Pocket Depth Reduction Research Articles

Efficacy of a herbal mouthwash for management of periodontitis and radiation-induced mucositis – A consolidated report of two randomized controlled clinical trials

BackgroundOral diseases like periodontitis and mucositis often require home care using topical agents in the form of mouthwashes. Many herbal mouthwashes are found to be beneficial; however lack proper scientific evidence to support their use. ObjectivesStudy 1 evaluated clinical efficacy of herbal mouthwash in the management of chronic periodontitis in comparison with chlorhexidine mouthwash. Study 2 aimed at assessment of herbal mouthwash in patients of radiation-induced mucosititis. MethodsThe novel herbal mouthwash used in the present study wa prepared from extracts of five plants namely Emblica Officinalis, Terminalia chebula, Terminalia bellerica, Glycyrrhiza glabra, and Azadirachta indica. 50 periodontitis patients were randomly allocated to two groups. As per allocation, they were instructed to use either herbal mouthwash or chlorhexidine mouthwash twice daily for two weeks after nonsurgical periodontal therapy. Similarly, patients with radiation-induced mucositis were randomly given herbal mouthwash and soda saline mouthwash. Intergroup and intragroup comparisons of continuous variables were conducted using paired and unpaired t-tests. Categorical variables were compared using the chi-square test. ResultsSignificant reductions in gingival bleeding, plaque accumulation, and pocket depth were noticed in periodontitis patients in both groups. Patients reported acceptable taste, freshness, and satisfaction after the use of herbal mouthwash. The herbal mouthwash group noticed a significant reduction in the severity of radiation-induced mucositis and analgesic requirements. The intensity of pain, dryness of mouth, oral hygiene, and need for the use of antibiotic and antifungal during radiotherapy was not significant among the groups. ConclusionThe results of this preliminary clinical trial support the use of the tested herbal formulation mouthwash as an adjunct in the treatment of periodontitis as well as radiation-induced mucositis. Clinical trial registration NumberFor Study 1: CTRI/2019/10/021574, Study 2: CTRI/2020/04/024851.

Is Autologous Sticky Bone Better Than a Simple Mixture of Autologous PRF and Bioactive Glass in the Regeneration of Human Periodontal Intrabony Defects? An Extensive Clinical and CBCT Study.

Periodontal intrabony defects (IBDs) are commonly encountered in dental practice and are usually treated by open flap debridement (OFD) with or without bone grafts and/or guided tissue regeneration (GTR), platelet-rich fibrin (PRF), or other additives. A difficulty with these approaches is maintaining the space for bone growth at the determined location. In this report, autologous sticky bone (ASB) was used and compared to a simple mixture of PRF and bone graft (PRF-BG) using the identical graft material-bioactive glass morsels-to assess its regenerative potential in IBDs, as sticky bone is known to maintain the space, according to previous research. A total of 21 IBDs were treated by OFD, PRF-BG mixture, or ASB. Regenerative assessment was clinically and radiographically performed by CBCT at 1 year. All the treatment modalities (OFD, PRF-BG, and ASB) showed statistically significant improvements clinically and radiographically at 1 year in terms of probing pocket depth reduction (PPDR), clinical attachment level gain (CALG), CBCT defect fill (CBCT-DF), and CBCT defect resolution (CBCT-DR); P < .05. The ASB group depicted the most favorable results (P < .05) in terms of the parameters at 1 year followed by the PRF-BG group and then the OFD group. Treatment of periodontal IBDs with ASB resulted in significant improvements in clinical and CBCT parameters compared to baseline at 1 year, and intrasurgical graft handling was much better in the ASB group.

