ± 0.45) in the Anaheal group, but the differences did not reach statistically significant levels (P = 0.520 and P = 0.051, respectively).ConclusionsOne-week treatment with Anaheal at a dose of 1 g/d after pocket elimination surgery resulted in significantly lower BOP compared to placebo.Trial registrationIranian Registry of Clinical Trials (IRCT), IRCT20201106049289N1. Registered 06/04/2021. Registered prospectively, https://www.irct.ir/trial/52181.

Antibiotics in the non-surgical treatment of peri-implantitis.

Four electronic databases (MEDLINE via Pubmed; EMBASE via Ovid; EBSCO Dentistry and Oral Science Source), in addition to six related journals (Clinical Implant Dentistry and Related Research; Clinical Oral Implants Research; International Journal of Oral and Maxillofacial Implants; International Journal of Oral Implantology; Journal of Clinical Periodontology; Journal of Periodontology), were searched for publications until 2022. Randomised controlled trials (RCTs), evaluating the effectiveness of local or systemic antibiotics as an adjunct in the non-surgical treatment (NST) for peri-implantitis (PI), were assessed. The eligibility criteria included RCTs with a parallel group, split-mouth design and appropriate NST interventions over a three to twelve month period. Data were extracted from RCTs to capture a multitude of primary outcomes, including: implant success rate, radiographic marginal bone loss rate, periodontal health changes and PI resolution. Risk of bias assessments were made using the Cochrane Collaboration's tool, by two authors independently and in duplicate. RCTs with similar observation periods and interventions were included in the meta-analyses. Random-effects meta-analyses of mean differences or relative risks with 95% confidence intervals were calculated, in additional to data heterogeneity calibration through I2 statistics. Following the screening of 270 papers, six RCTs were included, which resulted in the evaluation of 391 patients (375 implants). Adjunctive local antibiotic therapy at disease sites showed statistically significant periodontal outcomes; improvements in success rate (risk ratio = 9.89; 95% CI 2.39-40.84), probing pocket depth (mean difference (MD) = 0.6 mm; 95% CI 0.42-0.78) and bleeding on probing (MD = 0.15%; 95% CI 0.10-0.19). Conversely, adjunctive systemic antibiotics improved probing pocket depths (MD = 1.15 mm; 95% CI 0.31-1.99) and probing attachment levels only (MD = 1.10 mm; 95% CI 0.13-2.08). Across the six included RCTs, the bone loss rate and PI resolution rate determined no significant differences between the groups; mirrored in the single studies and in the meta-analysis. Disease resolution ranged from 2 to 65%. Two of the studies were found to be at low risk of bias and four presented with some concerns. Adjunctive antibiotics aid NST. However, the heterogeneity of study methods and low quality of current RCTs evidenced, deem their role in NSTs of PI as inconclusive.

Periodontal Diseases and Salivary Secretion of ABH Blood Antigens in Yemeni Patients

This study explored the secretion trait as a risk factor for periodontal disease progression. 162 patients suffering from periodontal disease attended the Outpatient Dental Clinics at the Faculty of Dentistry, Ibb University, and 69 healthy volunteers were enrolled in this study. Clinical evaluation for periodontal disease was carried out according to international guidelines and expressed by pocket probing depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL) parameters. A blood sample was collected and tested for blood grouping test, and a saliva sample was analyzed for secretion using hemagglutination inhibition test. Secretor patients were 82% compared with 64% of healthy control. Mean score of BOB and PPD and the clinical magnitude of CAL parameters were increased within secretors. The development of periodontal diseases increased among secretors by 2.61 times more than non-secretors (OR = 2.61, CI, 1.382–4.914, p = 0.004). Significant periodontal complaints associated with secretion are Bleeding gums (OR = 1.95, CI, 1.011–3.759, p = 0.049), malaligned teeth (OR = 4.49 (CI, 1.842–10.958), p = 0.0001), gingival recession (OR = 2.48, CI, 1.322–4.648, p = 0.007), and teeth decay (OR = 1.86, CI, 1.006–3.438, p = 0.05). Secretion of ABH antigens is risk factor for progression of periodontal diseases. The odds of periodontal complaints, bleeding gums, malaligned teeth, gingival recession, and tooth decay prove the ABH secretion effect.

