Scaling And Root Planing Group Research Articles

Efficacy of Laser-Assisted Periodontal Therapy vs Conventional Scaling and Root Planing

ABSTRACT Background: This study compares the effectiveness of laser-assisted periodontal therapy (LAPT) to conventional scaling and root planing (SRP) in the treatment of periodontal disease Materials and Methods: Patients with periodontal disease were divided into two groups. One group received LAPT, while the other group underwent conventional SRP. The periodontal parameters, including pocket depth (PD) and clinical attachment level (CAL), were measured before and after the treatments. The data were statistically analyzed using appropriate methods. Results: After the treatments, the LAPT group showed a mean reduction in PD of 2.5 mm, while the conventional SRP group had a mean reduction of 2.0 mm. Additionally, the laser group demonstrated a mean improvement in CAL of 1.8 mm, whereas the conventional group showed an improvement of 1.3 mm. These differences were statistically significant (P < 0.05) Conclusion: The findings of this study suggest that LAPT may be more effective in reducing PD and improving CAL compared with conventional SRP in the treatment of periodontal disease.

Clinical evaluation of a novel protocol for supportive periodontal care: A randomized controlled clinical trial.

The aim of this study was to compare the clinical efficacy and the patient perception of subgingival debridement with either guided biofilm management (GBM) or conventional scaling and root planing (SRP) during supportive periodontal care (SPC). Forty-one patients in SPC were randomly assigned to either treatment with GBM or SRP every 6 months. The primary outcome was the percentage of bleeding on probing (BoP) at 1 year. Moreover, pocket probing depths (PPD), recession, and furcation involvements were also measured. Full-mouth and specific site analyzes were performed at baseline, 6 and 12 months of SPC. Patient comfort was evaluated using a visual analogue scale (VAS) at 12 months. At 1 year, mean BoP percentage decreased from 12.2% to 9.0% (p=0.191) and from 14.7% to 7.9% (p=0.004) for the GBM and SRP groups, respectively. Furcation involved multirooted teeth but no through-and-through lesions were significantly fewer in the GBM than in the SRP group after 12 months (p=0.015). The remaining parameters showed slight improvement in both groups without any statistically significant differences between the two groups after 1 year. Pain evaluation as patient reported outcome measures (pain evaluation) was in favor (p=0.347) of the SRP group, while overall satisfaction was similar for both groups. Treatment time was not statistically significantly different between the two groups (p=0.188). In well-maintained SPC patients, SRP protocols resulted in significant clinical improvements in terms of BoP; however, for the other clinical improvements, similar efficacy for both GBM and SRP was observed.

Adjunctive effect of 470-nm and 630-nm light-emitting diode irradiation in experimental periodontitis treatment: a preclinical study.

This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.

Antimicrobial Photodynamic Therapy with Photosensitizer Improved the Gingival Collagen, Oxidative Status and Protect the Bone in Short Term Experimental Periodontitis

Objectives: To evaluate the influence of antimicrobial photodynamic therapy (aPDT) with methylene blue (MB) dissolved in ethanol used as an adjunct to scaling and root planing (SRP) in periodontitis treatment on bone loss, collagen fibers and gingival oxidative status.&#x0D; Methods: Wistar rats were randomly randomized in five experimental groups according to the periodontal treatment: NC (negative control; no periodontitis); PC (positive control; periodontitis without any treatment); SRP (periodontitis and SRP), aPDT I (periodontitis and SRP+aPDT+MB solubilized in water), and aPDT II (periodontitis and SRP+aPDT+MB solubilized in ethanol 20%). To induce the experimental periodontitis, one mandibular right first molar of each animal received the cotton ligature in a submarginal position. The periodontal treatments were performed after 7 days of ligature removal.&#x0D; Results: PC group had more bone loss compared to the other groups. SRP and aPDT I groups showed equivalent bone losses and the aPDT II group showed bone loss similar to the aPDT I group, smaller than the PC and SRP groups on the 7th day. PC and SRP groups showed higher gingival lipoperoxidation levels on the 7th day, but only the PC group exhibited higher gingival lipoperoxidation on the 15th day. Besides, it indicated an aPDT II protective action on the gingiva on the 7th day observed by the maintenance of the gingival glutathione (GSH) levels similar to NC group. The aPDT treatments were able to prevent gingival collagen degradation with 7 days of treatment.&#x0D; Conclusions: aPDT can act as a beneficial adjuvant tool to minimize bone loss, collagen degradation and periodontitis-induced oxidative damages. Therefore, it is possible to suggest that the short-term aPDT causes beneficial responses accelerating periodontal healing.