Enhancing Periodontitis Treatment: A Comprehensive Literature Review of Locally Delivered Antibiotics as an Adjunctive Therapy

Background: Periodontitis is a prevalent and persistent infection that can significantly affect overall health. While scaling and root planing are effective treatments, they may not fully remove bacterial biofilms in difficult-to-reach areas, such as furcations and deep pockets. Therefore, numerous studies have demonstrated that supplementing mechanical debridement with locally delivered antibiotics can improve clinical outcomes. Objective: This study aims to review the effectiveness of different types of locally delivered antibiotics as adjunctive therapy to scaling and root planing in treating periodontitis. Methods: Pubmed, Scopus and Google Scholar were utilized to obtain papers addressing locally delivered antibiotics in periodontitis patients, antibiotics in periodontitis, or antimicrobial agents in periodontitis up to February 1, 2023. Results: Treatment with locally delivered antibiotics led to notable improvements in clinical outcomes. These improvements encompassed reductions in probing depths, gingival inflammation, and bleeding on probing. Additionally, enhancements in clinical attachment level and periodontal pocket depth reduction were consistently observed in the included studies. Conclusion: Based on individual antimicrobial agent analyses, we are unable to determine which local antibiotic is the best. It is challenging to accurately assess the use of sustained or released local antimicrobials due to the unique features of each product. Local medication administration into the periodontal pocket could be an effective therapy adjunct to mechanical instruments.

The Effect of Xenograft and Platelet-Rich Plasma in the Surgical Management of Intrabony Defects in Periodontitis Patients: A Systematic Review.

When treating intrabony defects to regenerate periodontal structure, platelet-rich plasma (PRP) alone or in conjunction with various grafting materials, enamel matrix proteins, and barrier membranes have shown promising results. This evidence-based review aimed to systematically appraise the efficacy of xenograft in combination with PRP in the surgical treatment of periodontal intrabony defects in comparison to xenograft alone in terms of clinical and radiographic outcomes in adults with periodontitis. Electronic and manual data were searched exhaustively by 2 reviewers, including PubMed-Medline, Cochrane Central Register of Controlled Trials, Embase and Scopus from the earliest available date till January 31, 2023 without restriction on language. Randomized controlled clinical trials of either parallel or a split-mouth design and studies where xenograft and PRP were in the intervention group or as a comparator was included. After screening the articles, 3 studies were included. The current systematic review reveals that PRP used as an adjunct with a xenograft resulted in a significant reduction in pocket depth and greater clinical attachment level gain in comparison to xenograft alone. The analysis of the present review concludes that PRP in conjunction with xenograft for the treatment of intrabony defects shows promising outcomes. However, owing to the short follow-up time and heterogeneity of included studies, caution should be followed while using this material clinically.

Evaluation of the effects of Curcumin gel against Periodontopathic Bacteria (Porphyromonas gingivalis) using real-time time-polymerase chain reaction technology

Periodontal disease is typically treated with mechanical debridement of the tooth surface. It may, however, be insufficient to eradicate pathogenic microorganisms on its own. Because of the microbial etiology of periodontitis, systemic or local antibiotic therapy is used as an adjunct treatment. The present study aimed to determine the effects of curcumin gel on Porphyromonas gingivalis. Eleven patients with stage II and III periodontitis were registered in the study. A double-blinded split-mouth design followed. Periodontal pockets were distributed into 2 groups; the test group received scaling and root planing along with curcumin gel, while the control group received scaling and root planing along with a placebo gel. Plaque index, probing pocket depth and relative attachment level were recorded with the collection of subgingival plaque samples at different time intervals for bacterial analysis using real-time time-polymerase chain reaction. Results showed a significant reduction in the bacterial outcomes in the test group. There was a significant improvement in the Plaque index, probing pocket depth and relative attachment level in the test group compared to the control group. On intra-group comparison, both groups showed a significant reduction of Plaque index and probing pocket depth with a more significant reduction in the test group, and only the test group showed a significant reduction of relative attachment level. A strong positive correlation of P.gingivalis with probing pocket depth and relative attachment level in the test group was estimated. Curcumin gel has an antibacterial effect against Porphyromonas gingivalis and showed a potent improvement in the outcomes of the periodontal parameters. Keywords: Curcumin gel, periodontal pocket, Porphyromonas gingivalis

The Clinical and Microbiological Effects of LANAP Compared to Scaling and Root Planing Alone in the Management of Periodontal Conditions.