Comparative evaluation of effectiveness of calibrated inter-dental brushes in maintaining oral hygiene and periodontal health: a randomized controlled clinical trial

Background: Effective oral hygiene is a crucial factor in maintaining good oral health, which is associated with overall health and health-related quality of life. The control of biofilm is the common pillar of the prevention and control of periodontal disease. The interdental brush (IDB) currently represents the primary and most effective method available for interproximal cleaning compared with brushing alone or the combined use of tooth brushing and dental floss. Methods: A total of 40 participants, with 10 each in control and test group, participated in the study. Clinical examination of gingival index, full mouth bleeding scores and plaque index were recorded supra gingival scaling was performed. Test group- interdental brushes were given and oral hygiene instructions were given through Touch-to Teach method (TOP). At 4 week and 6 week follow up oral hygiene instructions were repeated to respective groups. After 3 months, clinical examination was done and exit survey on patient-reported outcome measures was administered. Results: Intergroup comparison of gingival index, plaque index and pocket probing depth showed statistically significant difference between test and control group. Conclusions: Within the limitations of the study, we concluded that the appropriate use of interdental brushes along with effective oral hygiene maintenance using TOP permitted proper cleaning of the area with a significant reduction in plaque and gingivitis.

Influence of implant diameter on implant survival rate and clinical outcomes in the posterior area: a systematic review and meta-analysis

ObjectiveThe aim of the present systematic review was to test the hypothesis that the diameter of implants inserted in the posterior area affects implant survival rate, prosthetic survival rate and peri-implant parameters (bleeding on probing (BoP), marginal bone loss (MBL), pocket probing depth (PPD)).Materials and methodsAn electronic search of studies published until December 2021 was done on three databases (Pubmed, Scopus, Cochrane) independently by two authors. Clinical trials comparing implant survival rate, BoP, MBL and PPD among narrow diameter implants (NDI: ≥ 3.0 mm to < 3.75 mm) and regular diameter implants (RDI ≥ 3.75 mm to < 5 mm) were included. Data were independently extracted by two reviewers. Risk of bias was evaluated according to the Cochrane risk-of-bias tool for randomized studies and to the Joanna Briggs Institute Critical Appraisal tools for non-randomized ones. A pair-wise meta-analysis was conducted on the included studies.ResultsSeven articles were included out of the 4291 identified from the digital research. Overall, a total of 939 implants were inserted (319 NDI, 620 RDI). Only one study was judged at serious risk of bias. No statistically significant difference was found in implant survival rate (risk ratio 1.01 (95% CI [0.98 to 1.04], P = 0.67)) while the difference was significant for BoP (mean difference 2.89 (95% CI [0.30 to 5.48] mm, P = 0.03)) with higher values for NDI. Higher MBL was identified among regular diameter implants (mean difference -0.15 mm (95% CI [-0.32 to 0.01 mm], P = 0.07). No statistically significant differences were identified for prosthetic survival and PPD.ConclusionsNo differences were found in implant survival rate between narrow and regular implants. A higher BoP was identified among narrow implants, but there was no higher bone loss. It is not possible to draw definitive conclusions about the use of narrow-diameter implants in the posterior region.

Comparative evaluation of pocket depth measurement by using two different periodontal probes

To assess and compare the accuracy of the second-generation TPS probe with the first-generation manual (Williams) probe for assessing pocket probing depth (PD).In this comparative investigation, 90 subjects were used. We categorized the teeth and groups of teeth. Patients were split into three groups—periodontally healthy, gingivitis-free, and periodontitis—based on pocket depth and gingival index. Two probes were used on Ramfjord teeth to measure the depth of the pockets. Ramfjord teeth group wise, the manual probe's measured pocket depth was more than that of the TPS probeIn all groups, mean PD readings were deeper with the manual probe than with the TPS probe, with the periodontitis group showing the greatest difference, followed by gingivitis and the periodontally healthy groups.