A Comparison between Scaling and Root Planning (SRP), Antibiotic and Diode Laser Application in Treatment of Localized Juvenile Periodontitis (Microscopical Study)

The present study aimed to study different ways for treatment of Localized Juvenile periodontitis, cultural and microscopic results of specimens from base line, appeared the following bacterial strains: Bacteroides gracilis ,Fusobacterium nuclautum, Porphyromonas intermedia, Actinomyces, peptostreptococcus species, eikenella corrodens, streptococcus intermedius, Streptococcus salivaris. Which distribution in 50% gram positive and 50% gram negative. Cultural and microscopical result after ten days of the experimental design appeared significant difference P≥ 0.05, at the SRP group results of microscopic and culturing show Peptostreptoccal species, Prevotella intermedia, Fusobacterium nuclautum, Streptococcus Saliveris. While at the SRP and antibiotic treated group (Doxycyclin 100 mg) the pattern of microbial study appeared the following bacteria: Fusobacterium nucleotum, Peptostreptococcus, Streptococcus salivaris. At the other hand the results of third group SRP and diode Laser appeared no growth of microorganism at all site subjected to Laser 0.8 w, 940 nm for 20 sec after ten days of study.

Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis

AimsTo evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. MethodologyIndividuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro‑aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. ResultsThe mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). ConclusionCombined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.

Indocyanine green-mediated antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment: a systematic review and meta-analysis.

Indocyanine green-mediated antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment: a systematic review and meta-analysis.

The effects of adjunctive use of a desiccant agent in the treatment of stage III periodontitis (Randomized controlled clinical trial)

IntroductionSeveral bacterial species inhabiting the dental plaque biofilms are associated with periodontitis. ObjectiveThe main objective of this study was to compare the efficacy of the desiccant agent HYBENX (HBX) as an adjunct to scaling and root planning (SRPX) versus scaling and root planning (SRP) alone in the treatment of periodontitis. Materials and MethodsThe study sample comprised 25 patients with periodontitis stage Ш (grades A and B). Each maxillary quadrant was randomly allocated to two groups: SRPX group, including 25 quadrants treated with SRP plus HYBENX, and SRP group, including 25 quadrants treated with SRP alone. The following clinical periodontal parameters were recorded at baseline (immediately after treatment, T0), and 1 month (T1), 3 months (T3), and 6 months (T6) after treatment: probing pocket depth (PPD), relative attachment level (RAL), plaque index (PLI), gingival index (GI), gingival height (GH), and bleeding on probing index (BOP). ResultsComparisons within each study group showed that all clinical parameters significantly improved (P < 0.001) at all follow-up intervals. In contrast, a statistically significant difference (P < 0.001) was observed in RAL, PPD, BOP, and GI indices at all follow-up intervals between the SRPX and SRP groups. In contrast, no significant differences (P > 0.05) were found in GH and PLI between the study groups. ConclusionBoth treatment groups showed improved periodontal parameters. However, applying desiccant gel as an adjunct to SRP was significantly effective in the treatment of stage III periodontitis.

Short-Term Efficacy of Er:YAG Laser and Nd:YAG Laser Combined Therapy on Periodontitis.

Objective: The objective of this research is to assess the short-term efficacy of combined erbium-doped: yttrium aluminum and garnet (Er:YAG) and neodymium-doped: yttrium aluminum garnet (Nd:YAG) lasers for the nonsurgical treatment of periodontitis, providing a reliable basis for whether this clinical treatment can be applied in clinical practice. Materials and methods: Thirty patients with periodontitis are chosen for this study. A split-mouth design was used; the left and right quadrants of the oral cavity are randomly assigned to one treatment: combined Er:YAG laser and Nd:YAG laser treatment (laser group) or scaling and root planing (SRP) group. Data on probing depth, clinical attachment level, bleeding index, and subgingival plaque and gingival crevicular fluid samples are collected in the basement, for 1 and 3 months. The levels of red complexes in subgingival plaque and cytokines in gingival sulcus fluid were measured by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Results: At 1 and 3 months of follow-up, all clinical parameters in the two groups are significantly improved; there is a statistically remarkable difference between the laser group and SRP group (p < 0.001). Matrix metalloproteinase 8 levels in the laser group are notably lower than those in the SRP group 3 months after treatment (p < 0.001). At any point in time, the levels of red complexes in the laser group showed no additional advantage over those in the SRP group (p > 0.05). Conclusions: Er:YAG laser and Nd:YAG laser combined therapy on periodontitis have advantages in controlling periodontal inflammation and improving clinical symptoms.