The purpose of this study was to evaluate the efficiency of two therapeutic procedures clinically and microbiologically in the management of periodontally affected teeth: scaling and root planing alone and the laser-assisted new attachment procedure (LANAP). Molecular biological determinations of bacterial markers through the polymerase chain reaction (real-time PCR) method with standard PET tests (species-specific DNA probes at a time) were used for the quantification of three of the most important periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola). Both nonsurgical periodontal therapies were proven effective in patients with chronic periodontal disease; however, LANAP was associated with a greater reduction in pocket depth and improved clinical outcomes, associated with a significant decrease in the amount of Porphyromonas gingivalis. The clinical results included a decrease in periodontal pocket depth, bleeding on probing, and dental plaque, with LANAP having better overall outcomes than SRP alone. The use of Nd:YAG lasers in LANAP therapy is a safe and effective procedure that is well accepted by patients.

Probing pocket depth reduction after non-surgical periodontal therapy: Tooth-related factors.

To investigate tooth-related factors that influence the reduction of probing pocket depths (PPD) after non-surgical periodontal therapy (NST). Seven hundred forty-six patients with a total of 16,825 teeth were included and retrospectively analyzed. PPD reduction after NST was correlated with the tooth-related factors; tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration; using logistic multilevel regression for statistical analysis. NST was able to reduce probing depth overall stratified probing depths (1.20±1.51mm, p≤0.001). The reduction was significantly higher at teeth with higher probing depths at baseline. At pockets with PPD ≥6mm, PPD remains high after NST. Tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration are significantly and independently associated with the rate of pocket closure. The tooth-related factors: tooth type, number of roots, furcation involvement, vitality, mobility, and type of restoration had a significant and clinically relevant influence on phase I and II therapy. Considering these factors in advance may enhance the prediction of sites not responding adequately and the potential need for additional treatment, such as re-instrumentation or periodontal surgery, to ultimately achieve the therapy end points.

Clinical and Radiological Benefits of Hyaluronic Acid in Periodontal Infrabony Defects: A Systematic Review and Meta-analysis

Purpose:There is no consensus on the clinical and radiological benefits of hyaluronic acid (HA) in patients with periodontitis having infrabony defects. Hence, this study examined the effects of HA in periodontitis patients with infrabony defects through a comprehensive systematic review process.Methodology:A systematic literature search was performed using PubMed/Medline, Scopus, Embase and Cochrane Library from inception to March 2022. Randomized or non-randomized clinical trials and single-arm clinical trials that assessed the clinical and radiological benefits of HA in periodontitis patients with infrabony defects with a minimum of 6 months follow-up were included in this study. Surgical regenerative therapy was considered as the comparator. The Cochrane risk of bias assessment tool and Downs and Black checklist was used for the quality assessment of randomized and non-randomized interventional studies, respectively. A subgroup and sensitivity analyses were performed to explore the heterogeneity and robustness of the findings, respectively.Results:A total of 13 out of 725 studies were included in this systematic review, of which 9 were considered for meta-analysis. The meta-analysis indicated significant benefits of HA in terms of reduction in probing pocket depth (SMD: 1.12 mm; 95% CI: 0.60-1.65; 9 studies), bone defect depth (SMD: 1.04mm; 95%CI: 0.62-1.47; 3 studies) and gain in clinical attachment level (1.04 mm; 95% CI: 0.33-2.47; 8 studies). Overall, the quality of included studies was good.Conclusion:The current evidence indicates that the administration of HA in the periodontal regenerative treatment of infrabony defects was significantly effective in increasing clinical attachment levels and reducing probing pocket and bone defect depth.

Effects of Omega-3 as an adjuvant in the treatment of periodontal disease: A systematic review and meta-analysis.