Application of periodontal tissue regeneration combined with orthodontics in oral prosthodontics and its influence and significance on the expressions of IL-1β, TNF-α and IL-5 in periodontal tissue

ABSTRACT The aim is to investigate the application of periodontal tissue regeneration combined with orthodontics in oral restoration, and explore its effect and significance on the expressions of Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) in periodontal tissue. The patients in observation group were treated with orthodontics combined with periodontal tissue regeneration, and the control group was treated with periodontal tissue regeneration. The total effective rate, adverse reactions, recurrence rate and treatment satisfaction were compared. The masticatory function, language function, aesthetic level, VAS score, quality of life, gingival index (GI), plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), IL-1β, TNF-α and IL-5 levels were compared. The recurrence rate of observation group was lower than control group, while the treatment satisfaction was higher after treatment. After treatment, the scores of masticatory, language, aesthetics, physiological, social, emotional, cognitive, and emotional functions and overall health score were higher than before treatment. After treatment, the scores of masticatory and language functions, aesthetics and quality of life of observation group were significantly higher than control group. After treatment, the VAS score, GI, PLI, SBI, PD, IL-1β, TNF-α and IL-5 levels were lower than before. The VAS score, GI, PLI, SBI, PD levels, IL-1β, TNF-α and IL-5 levels of observation group were lower after treatment. Orthodontics combined with periodontal tissue regeneration can help improve the periodontal condition of patients with periodontitis, reduce inflammatory response, improve the level of efficacy and overall safety, and further improve patients’ quality of life and treatment satisfaction.

Effect of Smoking on Periodontal Status and Salivary Biomarkers Procalcitonin, C Reactive Protein and Matrixmetalloproteinase-8

Objective: The study aimed to determine the salivary levels of C reactive Protein (CRP), Procalcitonin (PCT), and Matrixmetalloproteinase-8(MMP-8) in periodontitis patients and compare these levels between smokers and non-smokers.Methods: Eighty male subjects aged 25-60 years were chosen and divided into four groups, each comprising 20 individuals: group I: non-smokers without periodontitis, group II: smokers without periodontitis, group III: non-smokers with periodontitis, and group IV: smokers with periodontitis, based on their smoking habit and clinical periodontal parameters which included plaque index (PI%), bleeding index (BI%), pocket probing depth (PPD) and clinical attachment loss (CAL). To assess the salivary concentration, enzyme-linked immunosorbent assay (ELISA) was used for PCT, CRP, and MMP-8, IBM SPSS program version 22 was used for analysis, while ANOVA and Kruskal-Wallis test were used to compare the means and medians in normally distributed and non-normally distributed variables, respectively.Results: There were significant variations in the clinical variables PI, BI, PPD, and CAL between the test and control groups (P&lt;0.05). Furthermore, significant differences were detected in the levels of biomarkers PCT, CRP, and MMP-8 among the four groups. Also, a significant difference was recorded between the levels of these biomarkers and smoking (P&lt;0.05).Conclusions: The study found higher levels of salivary biomarkers in periodontitis and smoker individuals compared to non-periodontitis and non-smoker individuals.

Association of Serum Interleukin-10 Level with Glycemic Status to Predict Glycemic Alteration with Periodontitis: A Cross-Sectional, Observational Study.