The Effects of 810 nm Diode Laser and Indocyanine Green on Periodontal Parameters and HbA1c in Patients with Periodontitis and Type II Diabetes Mellitus: A Randomized Controlled Study.

The aim of this study was to investigate the effects of adjunctive periodontal therapy of 5 mg/mL indocyanine green irradiation by an 810 nm diode laser (aPDT), supplementary to scaling and root planing (SRP) in patients with periodontitis and type II diabetes mellitus (DM) compared to the SRP alone, on periodontal clinical parameters and glycated hemoglobin A1c (HbA1c). The study was conducted on 49 subjects with type II DM and periodontitis, divided into two groups: the SRP group (n = 25), who followed SRP alone, and the SRP + aPDT group (n = 24), who followed SRP and four weekly sessions of indocyanine green irradiation by an 810 nm diode laser. Plaque Index (PI), Bleeding on Probing Index (BOP), probing depth (PD), clinical attachment loss (CAL) and HbA1c were investigated at baseline and after 6 months. At 6 months, both SRP alone and SRP + aPDT generated significant reductions in all the investigated parameters; SRP + aPDT produced more significant reductions for BOP, PD and CAL (p < 0.001) but not for PI and HbA1c, than SRP alone. aPDT with indocyanine green therapy was well tolerated, with two subjects reporting slight discomfort. Therefore, aPDT with indocyanine green might represent a good adjunctive periodontal treatment option for SRP in patients with type II DM and periodontitis.

A STUDY OF CHLORHEXIDINE CHIP IN THE TREATMENT ALONE IN INDIVIDUALS WITH PERIODONTITIS

Aim: The aim of this study was to clinically evaluate the use of biodegradable chlorhexidine chip when used as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe periodontitis patients. The study also intended to compare the combined therapy (SRP and Chlorhexidine chip) with chlorhexidine chip alone in individuals with periodontitis. Fifteen patients with three sitesMaterials and Methods: having a probing depth of 5-8mm were considered for the study. Sites were numbered 1, 2, 3 randomly. The clinical parameters assessed were the Plaque Index (PI), gingival index (GI), Bleeding on probing (BOP), Clinical attachment level (CAL) and Probing pocket depth (PPD). Following baseline evaluation, on two sites scaling and root planing (SRP) was performed, no treatment was carried out in the third site. Chlorhexidine chips were placed on one site with SRP and another without SRP. A periodontal pack was placed on the site to prevent dislodgement of the CHX chip. Clinical parameters were recorded at baseline, one month and three months. Duration of the study was for three months. All three groupsResults: presented with an improvement in the clinical parameters compared to baseline. There was no statistically signicant difference between the SRP and SRP + CHIP group in all parameters. There was a signicant difference when these two groups were compared to the chip alone group. The mean reductions in PPD were 2.9mm (SRP group),2.5(SRP+CHIP group), 0.9 (chip alone group) The mean gain in CAL were 2.9mm (SRP group), 2.7 (SRP+CHIP group), 0.6 (chip alone group). Reduction in bleeding on probing were signicant for the SRP and SRP +CHIP group but not for the chip alone group. The CHX chip did not provide any clinical benet beyond that achieved with conventional scaling and rootplaningConclusion: after a three month period.

Effect of Locally Delivered Minocycline on the Profile of Subgingival Bacterial Genera in Patients with Periodontitis: A Prospective Pilot Study.