The data search was conducted into three main databases: PubMed, Embase, and Cochrane. The search equation was built around the PICO framework in which the population was constituted by human adults suffering from chronic periodontitis that had to be treated with conventional SRP with the adjunction of omega-3 fatty acids (I) or without the adjunction of omega-3 fatty acids (C), with, as a first outcome the probing pocket depth reduction (PPD) and as a second outcome the clinical attachment loss reduction (CAL). Risk of bias within studies was evaluated for each included study using the Cochrane collaboration tool for randomized studies (RoB Tool). A meta-analysis was performed using REVMAN 5.3. After a global search, 117 studies were selected but only seven of them were eligible for the systematic review and meta-analysis. Six out of seven studies showed a significantly better PPD reduction in the omega-3 fatty acids group compared to the control group and five out of seven studies showed a significantly better CAL reduction in the omega-3 fatty acids group compared to the control group. The meta-analysis showed a statistically significant difference for PPD reduction (SMD: -0.78 [95% CI: -1.02, -0.54, p < .0001]) and CAL reduction (SMD:-0.80 [95% CI: -1.04, -0.56, p < .0001]) in favor of the test group. After scaling and root planning, PPD reduction and CAL reduction were observed in both control and test groups, but with statistically significant better values for the omega-3 fatty acids group. Patients suffering from periodontitis could benefit from the use of omega-3 fatty acids to increase the effectiveness of a nonsurgical treatment.

Comparative clinical evaluation of xenograft (Cerabone) versus allograft combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects

Abstract Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects. Method: This clinical study included 20 systemically healthy patients, with grade II mandibular furcation defects, performed over 6 months. Control group comprised of open flap debridement + demineralized freeze-dried bone allograft + platelet-rich fibrin and test group comprised of open flap debridement + Cerabone + platelet-rich fibrin. Clinical parameters included: Plaque index, Modified Sulcular bleeding index, Vertical probing pocket depth, Horizontal probing depth, Probing clinical attachment level, Radiographic furcation depth, and radiographic bone fill percentage. Results: Both groups showed satisfactory bone regeneration and improvement in clinical parameters. The test group exhibited greater reduction in vertical probing pocket depth, horizontal probing depth, and higher radiographic bone fill percentage when compared to control group, although these findings were not statistically significant. Conclusion: Both bone grafts were equally effective in treatment of grade II furcation defects. Further long-term studies are required to explore their maximum regenerative potential.

Effect of Ocimum sanctum L as LDD in periodontal therapy.

Ocimum sanctum L (Tulsi) has various properties like antibacterial, anti-inflammatory and anti-oxidant. To compare the effect of the local-drug delivery system containing 2% Ocimum sanctum L (Tulsi) as an adjunct to scaling and root planing (SRP).The main aim of the study was to evaluate the efficacy of Ocimum sanctum L (Tulsi) gel with Tetracycline fibers (Actisite) for the treatment of periodontitis patients. 40 subjects with periodontitis (pocket depth of 5 mm) were selected and divided into 2 groups Group I: Ocimum sanctum L (Tulsi) gel (n= 20) and Group II: Tetracycline fibers (Actisite) (n = 20). Clinical parameters assessed were Gingival Index , Plaque Index , Probing Depth and Clinical Attachment Loss were assessed at baseline, 1 month, 3 months, 6 months, 8 months. Our results showed that Gingival index and Plaque index for for GROUP I: Ocimum sanctum L (Tulsi) and GROUP II: Tetracycline fibers (Actisite)are not statistically significant p>0.05 for baseline, at 1 month, 3 months, 6 months, 8 months. Probing depth and Clinical attachment are not significant p>0.05 for baseline, at 1 month, 3 months, 6 months, and statistically significant difference seen at 8 months p<0.05. 2% Ocimum sanctum L (Tulsi) gel can be effectively used as an adjunct to scaling and root planing. When used as an adjunct to scaling and root planing, it helps in reduction of pocket depth and gain of clinical attachment. Ocimum sanctum L (Tulsi) showed promising results when compared to Tetracycline fibers (Actisite).

Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial.

This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. Two sites in 18 patients having residual periodontal pockets of ≥5mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12months. Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78mm vs. 1.89mm on average; p=0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67mm vs. 1.06mm; p=0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p=0.031), compared with SRP alone. The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.