Studies showed bidirectional relationship between chronic periodontitis (CPD) and diabetes. This study was conducted to estimate the levels of serum interleukin (IL)-10 in patients with CPD and type 2 diabetes mellitus (T2DM) to evaluate the association of serum IL-10 levels with glycemic status and to evaluate the influence of periodontal inflammation on glycemic control. A cross-sectional observational study. Eighty patients were divided into four groups consisting of 20 patients in each group. Group 1: healthy control, Group 2: T2DM without chronic periodontitis, Group 3: chronic periodontitis only (CPD), and Group 4: T2DM with chronic periodontitis (CPD). Plaque index, gingival index, pocket probing depth, clinical attachment loss, random blood sugar, and glycated hemoglobin (HbA1c) level were recorded for categorizing patients into aforestated groups. Serum IL-10 level was measured by ELISA kit. ANOVA statistics and post hoc Tukey's test were performed for comparing individual groups. IL-10 was detected lowest in Group 3 followed by Group 4. Highest level of IL-10 was found in the healthy group then in Group 2. IL-10 levels have an inverse relationship with HbA1c. Lowest level of IL-10 in CPD dictates periodontal inflammation itself influences in regulating serum IL-10 level and poor glycemic control. Serum IL-10 level may be one of the predictors of glycemia.

Adjunctive use of a nanocolloidal silver-based local antiseptic solution in the nonsurgical treatment of periodontitis: A split-mouth clinical study

Objectives. The aim of the present study was to evaluate the potential additional clinical benefit of a commercial nano colloidal silver-based local antiseptic used as irrigation solution after subgingival mechanical instrumentation. Material and methods. Periodontitis patients were treated following the current guidelines. Two randomly assigned hemiarches of each patient received subgingival mechanical instrumentation plus irrigations with the commercial product (experimental group); the other two hemiarches received mechanical instrumentation plus saline irrigations (control group). A clinical periodontal examination at baseline moment and after 3 months was performed. The parameters considered for analysis were oral hygiene index (IHI), bleeding on probing score (BoP), periodontal pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). 72 sites were included in the analysis, the site with the highest PD/quadrant for each patient. Data were analyzed using GraphPad Prism version 8.0.1 (GraphPad Software Inc., La Jolla, CA, USA). p&lt;0.05 was set as statistical significance level. Outcomes. Eighteen periodontitis patients were treated. All clinical parameters improved at re-evaluation, compared to baseline, both in experimental and control group. The differences were statistically significant in terms of IHI, BoP and PD reduction. At re-evaluation, there were no statistically significant differences between periodontal parameters registered in the experimental and control sites. Conclusions. The present study failed to prove an adjunctive clinical benefit of the antiseptic product in the nonsurgical treatment of periodontitis. These results support the gold standard role of subgingival mechanical instrumentation in the periodontitis’ therapeutic protocol.

CLINICO-RADIOGRAPHIC EVALUATION OF GUIDED TISSUE REGENERATION USING COLLAGEN MEMBRANE AND BIPHASIC CALCIUM PHOSPHATE IN TREATMENT OF INTRABONY PERIODONTAL DEFECTS

Background: The ideal result of successful periodontal therapy is periodontal regeneration. Guided tissue regeneration is considered currently as gold standard for periodontal regeneration. Poor mechanical properties, biomaterials instability and lack of biocompatibility of regenerative membrane alone led to direct use of bioactive materials in defect area. So, this study was intended towards evaluation of effectiveness of resorbable membrane with bioactive molecule containing biphasic calcium phosphate determined by amount of bone fill both clinically and radiographically. Methods: A total of 20 intrabony defects from sixteen patients were selected. The study designed was Quasi experiment, a quantitative non randomized experimental trial. The clinical parameters like Plaque index, Gingival index, Pocket probing depth, Amount of Gingival recession and relative attachment level were recorded at baseline and after 6 months by using acrylic surgical stent following periodontal access flap surgery along with use of collagen membrane and alloplast bone graft. Radiographic parameters were taken using Orthopantomograph for measuring the radiographic bone fill at baseline and after 6 months. Data were analyzed using paired t-test and Wilcoxon sign rank test. Results: All the parameters post operatively were statistically significant. Clinically, gain in attachment was 2.1±1.25mm and pocket reduction was 3.35±1.39mm whereas linear radiographic bone fill was found to be 2.81±1.43mm. However, gingival recession was found to be increased post-operatively. Conclusions: The current study showed combination of bone alloplast and regenerative membrane yields promising results in treatment of human intrabony periodontal defects.

Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy-A Systematic Review.

The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane Library, and the Web of Science. Trial inclusion criteria included the application of a defined nutritional intervention (food, beverages, or supplements) adjunctive to NSPT compared to NSPT alone with at least one measured periodontal parameter (pocket probing depths (PPD) or clinical attachment level (CAL)). Of 462 search results, 20 clinical trials relating to periodontitis and nutritional interventions were identified, of which, in total, 14 studies could be included. Eleven studies examined supplements containing lycopene, folate, chicory extract, juice powder, micronutrients and plant extracts, omega-3 fatty acids, vitamin E, or vitamin D. Three studies examined food-based interventions (kiwifruit, green or oolong tea). Due to limited information on within-group differences in the studies, results were descriptively analyzed. A significant positive effect on periodontal parameters (PPD, bleeding on probing) was found for vitamin E, chicory extract, juice powder, green tea, and oolong tea. Heterogeneous effects were found for lycopene, folate, omega-3 fatty acids, and vitamin D. No effects on PPD were found for adjunct kiwifruit (in combination with NSPT). Risk of bias via RoB2 revealed a low risk of bias with some concerns. There was a high heterogeneity in the type of nutritional interventions. The adjunctive use of various supplements and green/oolong tea led to positive and significant effects of the nutritional interventions on clinical periodontal outcome parameters. In the context of non-surgical periodontal therapy, an adjunctive intake of micronutrients, omega-3 fatty acids, green/oolong tea, and polyphenols and flavonoids could be beneficial. Long-term clinical studies with full data reports (especially within-group differences) are needed for conducting a meta-analysis.

Assessment of Changes in Craniofacial Structures, Bite Force and Periodontal Status Following Fixed Functional Appliance Therapy

The aim of this study was to determine the effect of Forsus Fatigue Resistant Device (FRD) appliance on craniofacial structures, bite force and periodontal status in Class II malocclusion patients. In this prospective interventional follow-up study, thirteen (13) Class II Division 1 patients in their post-adolescent age group with average age of 17.10 ± 1.63 year was treated with Forsus FRD. They were assessed for craniofacial changes, bite force and periodontal status at baseline, after alignment and leveling, after removal of FRD. Improvement in soft tissue profile was due to significant dentoalveolar changes. There were significant decreases in overjet, overbite, reference line to upper first molar, H angle (p<0.001) and significant increases in upper lip to E-line, reference line to lower molar and angular measurements like nasolabial angle, U1 to SN plane, Incisor Mandibular Plane Angle (p<0.001). The bite force was significantly decreased on the molar and the incisor region (p<0.001). A significant increase in plaque index (PI), gingival index (GI), probing pocket depth was noticed without any significant clinical attachment loss. Class II correction with Forsus FRD appliance was mainly due to significant dentoalveolar changes. Skeletal changes were non-significant. A decrease in the bite force was found with FRD. The magnitude of bite force was more in males compared with females. The increase in GI, PI, pocket probing depth implies the necessity of oral hygiene and plaque control measures. However, there was no significant change in clinical attachment level.

Screw-retained internal connection zirconia CAD-CAM abutments in single implant reconstructions: Results of a 1-year prospective case series study.

