Root Planing Research Articles

COMBINATION OF REGENERATIVE THERAPY AND FREE GINGIVAL GRAFT IN STAGE IV PERIODONTITIS: CASE REPORT

Introduction: Periodontal regenerative therapy can be used to repair damaged periodontal tissues caused by periodontitis. The combination of regenerative periodontal surgery and FGG (Free Gingival Graft) is expected to accelerate the regeneration of periodontal tissue. Case : A 37-year-old woman came with complaints of loose lower front teeth, frequent bleeding and pain when eating and drinking. The complaint was felt since 1 year ago. Clinical examination obtained an average pocket depth of 6 mm and an average second degree of tooth mobility. On radiographic examination found bone damage horizontally. Case Management: The patient received root planing scaling and occlusion adjustment, followed by dental periodontal surgery 42,41,31,32. Stage II surgery for recession closure therapy with FGG was carried out three months after stage 1 surgery was performed. Discussion: Regenerative periodontal surgery is performed to produce new periodontal tissue growth and restore connective tissue attachment to the teeth. Free Gingival Graft is performed to increase gingival keratinization and improve patient esthetics. Conclusion and Suggestions: The combination of regenerative periodontal surgery and FGG for the treatment of periodontitis cases involving severe bone destruction gives good results of periodontal tissue healing by alveolar bone healing and regeneration and quite good aesthetics.

Cracked tooth and endodontic-periodontal lesion: 2-years follow up of a conservative treatment

This study report diagnosis and management of an endodontic-periodontal lesion in a cracked mandibular tooth after a cyclist’s fall. A 34-year-old female patient with a chief complaint of pain and edema in the region of the mandibular right first molar was evaluated and treated. Patient presented excellent oral health. After clinical, radiographical and tomographic exams, it was diagnosed an acute periapical abscess in stage II combined with tooth cracks and a periodontal involvement (endodontic-periodontal lesion). After emergency dental care it was performed subgingival scaling and root planing, definitive endodontic treatment, indirect definitive restoration (overlay) combined with a reinforcement of the tooth structure with a high-resistance polyethylene tape. Patient was periodically followed up until 24 months and treatment was successful. It can be concluded that a correct diagnosis and a conservative and well-planned and -executed treatment of a compromised tooth by cracks can have good results even endodontic-periodontal lesion is present.

Effectiveness of Oral Health Education and Interventions in Improving Oral Health Outcomes in Type II Diabetes Mellitus Patients: A Prospective Study.

Introduction Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The study aimed to evaluate the effectiveness of oral health education and intervention in improving oral health outcomes in type 2 DM (T2DM) patients. Methods The present study was conducted in the Department of Oral Medicine and Radiology between February 2023 and August 2023 at Saveetha Dental College and Hospitals in Chennai, India. All of the patients in the study had T2DM with oral manifestations. This study enrolled 105 participants, of whom 63 were female and 42 were male. A standard pro forma was given to all the participants, and the findings were recorded. The pro forma comprises different oral manifestations, blood glucose levels, the Decayed, Missing, and Filled Teeth (DMFT) index, and Russell's periodontal index. The results were then statistically analyzed. Results This study of 105 individuals with T2DM (60% females and 40% males) revealed significant oral health challenges: 33% had periodontitis, 20% had gingivitis, 5% had lichenoid reactions, 23% had xerostomia, 11% had halitosis, and 8% had candidiasis, illustrating diabetes' impact on dental health. Following appropriate, tailor-made treatment for individual patients, such as scaling, root planning, oral hygiene education, pharmacotherapy, and post-intervention, the prevalence of complications notably decreased by 61%. A total of 7% of patients had gingivitis, 11% had periodontitis, 12% had xerostomia, 4% had halitosis, 2% had candidiasis, and 1% had lichenoid reactions, respectively. This highlights the importance of regular oral care positively impacting diabetes patients, with 61% experiencing improved oral health and 39% experiencing no improvement. Conclusion This study provides compelling evidence for the effectiveness of oral health education and interventions in improving oral health outcomes in T2DM patients. This approach offers a promising strategy for managing the oral health complications associated with diabetes and improving this population's overall health and well-being.

Periodontal tissue regeneration: current therapeutic strategies and future directions in further research

Chronic and progressive destruction/damage of the periodontal tissues resulted from periodontitis is the leading cause of tooth loss in adults. Traditional periodontal therapies such as scaling and root planning or flap surgery have demonstrated effective in controlling local inflammation and in suppressing/arresting the disease progression of periodontitis. However, those infection control measures cannot help to regenerate lost periodontal tissues to a statistically or clinically significant degree. Although some successes regarding the reduction of the intrabony defect and maintenance of the periodontal homeostasis have been achieved in periodontal regenerative procedures, comprising but not limited to guided tissue regeneration (GTR) or bone grafting technique, the restorative effectiveness of the architecture and function of the lost or injured tissues is far from our clinical expectation. The use of the concept, technique, and method of tissue engineering for periodontal regeneration is a hotspot and animal studies have shown interesting outcomes in terms of functional regeneration of lost/damaged support tissues in the periodontium, including alveolar bone, periodontal ligament, and cementum. However, numerous issues need to be addressed before those regenerative approaches can be responsibly transformed to novel clinical therapies. Recently, paradigm that induces homing of host stem cells to site of the periodontium and encourage the body's innate capability to repair is a new research field termed endogenous regeneration. Given that endogenous regenerative technique avoids ex-vivo cell culture and transplantation, it should be relatively easier to be used in the treatment of clinical patients. Due to the limited oral microenvironment and harsh periodontal local condition for tissue regeneration, as well as poor understanding of periodontal regenerative biology, there is still a long way ahead to explore new effective, practical, and economical therapies to save and protect natural tooth and for combating highly prevalent periodontal disease.

Passive Root Coverage Through Creeping Attachment of the Gingiva Before and After Scaling and Root Planning Therapy in the Mandibular Anterior Teeth: A Clinical Study.

Introduction Root coverage is one of the most imperative procedures in periodontal therapy. The demands from patients for aesthetics and sensitivity are some of the complaints in root exposure cases. Creeping attachment is a passive apical migration of the marginal gingiva and can be proposed as a noteworthy root coverage technique. The purpose of this study was to evaluate the position of the marginal gingiva and quantify the creeping attachment before and after the scaling and root planning (SRP) procedure. Materials and methods The present study was based on a single-centreclinical trial in which 30 sites from 10 patients were selected. Patients with Miller's class I gingival recession were selected. The plaque index, gingival biotype, and gingival margin position were measured at baseline and then at 10 and 21 days after SRP. The gingival biotype was measured with an endodontic file with a stopper and a digital vernier calliper. The gingival margin position was measured from the incisal surface of the tooth to the marginal gingiva with the help of a University of North Carolina (UNC) 15 periodontal probe. After recording the clinical parameters, a thorough SRP was performed using an ultrasonic scaler and manual instruments. Results The results were compared clinically at baseline and after 10 days and 21 days postoperatively. Statistical analysis was conducted for pre-SRP and post-SRP findings using the IBM SPSS Statistics for Windows, Version 19 (Released 2010; IBM Corp., Armonk, New York) software. A statistically significant improvement was seen in all the clinical parameters at baseline, at 10 days, andat 21 days postoperatively after the procedure (P < 0.01). Conclusion The position of the gingival margin was shifted towards the crown, and the creeping attachment was significantly observed from baseline to 10 and 21 days. Clinical significance Creeping attachment after the SRP procedure can be considered a significant root coverage technique. The genetic memory of the gingiva may playan important role in achieving root coverage. Once local irritants are removed, the gingiva attempts to regain its original position. In addition, the gingival phenotype plays an important role in gingival marginal positioning after basic therapy and root coverage procedures.

Comparative Evaluation of 0.2% Chlorhexidine and Oxygenated Mouthwash as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients - A Clinico-microbiological Study

ABSTRACT Background and Objective: Oxygen therapy has been proven to be beneficial in the treatment and healing of chronic wounds. Oxygenated mouthwash could help in the management of oral infections like periodontal disease by reducing the levels of reactive oxygen species. The current study was designed to evaluate the effectiveness of Blue M, an oxygenated mouthwash as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). Materials and Methods: Forty-two CP patients were randomly divided into 3 groups (Group A – only SRP, Group B – SRP with oxygenated blue®m mouthwash, and Group C-SRP with 0.2% chlorhexidine [CHX] mouthwash). Clinical parameters-plaque index, gingival index, probing pocket depth, and relative attachment level were evaluated at baseline, 1 month, and 3 months while microbial analysis was carried out, using chairside N-benzoyl-DL-arginine-2-naphthylamide Assay for detection of either presence or absence of Treponema denticola, Porphyromonas gingivalis, and/or Tannerella forsythia at baseline and 3 months. Results: All groups showed a significant reduction in clinical and microbiologic parameters from baseline to 3 months (P &lt; 0.05). Intergroup analysis showed Group B and Group C to be significantly better than Group A (P &lt; 0.05) while Group B showed similar results when compared to Group C (P &gt; 0.05). Conclusion: Blue M mouthwash showed better improvement as compared to SRP alone while it showed similar improvements in clinical as well as microbiologic parameters when compared with CHX. It can be concluded that Blue M mouthwash could well be a futuristic prospect as an alternative to chemical agents like CHX in the treatment of CP.

A Clinico - Microbial Study to Assess the Benefits of Medicinal Plant Extracts in Chronic Periodontitis

Background: There has been an increasing trend for the development of natural formulations for plaque control using medicinal plants as an adjunct, which can be a feasible alternative as these are widely available, cost-effective, and have fewer side effects. Aim: The evaluation of the effects of medicinal plant extracts in chronic periodontitis (CP). Materials and Methods: This study was carried out in two phases; first the antibacterial activity of two medicinal plant extracts was tested on periodontal pathogens, thereafter, a clinical assessment was carried out on subjects with CP. Forty-five individuals suffering from CP were randomized into three different groups; Group A: Scaling and root planing (SRP) along with Piper longum rinse, Group B: SRP along with mixture of Tinospora cordifolia and P. longum rinse, Group C: SRP along with chlorhexidine (CHX) (control group). The clinical parameters (gingival index [GI], plaque index, gingival bleeding index [BI], probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and months 1 and 3. The intra- and intergroup comparison of clinical parameters for all groups at different time intervals was performed. Results: At the end of the trial, all the three groups showed a statistically significant reduction when compared to baseline for all the clinical parameters. In intergroup comparison, statistically significant reduction in GI, PPD, and CAL for both Group A and Group C was seen at 3 months as compared to Group B. Comparable reduction was seen between Group A and C for all the clinical parameters. Reduction in plaque and gingival BI was seen to be highest in Group A. Conclusion: P. longum can be effectively utilized as an additive to mechanical periodontal treatment in comparison to CHX mouthwash for CP patients.

A comparative evaluation of nano curcumin gel versus nano doxycycline gel in treatment of chronic periodontitis stage II grade B

Purpose Nanoparticles have many advantages as they have very small size and can penetrate extracellular and intracellular areas such as gingival fluid, bacterial cells, from the gingival sulcus to the underlying connective tissue and to the periodontal pocket areas below the gum line that may be inaccessible to other delivery systems. So, this study aimed to evaluate nano curcumin gel versus nano doxycycline gel in the treatment of periodontitis stage II grade B. Patients and methods This study was conducted on thirty sites among 22 patients with periodontitis stage II grade B. They were classified randomly into two treatment groups: Curcumin group (G1): consisting of 15 sites were treated by scaling and root planning (SRP) plus nano curcumin gel 2% and Doxycycline group (G2): consisting of 15 sites were treated by SRP plus nano doxycycline gel (20 mg/ml). Clinical evaluations including probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP) were done before starting phase I therapy (zero time) 1 month after finishing phase I therapy (baseline), at 3 months and 6 months after baseline. Level of interleukin-6 (IL-6) was evaluated at zero time, 3 and 6 months after baseline. Results Intra group comparison of both groups showed a statistically significant reduction (P ≤ 0.05) regarding PD, CAL, and BOP from zero time to 6 months follow-up periods. Also, the level of IL-6 in GCF was reduced significantly up to 6 months (P ≤ 0.05). However, inter group comparison between the two studied groups was nonsignificant regarding to PD, CAL, BOP, and level of IL-6 (P &gt; 0.05). Conclusion Both nanocurcumin gel 2% and nano doxycycline gel 20 mg significantly improved PD, CAL and BOP and reduce IL-6 level until 6 months when applied as adjunct to scaling and root planning. So, nano drugs gels (nanocurcumin gel and nano doxycycline gel) are considered useful new modalities in treatment of periodontitis.

Comparative Evaluation of L-PRF and Ofloxacin Incorporated L-PRF as an Adjunctive to SRP-A Split-Mouth Randomized Clinical Trial

ABSTRACT Aim and Objectives: To compare and evaluate the clinical efficacy of “ofloxacin incorporated L-PRF” and “L-PRF alone” when used as an adjuvant to non-surgical periodontal therapy. Materials and Methods: A split-mouth study was conducted in 50 patients diagnosed as chronic periodontitis with pocket depth ≥6 with at least one site in each quadrant. All patients underwent scaling and root planning. Test site received with ofloxacin incorporated L-PRF and control site received L-PRF alone. Clinical parameters pocket depth (PD), plaque index (PI), and gingival bleeding index (GBI) were recorded at baseline and 1 month after scaling and root planning. Results: In total, 100 sites were treated (50 test group and 50 control group) with no uneventful healing effects. Statistically significant decreases in PD (P = .0001 for both test and control groups), PI (P = .001), GBI (P = .001 for both groups), between pre-treatment and 1 month post-treatment were noted in both test and control groups. For intergroup comparisons, there was a statistically significant difference in all clinical indices (P &gt; .005). Conclusion: Use of L-PRF with ofloxacin as an adjuvant to non-surgical periodontal therapy showed better improvements in clinical parameters.

Peripheral Cementoossifying Fibroma - A Case Report and Review

Peripheral cemento-ossifying fibroma is an unusual, localized reactive, benign lesion of the oral cavity that shows various degrees of fibrous maturation and calcification in the histopathology. The lesion is often misdiagnosed, hence appropriate radiographs and histopathological examination are crucial for its correct diagnosis and management. The lesion has a high recurrence rate. The present report highlights a case of peripheral cement-ossifying fibroma in a 24-year-old female patient who was surgically excised. The growth, however, recurred after 4 months which was then managed by scalpel excision as well as aggressive curettage and root planing.

Stage III Grade A Mandibular Anterior Tooth Periodontitis Treatment

Chronic periodontitis is inflammation caused by periodontopathogenic microorganisms characterized by alveolar bone resorption, loss of attachment and apical migration of junctional epithelium. Non-surgical and surgical periodontitis treatments including curettage are performed to reduce inflammation and form new attachments before flap surgery. The purpose of this writing is to treat periodontitis before flap surgical treatment is carried out. Case report: Female, 39 years old, came to RSGM UMY with complaints of loose lower front teeth and gums that bleed easily when brushing her teeth. The patient had no history of systemic disease. Intra-oral examination at the first visit revealed that the gingiva of the mandibular anterior teeth was reddish, unstippling and loose texture grade 2, OHI 7.3 (poor), PD 8 mm, PI score 30%, CAL 8 mm, and 3 tooth loss due to periodontitis. X-ray results showed resorption of the alveolar bone horizontally in the apical 1/3. DHE treatment plan, scaling and root planning, occlusal adjustment, splinting, curettage, flap surgery. Results: Control 2 weeks after curettage, gingiva was coral pink and PD was reduced. Conclusion: Curettage treatment in periodontitis cases reduces the depth of periodontal pockets and there are changes in clinical attachment levels (CAL) in mandibular anterior teeth. Surgical flap treatment is required in this case after curettage

Periodontal Abscess Occurrence Post Wire Splint Therapy on Mobile Teeth

Tooth mobility is one of the cases of periodontal disease caused by the destruction of the bone that supports the teeth. Stabilization of loose teeth using splinting wire can be one of the treatment options. The use of splinting wire may increase plaque accumulation and is sometimes difficult to clean. Plaque accumulation will cause bacterial invasion into the surrounding tissues of the periodontal pockets which will eventually develop into an inflammatory process. As time goes by, connective tissue destruction and pus formation will occur which eventually leads to a periodontal abscess. Periodontal abscess is a localized accumulation of pus in the gingival wall of a periodontal socket with periodontal tissue destruction. The purpose of this case report is to report the incidence of periodontal abscess after wire splinting application in a case of tooth unsteadiness. A 76-year-old female patient came to RSGM with complaints of feeling uncomfortable because some of her teeth were loose. The complaint has been felt approximately 1 year ago. The complaint was accompanied by pain when used to eat and toothbrushing. Objective examination showed reddish gingiva, rounded interdentals, soft consistency, and unstippling texture on the labial and lingual side of teeth 33, 32, 31, 41, 42 and 43 with BOP (+) at all points. The patient's Oral Hygiene Index (OHI) was 2.16 and PI was 18.67%. Probing depth average was 3 mm, recession was 3 mm, and tooth decay was grade 2. Supportive examination showed horizontal bone destruction in the anterior region of the mandible. The first visit was carried out wire splinting on the lingual part of the loose tooth, at the time of control there was a periodontal abscess on the labial side so the splinting was moved to the labial side. The increase in socket depth and the appearance of periodontal abscesses are caused by plaque accumulation which eventually makes bacteria invade the periodontal tissue. Periodontal therapy really needs to pay attention to the patient's OHI, therefore plaque control and removal of bacterial deposits must be carried out by scaling and root planning regularly and carrying out other periodontal therapies such as curettage if tissue destruction is severe enough

Evaluating the Effects of Diode Laser 940 nm Adjunctive to Conventional Scaling and Root Planning for Gingival Sulcus Disinfection in Chronic Periodontitis Patients

Background: Chronic periodontitis (CP) can lead to the loss of tooth-supporting structures. Scaling and root planning (SRP) is the standard treatment, but lasers may provide additional benefits. This study evaluated a 940 nm diode laser as an adjunct to SRP for CP treatment. Methods: In this split-mouth, randomized clinical trial, 32 CP patients with at least two teeth with a pocket depth of more than 4 mm were treated with regular treatment of SRP plus health education with or without the intervention group. Further, a 940 nm diode laser was applied for the decontamination of the gingival groove. Probing pocket depth, clinical attachment loss (CAL), gingival index (GI), bleeding on probing (BOP), and plaque index (PI) were evaluated at baseline, 4 weeks, and 8 weeks after scaling. The data were analyzed by SPSS software (version 21), where descriptive methods and statistical tests such as the analysis of variance test were used with repeated measurements, and P&lt;0.05 was accepted as statistically significant. Results: All parameters improved significantly in both groups (P&lt;0.05), except for GI, which decreased significantly more with a laser versus SRP alone (P&lt;0.05). The results revealed no other statistically significant between-group differences. Conclusion: The adjunctive diode laser provided limited additional improvements compared to SRP alone over 8 weeks. The significant GI reduction indicated that a diode laser may provide some benefits for enhancing non-surgical periodontal treatment. Larger trials are needed to determine if this extra improvement is clinically meaningful in the long term. Clinical Relevance: Diode laser adjuncts to SRP demonstrated minimal short-term benefits over SRP alone in CP patients. The role of lasers in periodontal therapy requires further study. Trial Registration: IRCT20120215009014N234 (retrospectively registered).

Systemic Observation-Surgical Periodontic Approach In The Management Of Amlodipine Induced Gingival Enlargement

Background: Drug induced gingival enlargement is frequently observed in patients taking three main group of drugs like calcium channel blockers (CCBs), immunosuppressant’s and anticonvulsants. Amlodipine belongs to the dihydropyridine-a third generation calcium channel blockers agents that may cause the side effect of drug-induced gingival enlargement and oral bacteria intervention due to calculus retention. This case report describes the management of gingival enlargement in a hypertensive patient taking amlodipine. Purpose: This case report was aimed to discuss the treatment and maintenance of systemic observationsurgical periodontic approach to restore gingival enlargement. Case Report: A 47-years old man was referred to the Department of Periodontology, Faculty of Dentistry, Airlangga University complaining of swellings and bleeding on his gingiva in all region. He felt very uncomfortable as the swelling interfered while chewing and sometimes there was bleeding spontaneously and halitosis. He had hypertension since 5 years and was on medications Captopril 12,5 mg daily during 4 years and Amlodipine 5mg daily during last 1 year. A provisional diagnosis and systemic observation-periodontal phases treatment were taken to restore gingival enlargement condition. Case Management: Systemic observation of medication use, periodontal phases treatment such as scaling root planning, periodontal surgery as flap surgery, home oral hygiene maintenance, control recall every month during first 3 months were taken. Conclusion: The successful of combination carefully systemic observation-surgery periodontal approach are promising to maintain Amlodipine induced gingival enlargement.

Clinical and Microbiological Evaluation of Diode Laser and Systemic Doxycycline as an Additive to Scaling and Root Planing for Stage II and Stage III Periodontitis Patients.

To assess and contrast the effectiveness of systemic doxycycline and diode laser as supplements to scaling and root planing (SRP) in terms of clinical and microbiological parameters. A total of 33 patients diagnosed with periodontitis stages II and III were included and randomized into group A (SRP + diode laser), group B (SRP + doxycycline), and group C (SRP alone). Selected sites were assessed for clinical and microbial parameters-plaque index (PI), gingival index (GI), pocket probing depth (PPD), relative attachment level (RAL), and colony-forming units (CFUs). Every clinical parameter was noted at baseline and after three months. The arithmetic mean, followed by the standard deviation, was calculated for the required assessment intervals. Analysis of variance (ANOVA) was used to compare all parameters between groups, and if the results of the ANOVA test were significant, post hoc analysis was performed. For intragroup comparison, student t-tests were performed. The clinical parameters significantly improved within three months for all groups. In terms of relative attachment level, a statistically significant difference (P < 0.001) was obtained at the three-month interval compared to the baseline value, with the most statistically significant difference seen in group A (3.36±0.50 to 0.64±0.50), followed by group B (3.18±0.40 to 2.18±0.40). The mean pocket probing depth observed at three months, compared to the baseline value, showed a statistically significant difference (P < 0.001) in group A (5.91±0.70 to 2.18±0.40) compared to group B (6.18±0.75 to 4.36±0.50), followed by group C (5.82±0.75 to 5.27±0.64). The use of diode laser-assisted pocket disinfection and systemic doxycycline, in addition to scaling and root planing, has proven to be efficient for treating periodontal pockets.

Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split-mouth randomized clinical trial.

The aim of this study was to assess the efficacy of photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) on clinical parameters and microbial composition in subgingival plaque of periodontitis patients. Seventeen patients were included in this split-mouth randomized clinical trial. Sites with probing pocket depth (PPD) ≥5mm in combination with bleeding on probing in different quadrants were randomized into the control group, the group with a single PDT application right after SRP, and the group with three repeated PDT applications 1week after SRP. The subgingival plaque was collected for 16S rRNA gene sequencing at baseline, Week 2, and Week 8. Seventeen patients with 60 sites completed this 8-week follow-up, and 157 subgingival plaques were successfully analyzed by sequencing. Significant improvements were observed in two primary outcomes: PPD at Week 8 and subgingival microbial composition. Compared to the control group, the repeated-PDT group showed a notable improvement in PPD, substantial alterations in the microbial profile, including a reduction in α-diversity and anaerobic bacteria, and an increase in aerobic bacteria at Week 2. Secondary outcomes, such as clinical attachment level and sulcus bleeding index, also showed improvement at Week 8. Furthermore, both the single- and repeated-PDT groups exhibited a decrease in periodontopathogens and an increase in beneficial bacteria compared with baseline. PDT promotes changes in the microbial composition of periodontitis patients' subgingival plaque in a direction favorable to periodontal health, and repeated PDT is a promising adjunctive therapy for periodontal treatment.

Radiographic evaluation of the S2-complex drug on the alveolar bone height

The S2-complex drug is a chemical preparation of a low molecular weightsynthetic organometalic complex, and it has experimented in many researches to proveit’s activity in the treatment of the cancerous tumors, without any side effects. This drugis a potent immunomodulat or that stimulates both, the humoral a.nd cell mediated,immune responsesTo examine the effect of S2—complex administered locally and was designed totest the potential effectiveness of S2-complex in the management of periodontal disease.associated bone loss by radiographic evaluationThirty six pairs of similarly involved periodontal pockets in (20) patients agedbetween (30-50) years old with pocket depth more than 6 mm were selected. Split mouth,randomized study was carried out. Scaling and root planing was carried out in both sidesin test side received S2- complex for five days in a daily dose of O.l mm/kg injecteddeeply until reaching the bone of affected site, while the control side was received distalwater for 5 days in a daily dose of 0.l mm/kg injected in the same way as that for testside. S2 complex was infiltrated locally through the gingival tissue of the effected site.deeply until reach the defect bone using disposable insulin syringesClinical attachment level of gingiva were recorded at baseline and repeatedonce every 2 weeks. Periapical radiographs were taken for both test and control sides atbaseline and at the termination of the treatment after 2 months. A long the time of study,the patients put on a program of motivation to keep a good stander of oral hygieneClinical and radiographical parameters in general showed improvement with both test.and control groups, with a statical significant difference between themRadiographical evaluation showed high differences in hight and density of bone forboth groups, and effect to S2-complex was on sites of anterior and molar areas according

Roduction of Polyvinyl Pyrrolidone (PVP) in the non surgical periotherapy of aggressive periodontitis

The non surgical periotherepy are based on the baeteriologic back ground ofperiodontal diseases. More than 46 different verulant species were composing thebacterial flora. Tetracyclin , Doxycyline , Minocyline were used systemically and / ortopicaly in association with conventional scaling and root planning , as wellchlorhixidine and wide variety of antiseptics were used . Generalized and localizedaggressive periodontitis being a complex disease showing a specific entity and acomplex bacterial flora, a curative non surgical remedy not yet well realized. The,polyvinyl pynolidone (PVP) a highly effective wide broad spectrum bactericidalfungycidal and virocidal antiseptic used in low concentration (3%) as an intrapocketirrigation solution accompanied with conventional ultrasound scaling and rootplanning . Eight patients having aggressive were involved in this study, 12 therapeuticsessions were performed during 6 months. Once a week , in the first month , twice amonth in the next 3 months , then once a month in the later 2 months . The resultshowed a significant improvement of the clinical parameters, gingival bleeding indexGBI), clinical pocket depth (CPD) , and clinical tooth mobility (CTM) , with(. radiologic evidences of bone formationThe result suggests that PVP could be the promising effective, save clinically. applicable , easy to use , and cheap remedy of complex periodontal diseases

Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study.

The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth. The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed. The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third. On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent. Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay.

The study aims is to evaluate the antibacterial effect of vitamin D3 against the red complex bacteria, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia in chronic periodontitis patients. The study comprised 98 participants with chronic periodontitis. All clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and a microbiological assay of P. gingivalis, T. denticola, T. forsythia were assessed at the baseline. All study participants who underwent scaling and root planning were divided into two groups, A and B, each with 49 patients and only group B patients were advised to take vitamin D supplementation of 60,000 IU granules, once daily for 2 months. All the patients of both the groups were recalled at the end of 2nd month and all the clinical and microbiological parameters were reassessed. After two months, there was a reduction in all the clinical markers in both groups, but the group B patients showed more improvement following non-surgical treatment vitamin D intake. There was also a statistical reduction in P. gingivalis, T. denticola, and T. forsythia following administration of vitamin D in group B patients compared to group A. These discoveries proposed that vitamin D has a superb antimicrobial impact against red complex periodontal microbes and might be considered a promising compound in the counteraction of periodontal disease. Vitamin D is considered to possess anti-inflammatory and antimicrobial activity, which may help to delay the progression of periodontitis. So, vitamin D3 can be used as a potential supplement that could be employed to stop the advancement of periodontal disease. How to cite this article: Govindharajulu R, Syed NK, Sukumaran B, et al. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024;25(2):114-117.