Clinical and Radiological Benefits of Hyaluronic Acid in Periodontal Infrabony Defects: A Systematic Review and Meta-analysis

Purpose: There is no consensus on the clinical and radiological benefits of hyaluronic acid (HA) in patients with periodontitis having infrabony defects. Hence, this study examined the effects of HA in periodontitis patients with infrabony defects through a comprehensive systematic review process. Methodology: A systematic literature search was performed using PubMed/Medline, Scopus, Embase and Cochrane Library from inception to March 2022. Randomized or non-randomized clinical trials and single-arm clinical trials that assessed the clinical and radiological benefits of HA in periodontitis patients with infrabony defects with a minimum of 6 months follow-up were included in this study. Surgical regenerative therapy was considered as the comparator. The Cochrane risk of bias assessment tool and Downs and Black checklist was used for the quality assessment of randomized and non-randomized interventional studies, respectively. A subgroup and sensitivity analyses were performed to explore the heterogeneity and robustness of the findings, respectively. Results: A total of 13 out of 725 studies were included in this systematic review, of which 9 were considered for meta-analysis. The meta-analysis indicated significant benefits of HA in terms of reduction in probing pocket depth (SMD: 1.12mm; 95%CI: 0.60-1.65; 9 studies), bone defect depth (SMD: 1.04mm; 95%CI: 0.62-1.47; 3 studies) and gain in clinical attachment level (SMD: 1.40 mm; 95%CI: 0.33-2.47; 8 studies). Overall, the quality of included studies was good. Conclusion: The current evidence indicates that the administration of HA in the periodontal regenerative treatment of infrabony defects was significantly effective in increasing clinical attachment levels and reducing probing pocket and bone defect depth.

Comparison of Clinical Parameters between the Treatment of Infrabony Defects with and without Concentrated Growth Factors in Open Flap Debridement: In vivo Study

Introduction:This study aimed to clinically and radiographically compare the regenerative effects of open flap debridement alone and in combination with concentrated growth factor (CGF) in the treatment of periodontal three-walled infrabony defects.Materials and Methods:Fifteen patients who fulfilled the inclusion criteria were selected from the outpatient department of periodontology. A split-mouth study was conducted and bilateral or contralateral defects were divided into two groups using computer-generated randomisation sheets-control site (open flap debridement alone) and case site (open flap debridement with CGF). Clinical parameters were assessed at baseline, 1 month, 3 months and 6 months. Radiographic parameters were assessed at baseline and 6 months postoperatively.Results:At 3 and 6 months postoperatively, the test group showed statistically significant improvement in clinical parameters as compared to the control group. At 6 months postoperatively, the test group showed improved bone fill as compared to the control group.Conclusion:Present study indicates that CGF, as a biological material has the property to enhance wound healing and result in mean pocket depth reduction of periodontal infrabony defects. In addition, long-term, multicentered randomised, controlled clinical researches will be required to better understand the clinical and radiographic effects of CGF on periodontal regeneration.

THE APPLICATION OF AN ENAMEL MATRIX PROTEIN (EMDOGAIN) IN REGENERATIVE PERIODONTAL THERAPY. CLINICAL SERIES

Objectives: The purpose of this clinical series is to present indications for regenerative therapy with EMD. Materials and Methods: The study included 53 patients with osseous defects from 7-15mm’s in depth. Each patient understood that the procedures were not within the normal treatment due to the severity of the defects but opted to accept treatment. Along with EMD each defect also had freeze fried demineralized bone placed in the defect as well. Results: Reentry of the original defects was undertaken at approximately 1 year after surgery. It was noted that for the most part significant improvement was noted in almost all defects. Exact improvement of defects was not calculated. In several cases 10-year reentry was undertaken and in fact further reduction in defects were noted. It could not be determined at any time over the 10-year period that the reduction in pocket depth was in fact bone as no histology was ever taken to verify what the defects were filled with. Conclusions: Clinical studies have indicated that treatment with EMD with freeze dried demineralized bone positively influences regenerative periodontal therapy.

Clinical and bacterial periodontal parameters with methylene blue-loaded nanoparticles incorporated in a natural plant-based vehicle for the treatment of Stage III Grade B periodontitis.

AimThe aim of the present clinical trial was to assess the effectiveness of antimicrobial photodynamic therapy (PDT) versus poly-L-glycolic acid nanoparticles loaded methylene blue in aloe vera gel (PGA/MB/AV) on periodontal and microbial outcomes in patients with Stage III Grade B periodontitis. MethodsSeven-five patients undergoing scaling and root planing (SRP) were randomized equally into three groups: Group-I: PGA/MB/AV + SRP, Group-II: PDT + SRP, and Group-III: SRP alone. The assessed clinical periodontal parameters included plaque scores (PS), bleeding on probing (BOP), pocket depth (PD), and clinical attachment levels (CAL). Plaque samples were acquired from the patients to assess the levels of Tannerella forsythia (Tf) and Porphyromonas gingivalis (Pg). Clinical and bacterial recording were documented at the start of the study, 3 months, and 6 months after completion of treatment. ResultsA significant improvement was observed in both PS and BOP at the 3 months (p<0.01) and 6 months (p<0.001) follow-up in all three groups. A significant reduction in BOP scores was observed in Group II in comparison to the other groups on the inter-group comparison. Group-I showed significant PD reduction and CAL gain compared to Group II and III (p<0.01). Group-I displayed a significant decrease in the Tf and Pg after 3 months (p<0.05). A decrease was observed after six months of treatment for Tf only (p<0.05). Group I displayed a high decrease for only Tf at three months (p<0.05). ConclusionMethylene blue-loaded nanocarrier in AV gel produced pronounced periodontal healing compared to aPDT alone in stage III grade B periodontitis patients.

Efficacy of German chamomile mouthrinse on plaque, gingivitis, periodontal pockets and calculus in man

The aims of this study werc to evaluate the effectiveness of German chamomile extract as a mouthrinse on the development of plague, gingivitis, pathological pockets and calculus in man to determine whether it can provide any benefit without the addition of other additives.Fifty adult volunteers participated in this controlied single blind cross-over study. The subjects used either German Chamomile or a chlorhexidine mouthrinse for 1 minute twice daily during eight weeks period. 2 weeks interval between each visit for motivation and reinforcement of application of the material Four applied indices (plaque and gingival indices by Loe and Silness), CPITN index by Ainamo and calculus index by Ramfjord were recorded at baseline, after each experimental period and at the last visit. The mean reduction in plaque. gingival and periodontal pocket depths were determined by using paired Z-test between each visit at P&lt; 0.01 significantly lower for GC than for CHX mouthrinse. While for calculus index there was significant increase between each visit at P&lt; 0.05 using paired Z-test and for all visits using repeated measures ~~ F-test at P &lt;0.01.Using GC mouthrinse in a percentage of 1:4 appears to offer benefit in plaque, gingival, pocket depth reductions but with significant adverse increase in calculus index.

Effect or different concentrations of acidic olive leaves extractmouth rinse on plaque, gingivitis and periodontal pockets onadults

Aims: The aims of this study were to evaluate the effectiveness of olive leaves extract mouthrinse on the development of plaque, gingivitis, periodontal pockets in different concentrations as pure extract 50%, apple cider vinegar (ACV) extract rinse 50%, ACV + olive leave extract (OLE) 15% in acidic medium, 20% ACV + OLE mouthrinse compared with the ideal standard control mouthrinse chlorhexidine (CHX) 0.2%. Fifty adult volunteers participated in this controlled single blind cross— over study, 10 subjects for each group, one control and four experimental groups with different concentrations of the rinse for | minute twice daily during 8 weeks period, 2 weeks interval between each visit for motivation and reinforcement of application of the material. Three applied indices (plaque and gingival indices by Loe and Silness), CPITN index by Ainamo recorded at baseline, after each experimental period and at the last visit, then examining the biological activity of the material in the laboratory. It had been found that materials were effective on the three applied indices with significant percentage reduction (for OLE 50%, ACV 50%) at p &lt; 0.001 using unpaired Z-test, and at p &lt; 0.001, p &lt; 0.0! for OLE + ACV 51%, OLE + ACV 20% respectively using unpaired Z-test except for some visits for the two materials. Percentage reductions for the four applied concentrations were greatest for OLE + ACV 20%, OLE ~ ACV 15%, ACV, OLE respectively for the three applied indices with significant differences at p &lt; 0.05 using repeated measures analysis of variance and Duncan test. Using OLE mouthrinse in different acidic concentrations offer benefit in plaque. gingival, periodontal pocket depth reductions, but it is much lower than that of CHX 0.2% mouthrinsc.

Influence of Smoking on Periodontal and Implant Therapy: A Narrative Review

smoking is considered the most modifiable risk factor for periodontal disease. the aim of this narrative review is to emphasize the effect of smoking on periodontal and implant therapy. The authors reviewed the literature reporting the clinical outcomes of smoking on periodontal surgical and nonsurgical treatment. The impact of smoking on implant therapy and sinus lifting procedures were also reviewed. Periodontal and implant therapy outcomes are adversely affected by smoking. Smokers respond less favorably to periodontal therapy and periodontal flap procedures as compared to nonsmokers. Clinical outcomes for smokers are 50-75% worse than for nonsmokers. Studies reveal that smokers experience a significantly lower reduction in pocket depth compared to nonsmokers as well as less bone growth after treating infra-bony defects with guided tissue regeneration. The relative risk of implant failure is significantly higher in patients who smoke 20 cigarettes or more per day compared to nonsmokers. Additionally, smoking has also been shown to increase postoperative wound dehiscence and infection rates following sinus floor elevation. Longitudinal studies on smoke cessation have shown a reduction in bone loss and probing depths for periodontitis patients after cessation compared to those who smoke. Smoking cessation can reduce probing depths and improve clinical attachment after nonsurgical periodontal therapy. There is insufficient evidence regarding the effect of smoking on peri-implantitis, as well as the loss of implants in the long-term.

Comparative evaluation of conventional and diode laser-assisted gingival curettage in shallow suprabony periodontal pocket – Three months follow-up of a randomized clinical trial

Background: Chronic periodontitis is one of the most common forms of periodontal disease in adults. The primary goal of periodontal therapy is to remove dental plaque and bacteria to restore and maintain gingival tissue health. Subgingival scaling, root planning, and curettages are aimed at removing dental plaque, calculus, and necrotic cementum. Aim and Objectives: The main aim of our present randomized control clinical trial was to evaluate the clinical effectiveness of diode lasers compared to conventional curettage using hand instruments in patients with chronic periodontitis having shallow suprabony pockets. In addition, the pain sensation during conventional and laser-assisted curettage was compared during the procedure using Visual Analog Scale. Materials and method: Subjects with shallow pockets were divided into two groups and treated with either conventional curettage (Control group) with hand instrument or with diode laser (Test group). The data obtained were fed into Microsoft Excel 2000 package, and statistical analysis was carried out using SPSS software version 20.0 for Windows. Results: The control group elicited a reduction in probing pocket depth (PPD) from baseline to 1 month after treatment (6.60 ± 0.99 vs. 3.87 ± 0.64, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 2.43 ± 0.50, which was also statistically significant (P &lt; 0.05). The reduction between the 1 and 3 months after treatment (3.87 ± 0.64 vs. 2.43 ± 0.46, respectively), was also statistically significant (P &lt; 0.05). The test group elicited a reduction in PPD from baseline to 1 month after treatment (6.80 ± 0.86 vs. 4.00 ± 0.76, respectively), which was statistically significant (P &lt; 0.05). The 3-month postoperative scores had been reduced to 3.53 ± 0.48, which was also statistically significant (P &lt; 0.05). There was a marginal reduction of postoperative scores between the 1 and 3 months after treatment (4.00 ± 0.76 vs. 3.53 ± 0.48, respectively), which was nonsignificant (P = 0.53). The mean PPD at baseline between Control group versus Test group (6.60 ± 0.99 vs. 6.80 ± 0.86, respectively) was nonsignificant (P = 0.56). The PPD at 1 month also revealed nonsignificant reduction, i.e. Control group versus Test group (3.87 ± 0.64 vs. 4.00 ± 0.76, P = 0.60). The postoperative reduction of PPD at 3 months was statistically significant (P &lt; 0.05), i.e. Control group versus Test group (2.43 ± 0.46 vs. 3.53 ± 0.48). Conclusion: Within the limit of our study, it can be proved that both hand instrument-guided curettage and laser-assisted curettage can effectively reduce shallow pockets to a healthy gingival sulcus.