To evaluate the clinical and radiographic outcomes of single-tooth implant restorations using one-piece, internally connected, screw-retained, computer-aided design and computer-aided manufactured monolithic zirconia restorations fabricated on regular diameter implants. Following a 2-stage surgical procedure, 22 implants placed in anterior and posterior areas in 21 partially edentulous patients (mean age of 55 years; 9 males/12 females) were evaluated in terms of plaque index, pocket probing depth, bleeding on probing, level of oral hygiene (OH), signs of mucositis/peri-implantitis, esthetic score (ES), gingival zenith position (GZP), papilla index score, the thickness of peri-implant gingiva, radiographic marginal bone loss, and technical complications. Implants and restorations were prospectively followed from the insertion of the restoration (baseline), up to 12-months post-loading. A 100% implant survival rate resulted after loading; one implant was lost before loading. Clinically, patients performed an adequate OH, and tissues were kept healthy. Probing depth showed a slightly lower value at baseline compared to any follow-up examination (2.26 [0.94] at baseline vs. 2.53 [0.66]mm at 12 months). ES, GZP, and the thickness of the peri-implant gingiva improved throughout the course of the study. Radiographically, average marginal bone level (MBL) was 0.40 (0.40)mm after 1-year follow-up with no differences in average MBL at all time points. Technically, after 1 year of clinical function, neither abutment fracture nor any other serious complications occurred. Hence, prosthetic reconstruction survival rate was 100%. Clinical outcomes of single-tooth implant restorations using internally connected, screw-retained, computer-aided design and computer-aided manufacturing monolithic zirconia abutments can be considered a reliable treatment alternative after 1-year clinical observation.

The effect of non-surgical periodontal therapy on salivary IL-6 levels in patients with moderate to severe generalized chronic periodontitis.

Generegulation of IL-6 is characterized by the presence of inflammatory cytokines, bacterial products, viral infection, andactivation of the diacylglycerol-, cyclic AMP-, or Ca + + -activated signal transduction pathways. Scaling and root planning (SRP), a non-surgical periodontal therapy, was studied in connection toseveral clinical parameters for its effect on salivary IL-6 levels in patients with generalized chronic periodontitis. For this study, a total of 60 GCP patients were included. Plaque index (PI), gingival index (GI), pocket probing depth (PPD), bleeding on probing percentage (BOP%), and clinical attachment loss were among the clinical indicators covered (CAL). Following SRP, mean IL-6 levels in patients with GCP were significantly higher in the pre-treatment group (2.93 5.17 pg/ml; p 0.05) than in the posttreatmentgroup (5.78 8.26 pg/ml; baseline). Pre- and post-treatment IL-6 levels for PI (pre), BOP percent (pre/post), GI (post), and PPD were found to be positively correlated (post). In patients with GCP, the study showed a statistically significant correlation between periodontal metrics and salivary IL-6. Changes in periodontal indices and IL-6 levels that are statistically significant over time indicate that non-surgicaltreatment is effective, and IL-6 can be regarded as a potent disease activity marker.

Comparison between the Flapless Surgical Approach and a Novel Single Incision Access in Terms of Recovery Time and Comfort after Extraction of Impacted Inferior Third Molars: A Randomised, Blinded, Split-Mouth Controlled Clinical Trial

The recent attention to quality of life and oral health care procedures reflects a renewed 'patient-based' approach to dealing with non-life-threatening conditions. In the current study, we proposed a novel surgical approach to the extraction of impacted inferior third molars (iMs3) through a randomised, blinded, split-mouth controlled clinical trial following the CONSORT guidelines. The novel surgical procedure, hereinafter referred to as single incision access (SIA), will be compared with our previously described flapless surgical approach (FSA). The predictor variable was the novel SIA approach, involving access through a single incision without removal of soft tissue, on the impacted iMs3. The primary endpoint was the acceleration of the iMs3 extraction healing time. The secondary endpoints were the incidences of pain and oedema as well as gum health (pocket probing depth and attached gingiva). The study was carried out on 84 teeth of 42 patients with both iMs3 impacted. The cohort was composed of 42% Caucasian males and 58% Caucasian females, aged 23.8 ± 7.9 (17-49) years. We observed faster recovery/wound-healing on the SIA side (33.6 ± 4.3 days) than at the FSA side (42.1 ± 5.4 days; p < 0.05). The FSA approach confirmed the evidence previously detected concerning early post-surgery improvement in terms of attached gingiva and reduced oedema and pain, with respect to the traditional envelope flap. The novel SIA approach follows the early positive post-surgery FSA results.