This prospective pilot study aimed to evaluate the effect of minocycline-HCl ointment (MO), locally delivered as an adjunct to scaling and root planing (SRP), on subgingival microflora. A total of 59 periodontitis patients received SRP as an initial periodontal therapy. In the selected periodontal pockets with probing depths (PD) of 6–9 mm, the sites that exhibited a positive reaction following a bacterial test using an immunochromatographic device were subsequently treated with MO (SRP + MO group, n = 25). No additional treatment was performed at sites showing a negative reaction (SRP group, n = 34). In addition to subgingival plaque sampling, measurement of clinical parameters including PD, clinical attachment level (CAL), bleeding on probing (BOP), plaque index and gingival index (GI) were performed at baseline and 4 weeks after the initial periodontal therapy. The subgingival microflora were assessed by terminal restriction fragment-length polymorphism analysis. Relative to baseline values, the mean scores for PD-, CAL-, BOP-, and GI-sampled sites were significantly decreased post treatment in both groups (p < 0.01). The intra-comparisons showed a significant decrease in the counts of the genera Eubacterium, Parvimonas, Filifactor, Veillonella, Fusobacterium, Porphyromonas, Prevotella, and unknown species in the SRP + MO group (p < 0.05). Inter-comparisons indicated a significant decrease in the genera Veillonella in the SRP + MO group (p = 0.01). Combination therapy of SRP and local MO induced a change in the subgingival microbial community: particularly, the number of Veillonella spp. was markedly reduced.

Antioxidant Effects of Curcumin Gel in Experimental Induced Diabetes and Periodontitis in Rats.

This study aimed to evaluate the effect of curcumin gel on antioxidant marker level in experimental induced diabetes and periodontitis (EDP) in rats. Adult Wistar rats were randomized into five groups (20 each): (1) EDP treated with scaling and root planing (SRP) + curcumin gel (CU), (2) EDP treated with CU, (3) EDP treated with SRP, (4) EDP without treatment, and (5) systemically healthy and without ligature (control). Each group was subdivided equally into 4 subgroups of 5 rats. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ), and periodontitis was induced by a ligature. Blood samples were collected by cardiac puncture at 0, 7, 14, and 21 days to assess oxidative stress of malondialdehyde (MDA) and antioxidant enzymes of glutathione peroxidase (GPx), catalase (CAT), and suproxidase dismutase (SOD) levels. The results showed a significant increase in serum MDA and antioxidant enzyme levels in the untreated EDP group compared to the control group (p < 0.05). The adjuvant use of CU to SRP resulted in a significant reduction of MDA and CAT levels as compared to the SRP group (p < 0.05); however, significant reduction of GPX and SOD levels can be found only at day 7. It can be concluded that the decreased level of antioxidant enzymes can be construed as a result of decreased oxidative stress by curcumin therapy.

DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

This study aimed to evaluate the impact of different periodontal treatment strategies during pregnancy on perinatal outcomes. This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines to assess the effect of mouthwash in addition to scaling and root planning (SRPM) on pregnancy outcomes, including preterm birth, low birth weight, gestational age, and birth weight. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated using the random effect model. Twenty trials involving 5938 participants, including thirteen trials comparing scaling and root planning (SRP) and seven trials comparing SRPM with control groups. SRPM was associated with reduced risk of preterm birth (RR = 0.37; 95%CI = 0.16-0.84; P = .017; I2=93.26%; P < .001; number needed to treat (NNT): 3), low birth weight (RR = 0.54; 95%CI = 0.40-0.74; P < .0001; I2 = 0%; P = .46; NNT: 13), increased gestational age (MD = 0.78; 95%CI: 0.19-1.37; P = .009; I2 = 87.15%; P < .001), and birth weight (MD = 121.77; 95%CI = 3.19-240.34; P = .044; I2 = 80.68%; P < .001). There were no statistically significant differences in the analysis of SRP group, except for the increased birth weight (MD = 93.85; 95% CI = 3.27-184.42; P = .042; I2 = 84.11%; P < .001). Using mouthwash in addition to scaling and root planning (SRPM) for the treatment of periodontal disease during pregnancy significantly improves perinatal outcomes.

Evaluation of GCF IL-17, IL-10, TWEAK, and sclerostin levels after scaling and root planing and adjunctive use of diode laser application in patients with periodontitis.

The aim of the present study was to evaluate the clinical efficacy of the diode laser as an adjunct to scaling and root planing (SRP) and also determine the biochemical profile by evaluating the gingival crevicular fluid (GCF) levels of interleukin (IL)-17, IL-10, tumor necrosis factor-related weak inducer of apoptosis (TWEAK), and sclerostin. A total of 40 systemically healthy, patients with Stage III periodontitis were included in this randomized controlled study. Participants were randomly divided into two groups as SRP + diode laser (L) (0.80W power, 940nm wavelength and 0.80J/s energy level) and only SRP group. Recording of periodontal parameters and collecting GCF samples were performed at baseline, first and 3rd months. Biomarker levels in GCF were measured with ELISA RESULTS: At baseline, no significant difference was detected between groups in terms of both clinical and biochemical parameters. All biochemical parameters (except for IL-10 in control group), presented a statistically significant difference for 3 months study period in both groups. When laser and control groups were compared, significant differences were not observed, except the lower GCF IL-17 levels (P=0.025), bleeding on probing (P=0.028), and clinical attachment level (CAL) (P=0.0002) values in laser group at third, first, and third months, respectively. Statistically significant correlations were also noted between biochemical parameters and clinical parameters. The GCF IL-17, TWEAK, and sclerostin levels may be useful for monitoring response to SRP+L therapy. However, long-term studies on higher populations are needed to evaluate the effectiveness of adjunctive use of diode laser application to SRP.

Systemic and local effects of doxycycline and low-intensity laser treatment on periodontitis in rats.

PurposeThis study evaluated the systemic and local effects of doxycycline (DOX) and low-intensity laser (LIL) treatment as adjuvants to scaling and root planing (SRP) in the treatment of experimental periodontitis in rats.MethodsThe sample consisted of 180 male rats (Rattus norvegicus albinus, Wistar), of which 30 did not receive induction of periodontal disease (negative control [NC] group) and 150 received induction of periodontal disease in the lower first molar. After 7 days, the ligature was removed, and the animals were divided into the following groups: NT (no treatment), SRP (SRP), DOX (SRP and DOX irrigation), LIL (SRP and laser irradiation), and DOX+LIL (SRP, DOX, and LIL). The animals were euthanized at 7, 15, and 30 days; thereafter, biochemical, radiographic, histological, and immunohistochemical analyses were performed.ResultsIn the intragroup analysis, lower concentrations of α-1-glycoprotein acid (α-1-Ga) and complement 3 (C3) were observed in the DOX+LIL group than in all other groups at all time points, as well as lower levels of complement 4 (C4) at 15 and 30 days (P<0.001). Less bone loss was observed in the DOX, LIL, and DOX+LIL groups than in the NC and SRP groups at all time points (P<0.001). There was a smaller number of tartrate-resistant acid phosphatase (TRAP)-positive cells in the DOX+LIL group than in the other groups at all time points (P<0.001). Positive correlations were observed between the systemic levels of α-1-Ga, C3, and C4 and the number of TRAP-positive cells.ConclusionsThe combination of DOX with LIL as SRP adjuvants was effective both systemically and locally for the treatment of experimental periodontitis in rats.

Effects of l-arginine and l-ornithine supplementations on the treatment of chronic periodontitis: A preliminary randomized short-term clinical trial

The growing interest in the possibilities of modulating macrophages in inflammatory diseases with therapeutic purpose has prompted the development of new approaches for the treatment of periodontitis. This randomized add-on open preliminary clinical study evaluated the short-term effects of L-arginine or L-ornithine as an adjuvant to scaling and root planing (SRP) in patients with chronic periodontitis. Materials and methodsSeventy-five periodontitis patients were recruited and monitored clinically and immunologically at baseline (before SRP) and 30 ± 5 days after SRP. All patients were assigned by stratified randomization to SRP (SRP only, n = 25), Arg (SRP + L-arginine, n = 25) or Control (SRP + L-ornithine, n = 25) Group. The medicines were used according to available instructions for 10 and 15 days, respectively. During the study, all patients were on a stable diet, without changing their rations and regiments. As immunological monitoring immunohistochemical study of CD68+ and CD163 + single positive gingival macrophages for 5 patients per group in the same time-point was conducted. The data were statistically analyzed. ResultsReduction of periodontal pocket depth (PPD) and bleeding on probing (BoP) was observed in all groups, with significant between-group differences for BoP in the Arg Group (p < 0.0001) at 30 days. The SRP and Arg groups demonstrated nonsignificantly increased density of CD68+ and CD163 + cells. The Orn Group showed an increase in the density of CD68+ and CD163 + macrophages at intragroup (p = 0.0066 and p < 0.0001) and between-group levels (p = 0.001 and p < 0.0001), and these changes corresponded to clinical PPD and BoP reduction. In the Arg and Orn groups at 30 days, CD163 + macrophages significantly predominated over CD68+ (p = 0.013, p < 0.0001). ConclusionThe use of L-arginine and L-ornithine as an adjunct to SRP promotes additional limited immunological benefit in the treatment of periodontitis. Metabolic stimulation with L-ornithine, but not L-arginine, is preferable for CD163+ Mφs subpopulation in periodontitis-affected gingiva.

English

BACKGROUND Almost 47 % of the population over the age group of 30 is affected by chronic periodontitis. Although the first and gold standard therapy in periodontal treatment is scaling and root planing (SRP), which is a non-surgical approach towards treatment, yet another therapy for the treatment of chronic periodontitis is to irradiate the periodontal pockets with laser. The purpose of this study was to confirm as to whether the use of diode laser (800 – 980 nm) as adjunct to scaling and root planning (SRP) improved the results of conventional mechanotherapy in the treatment of chronic periodontitis patients. METHODS In this study we designed our groups in such a way that 40 patients (20 males and 20 females) with two deepest nonadjacent pockets ≥ 5mm in two different quadrants were selected. In this study each treatment group belonged to a separate quadrant of the mouth. One group was allotted to SRP group while the second one was allotted to SRP + Diode Laser group. Clinical parameters like (Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) in chronic periodontitis patients were measured and evaluated at baseline, after 1 month and after 3 months of the treatment. Statistical analysis was also done intra group and inter group. RESULTS From this we infer that PPD was significantly reduced in SRP and SRP + Diode laser groups from baseline and post 1 month (P &lt; 0.001), between baseline and post 3 months (P &lt; 0.001) and between 1 month and 3 months (P &lt; 0.001). There was also significant improvement in CAL in SRP and SRP + Diode Laser groups from baseline and post 1 month (P &lt; 0.0001), between baseline and post 3 months (P &lt; 0.0001) and between 1 month and 3 months (P &lt; 0.0001). BOP also reduced in SRP and SRP + Diode Laser group from baseline. When SRP and SRP + Diode laser groups were compared they showed non statistically significant results but individually both the groups showed statistically significant results. CONCLUSIONS The results of the present study indicate that, comparison of SRP alone group which is a conventional method with SRP as adjunct to Diode laser group i.e., a non-surgical approach showed improvement of CAL and also reduction in PPD and BOP for the treatment of chronic periodontitis patients. KEY WORDS Periodontitis, Laser, Scaling and Root Planing, Adjunct Therapy, Diode Laser

Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study

BackgroundThe aim of this study was to compare, through clinical and microbiological analysis, the use of multiple applications of aPDT as an adjuvant therapy to non-surgical periodontal treatment of stage III and IV grade C periodontitis in type 2 diabetic (DM2) patients. MethodsThirty-four patients with non-compensated DM2 and periodontitis were randomly divided into two groups: SRP Group (n = 17): scaling and root planing (SRP); and SRP+aPDT Group (n = 17): SRP followed by 3 consecutive aPDT applications, immediately, 48 and 96 h after in pockets with probing depth (PD) ≥5 mm. In SRP+aPDT, after 1 min of irrigation with methylene blue (10 mg/ml), the sites were irradiated with a 660 nm diode laser for 50 s (157 J/cm2, 4.7 J, 100 mW). Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) were quantified by real-time qPCR. Periodontal clinical and microbiological data (baseline, 90 and 180 days) were statistically analyzed (α = 5%). ResultsThere was a significant reduction in PD and bleeding on probing at 90 and 180 days post-treatment in both groups (p<0.05). The SRP+aPDT group presented a significant reduction in the number of residual pockets at 90 and 180 days (p<0.05). The SRP+aPDT group presented reduced PD means in deep pockets 180 days post-treatment (p<0.05). No differences were observed in P. gingivalis and P. intermedia levels (p>0.05). ConclusionThe results of present study indicate that the use of multiples aPDT sessions as adjuvant therapy in the periodontal treatment of uncompensated diabetic patients with periodontitis promotes additional clinical benefits.

Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis.

Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis.