Root Planing Research Articles

A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique in the treatment of intrabony defects: a retrospective cohort study

BackgroundGingival recession and post-operation discomfort are still a problem for patients receiving the periodontal regeneration surgery for intra-bony defects. To further reduce the trauma and the post-operation gingival recession, a novel periodontal endoscopy-aided non-incisional regeneration technique (NIT) was proposed in the treatment of intra-bony defects.MethodsRetrospective analysis of 21 subjects treated with NIT and 21 subjects with periodontal endoscopy-aided scaling and root planing (PSRP) at baseline and 1-year evaluation was conducted. After removing the subgingival calculus and granulation tissue, bone grafting materials were placed into intrabony defects with the assistance of a gingival retractor in the NIT group. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as the distance between bone crest (BC) level and base of the defect (BD) (intrabony defect depth, IBD) were evaluated at baseline and 1 year after treatment.ResultsAt 1-year follow-up, the value of CAL, PD and IBD were statistically significant different compared with baseline in both two groups (p<0.001). CAL gain (p = 0.012) and PD reduction (p = 0.004) was greater in the NIT than PSRP. However, no difference in the IBD reduction was found between the NIT group and PSRP. Better CAL gain and PD reduction was achieved in the 1-year term in the NIT when compared with PSRP.ConclusionNIT have resulted in significant gains in both clinical and radiographic parameters. NIT might be utilized as an alternative of the surgical treatment for periodontal intrabony defects.Trial registrationThis clinical trial registration was registered retrospectively (August 3, 2023) and the number is ChiCTR2300074317.

The effect of non-surgical periodontal therapy on HbA1c levels: A systematic review

Objective: The purpose of the present article is to summarize the evidence present in systematic regarding the non-surgical periodontal therapy effects on HbA1c levels.&#x0D; Methods: Our study considered the consultation of the bibliographic databases "Medical Systematic Analysis and Retrieval System". The research was carried out by using the keywords: "Diabetes mellitus" AND "Periodontal disease" AND "Scaling and root planing" AND "Non-surgical periodontal treatment" AND "Glycosylated hemoglobin".&#x0D; Our research resulted in 18 articles published between 1995 and 2018.&#x0D; Results: All studies have shown that periodontal indices have improved after non-surgical periodontal therapy, while the effects on metabolic control are controversial. Some authors find no influence on metabolic variables, others report an improvement. Some studies have used both topical and systemic antibiotics in combination with causal periodontal therapy, observing an improvement in metabolic compensation.&#x0D; Conclusion: The approach to diabetic patient with periodontitis must be multidisciplinary with close collaboration between periodontists, dental hygienists and endocrinologists.

Comparative oral health outcomes before and after periodontitis treatment: Scaling and root planning alone versus Nd: YAG Laser Assisted New Attachment Procedure.

Abstract Introduction: Periodontitis is a multifactorial condition that impacts the support tissues of the teeth. The purpose of the research was to correlate the results obtained in the treatment of patients with at least stage II periodontitis by scaling and root planing alone (SRP), or by the laser-assisted new attachment procedure (LANAP), and to assess the outcomes and patients' perceptions regarding the influence of these therapies on their quality of life by using The Oral Health Impact Profile-14 (OHIP-14) questionnaire. Materials and methods: The oral cavities of 15 patients were divided into quadrants, and, according to the inclusion and exclusion criteria, two quadrants were allocated to one of the groups after the effectuated therapy: SRP or LANAP. The patient’s periodontal status (VPI, PPD, BOP, and CAL) was assessed and filed in a periodontal chart at baseline and 6 weeks after the implementation of the treatments, along with the OHIP-14 questionnaire. SRP was conducted for the first group of patients, in the selected quadrant and in the two remaining quadrants that were not included in the study. The LANAP protocol was applied to the quadrant belonging to the second group (LANAP) using a 1064 nm Nd: YAG laser (Lightwalker AT-S, Fotona®, Slovenia). Results: The results showed that both noninvasive treatments are effective in diminishing VPI, PPD, BOP, and CAL in periodontal patients, and the scores obtained 6 weeks after the end of the periodontal treatments determined the improvement of the patient's perception in the questionnaire. Conclusion: Both the association of the Nd: YAG laser with scaling and root planing (LANAP) and SRP alone provided safe and efficient outcomes, resulting in high levels of satisfaction among patients at 6 weeks after treatment.

Diode laser targeting red-complex bacteria in periodontitis: a systematic review.

This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.

Antibacterial test of Peperomia pellucida (L.) Kunth extract against Porphyromonas Gingivalis as a potential herb for periodontitis: a laboratory experiment

ABSTRACTIntroduction: Periodontitis is a multifactorial inflammatory disease which is generally caused by plaque accumulation. Many studies have shown that Porphyromonas gingivalis (Pg) is the main etiological agent that contributes to chronic periodontitis. Scaling and root planing (SRP) is the gold standard for periodontitis treatment. The use of antibiotics as additional agents accompanying the SRP procedure has limitations that can cause resistance to subgingival periodontal pathogens. Peperomia pellucida (L.) Kunth i.e betel leaf is a natural ingredient that contains anti-inflammatory, antibacterial and antioxidant properties. This study aimed to analyze the inhibition of Peperomia pellucida (L.) Kunth extract against Pg bacteria. Methods: The type of study used was an experimental laboratory with a Post-Test Control Group Design research design which was divided into 6 treatment groups using the disk diffusion method with concentrations of Peperomia pellucida (L.) Kunth extract 25, 50, 75 and 100%, sterile aquades as a negative control and Chlorhexidine as a positive control. Data analyses of One Way Anova and Post Hoc Tukey were used Results: Peperomia pellucida (L.) Kunth extract concentrations of 25, 50, 75, and 100% had an effect on reducing the growth of Porphyromonas gingivalis (p≤0,05), the average inhibition response was 14.40 mm at 25% concentration, 16.58 mm at 50% concentration and 19.30 mm at 75%, 21.88 mm at 100% concentration.Conclusion: Peperomia pellucida (L.) Kunth extract has an antibacterial effect against Porphyromonas gingivalis which has the potential to be used as a periodontitis herb.Keywords: Betel leaf extract Peperomia pellucida (L.) Kunth, periodontitis, Porphyromonas gingivalis.

Effectiveness of Probiotic Therapy in the Management of PeriodontalDisease in Diabetic Patients: A Scoping Review.

Probiotics can compete with periodontal pathogens in the formation of dental biofilm, and they are able to modulate local and systemic immune responses. Thus, its use in diabetic patients with periodontal disease (PD) can overcome the limitations of conventional periodontal treatment. This scoping review aimed to understand the extent and type of evidence in relation to the effects of probiotic therapy on periodontal and glycaemic parameters of diabetic patients with PD. An electronic search was performed in the following databases: Cochrane Library, EMBASE, Virtual Health Library (including LILACS and BBO), PubMed (including Medline), Scopus, Web of Science, and Google Scholar. The review included clinical trials on patients with type 2 diabetes, diagnosed with gingivitis or periodontitis, who received probiotic therapy as a single therapy or adjuvant to scaling and root planning, and on whom the analyses of clinical periodontal, immunological, microbiological, or glycaemic parameters were performed. The electronic search yielded a total of 1165 articles. After removing duplicate titles and performing systematic screening, 6 studies were included in the qualitative summary. Probiotic administration improved clinical periodontal parameters (bleeding on probing and probing depth), oxidative stress markers, and inflammatory cytokines (IL-8, IL-10, and TNF-α) in relation to control groups. Experimental groups were also more advantageous in reducing the frequency of periodontopathogenic bacteria. However, the evidence of probiotics in decreasing glycated hemoglobin is still uncertain. Probiotics may provide safe additional benefits to periodontal parameters of patients with type 2 diabetes and periodontal disease.

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.

Efficacy of curcumin gel as an adjunct to scaling and root planing on salivary procalcitonin level in the treatment of patients with chronic periodontitis: a randomized controlled clinical trial

The aim of the studyTo evaluate the effect of curcumin gel combined with scaling and root planing (SRP) on salivary procalcitonin in periodontitis treatment.Materials and methodsseventy patients were selected from the Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, and sixteen patients were excluded. Patients in groups II and III included stage II grade A periodontitis. The participants were classified into three groups: group I as a negative control group (individuals with healthy gingiva), group II (SRP) were treated with SRP, and group III (curcumin gel) which was applied weekly for four weeks after SRP. Clinical indices (plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing depth (PD)) and saliva samples for procalcitonin (PCT) assessment using an enzyme-linked immunosorbent assay (ELISA) test were collected and measured at both baselines and after six weeks.ResultsThis randomized controlled clinical trial registered on ClinicalTrials.gov (NCT05667376) and first posted at 28/12/2022 included Fifty-four patients (20 male; 34 female). Regarding the age and sex distribution, there was no statistically significant difference between the three studied groups (p > 0.05). There was no significant statistical difference regarding PI, GI, PPD, and CAL between group II and group III at baseline p (> 0.05). However, there was a significant statistical difference regarding the clinical parameters at baseline of both group II and group III as compared to group I (p ≤ 0.05). At six weeks after treatment, group III showed greater improvement in the PI, PD, and CAL as opposed to group II (p ≤ 0.05). Regarding PCT values, at baseline, there wasn’t a statistically significant difference between group II and group III (p > 0.05). However, there was a significant statistical difference between group II, group III, and group I (p ≤ 0.05). At six weeks after treatment, there was a statistically significant decrease in PCT levels of both group II and III (p ≤ 0.05).ConclusionThe application of curcumin gel was found to have a significant effect on all clinical indices as opposed to SRP.

Efficacy of Lycium barbarum (Goji berry) mouthwash for managing periodontitis: a randomized clinical trial

Background Removal of the microbial deposits (plaque and calculus) by performing effective scaling and root planing (SRP) is the fundamental step for managing periodontal disease (gingivitis and periodontitis). Various adjuncts in the form of mouthwash, gels, and toothpaste are also being used as adjuncts to SRP for managing periodontitis. Recently, Lycium barbarum (L. barbarum), commonly known as goji berry or wolfberry, has gained popularity for managing chronic inflammatory and infectious diseases. However, its efficacy in managing periodontitis has never been explored. Hence the present study aims to evaluate the efficacy of goji berry mouthwash compared to chlorhexidine mouthwash for managing periodontitis. Methods 60 adult participants were divided randomly using computer-generated random sequences into two groups (case group: L. barbarum mouthwash (Males: 16; Female: 14); control group: 0.2% chlorhexidine gluconate mouthwash (Males: 14; Females: 16)). The changes in the gingival index (Gi), plaque index (Pi), bleeding on probing (BOP), clinical attachment loss (CAL), probing pocket depth (PPD), microbial load, and antioxidant levels (protein thiol) in saliva were noted at the baseline, at 15 days and one month. Results A significant reduction in the mean PPD, Pi, and Gi was seen from baseline to one month in both the control (P-value=0.006, 0.027, and 0.036 respectively) and test groups (P-value=0.035, 0.000, and 0.000 respectively). CAL was reduced significantly only in the control group. However, the antioxidant levels (protein thiol) in saliva were significantly increased only in the test group. Conclusion Goji berry mouthwash along with SRP reduced the Gi, Pi, BOP, and PPD in patients with periodontitis. However, no statistically significant difference was noted between the use of goji berry and chlorhexidine mouthwash. Goji berry mouthwash was more effective than chlorhexidine in increasing the antioxidant levels in saliva.

Effect of Curcumin gel on inflammatory and anti-inflammatory biomarkers in experimental induced periodontitis in rats: a biochemical and immunological study.

This study aimed to determine the effect of local application of curcumin gels as adjunct to scaling and root planing (SRP) on the inflammatory biomarkers matrix metalloproteinase-8 (MMP-8), interleukin-6 (IL-6), C-reactive protein (CRP), and alkaline phosphatase (ALP), and the anti-inflammatory biomarker interleukin-10 (IL-10) in rats with experimentally induced periodontitis. Fifty-five adult Wistar rats with experimentally induced periodontitis were randomly divided into four groups: 15 rats received SRP + curcumin gel (CU), 15 rats received SRP + Tetracycline gel (Tet), 15 rats were treated with SRP alone, and 5 rats had experimental periodontitis without treatment (EP). Five systemically healthy rats without experimental periodontitis were used as the controls. Blood samples were collected by cardiac puncture from all groups after 2, 4, and 6 weeks of therapy. Biomarker levels determined by enzyme-linked immunosorbent assay (ELISA) and, ANOVA were used to compare the study groups. The results showed a significant increase in pro-inflammatory biomarkers and a significant decrease in anti-inflammatory biomarkers in the EP group compared with the control group (p < 0.05). The local application of curcumin or tetracycline gels resulted in a significant reduction in all inflammatory biomarkers at all periods of examination compared to the EP group. IL-10 levels gradually increased after 2 weeks, peaked at 4 weeks, and then decreased after 6 weeks, however, Tet showed statistically significant improvement compared to CU (p < 0.05). Adjunctive application of CU gel was as effective as Tet gel in the treatment of EP in rats by reducing inflammatory biomarkers and enhancing anti-inflammatory cytokines.

Ozone Therapy as an Adjuvant in the Treatment of Periodontitis.

The current study aimed to assess the efficacy of ozone therapy in the treatment of stage II and stage III periodontitis. This prospective split-mouth study selected patients who were diagnosed with either stage II or stage III periodontitis. All patients were treated with scaling and root-planing (SRP) on the control side and SRP with ozone therapy on the test side. Probing depth (PD), clinical attachment loss (CAL), O'Leary plaque index (PI), and bleeding on probing (BOP) scores were recorded at baseline and six weeks after the SRP treatment. A total of 46 patients were selected for this study, including 31 males and 15 females. All periodontal variables (PD, CAL, PI, and BOP) showed significant changes (p < 0.0001) from baseline to six weeks. Moreover, significant changes (PD = 0.0001, CAL = 0.0001, PI = 0.042 and BOP = 0.0001) were also observed between the control and test sides. Gender showed no significance on periodontal variables (p > 0.05) except PD on the test side (p = 0.030). In addition, periodontal stages and grades showed no significant changes (p > 0.05) in any periodontal variables on both sides. Ozone therapy significantly improves the periodontal condition compared to SRP treatment alone. However, the stages and grades of periodontitis do not influence the outcome of ozone therapy.

The Application of Virtual Simulation Technology in Scaling and Root Planing Teaching

Virtual simulation (VS) technology has been widely utilised in various aspects of oral education. This study aimed to evaluate the impact of VS technology in a scaling and root planing (SRP) teaching programme and explore an effective teaching approach. A total of 98 fourth-year undergraduates from Guanghua School of Stomatology at Sun Yat-sen University were enrolled in this study and randomly assigned to either the VS teaching group or the traditional teaching (TT) group. All participants received SRP training before undergoing an operational examination. Subsequently, questionnaires were administered to both students and teachers involved in the programme to assess the teaching effect and fidelity of the VS training system. Unpaired Student t test was used to analyse the final test scores and residual rates amongst students. The overall residual rate of the calculus in the VS group was significantly lower than that in the TT group (48.81% ± 13.50% vs 56.89% ± 13.68%, P<.01). The difference was particularly notable in posterior teeth, proximal surfaces, and deep pockets. Additionally, the VS group students achieved higher final grades compared to the TT group (86.92 ± 6.10 vs 83.02 ± 6.05, P<0.01). In terms of teaching effectiveness assessment, the VS group students provided higher scores than the TT group, except in the areas of mastery of position, finger rests, and efficiency. The implementation of VS technology demonstrated improvements in students' performance in SRP teaching. Therefore, a novel integrated pedagogic approaches method that combines VS technology with traditional teaching approaches could be further explored in future training programmes.

Long-Term Stability of Er:YAG Laser Non-Surgical Periodontal Treatment

Background: Nonsurgical periodontal therapy is the first step of periodontal diseases treatment. It could be performed with various instruments and in recent years lasers have been tested too. The aim of the present study is to evaluate the long-term clinical effectiveness of Er:YAG laser monotherapy in the treatment of moderate chronic periodontitis. Methods: 451 teeth (1099 periodontal pockets) from 30 patients with moderate chronic periodontitis are allocated for subgingival scaling and root planing into two groups—hand instrumentation (control) and Er:YAG laser instrumentation with 100 mJ/15 Hz (test). Patients are examined for probing pocket depth, gingival recession, clinical attachment level, bleeding on probing, plaque presence at baseline, 1, 3, 6 and 12 months after instrumentation. Results: One year after therapy significant reduction of all clinical parameters examined is observed. The pocket depth decreases with 1.55 mm for the control group and 1.70 mm in the test group. The attachment level gain reveals 1.09 mm for hand instrumentation and 0.59 for laser instrumentation. The bleeding on probing reduces more significantly in the test group, where one year after treatment the index is 19.1%, whereas in the control group, it is 33.8%. Conclusions: The Er:YAG laser demonstrates similar clinical effectiveness to hand instrumentation in the non-surgical periodontal treatment. Better long-term stability is observed in the test group.

Preparation of Ocimum Sanctum-Based Hydrogel and Evaluation of Its Cytotoxicity: An In Vitro Study.

While traditional periodontal treatments like scaling and root planing, antibiotics, and surgical intervention remain the primary approaches, herbal medicine is continuously evolving as an alternative for the management of periodontal diseases. This study focused on the evaluation of the cytotoxicity of Ocimum sanctum (OS)-based hydrogel for its use in local drug deliveryin periodontitis. OS-based hydrogel was prepared using 50 g of OS powder and 200 ml of ethanol, along with carboxymethyl cellulose gel and sorbitol. The prepared formulation was evaluated for its cytotoxicity by using the MTT assay, cell viability, cell morphology, and brine shrimp egg assessment. Cell viability was assessed, and it was above 95% for the control and 85% for the OS hydrogel by the 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide assay. Brine shrimp egg assessment also showed a survival rate of 80% at low concentrations. The cell morphology test showed round and uniform cells growing in a monolayer shape. The findings of this study confirmed that OS-based hydrogel is cytocompatible and, hence, can be used as a local drug delivery agent for periodontitis management, especially in resource-constrained settings where affordable and natural treatment options are highly valued.

Effects of laser and indocyanine-green mediated antimicrobial photodynamic therapy on the red complex bacteria and crevicular procalcitonin level in periodontitis patients: A split-mouth randomized clinical trial

Abstract Objective: To determine the effects of laser and photodynamic therapy (PDT) on crevicular procalcitonin (PCT) and red complex bacteria in patients with periodontitis stage II grade A. Methods: Sixty-six sites with periodontitis were selected. After scaling and root planing (SRP), participants were randomized to receive 810-nm diode laser and PDT using indocyanine green (ICG). The primary outcome was the change in crevicular PCT levels and red complex bacterial loads measured using the BAPNA assay. Secondary outcomes included probing depth (PPD), clinical attachment loss (CAL), relative attachment level (RAL), plaque index, and gingival index, assessed at baseline and 3 months post-intervention. Results: Significant improvements (P &lt; 0.001) were observed for all variables within each group at the 3-month follow-up compared to baseline. Among the treatment groups, SRP+ICG-PDT demonstrated a greater reduction in BAPNA and PCT levels compared to SRP+laser and SRP alone. Correlation analysis between BAPNA and PCT revealed a significant positive correlation (r = 0.64; p = 0.001). Conclusion: In patients with periodontitis stage II grade A, a single application of PDT using 810-nm laser and ICG provided enhanced benefits compared to SRP alone or SRP+laser in terms of reducing red complex bacterial load and gingival crevicular procalcitonin levels at the 3-month follow-up.

Effectiveness of chlorhexidine gels and chips in Periodontitis Patients after Scaling and Root Planing: a systematic review and Meta-analysis

Periodontal pockets are characteristic of periodontitis. Scaling and root planing is the gold standard for periodontitis treatment. Additional local antimicrobials are recommended in patients with a probing depth of ≥ 5 mm. This study aims to determine the effectiveness of chlorhexidine compared to other local antimicrobials in periodontitis. Searches were conducted using the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Meta-analysis was performed on studies that met inclusion criteria after risk of bias assessment. Meta-analysis between chlorhexidine chips and other antimicrobials showed a mean difference in probing depth after one month of 0.58 mm (p < 0.00001) whereas after three months the mean difference in probing depth was 0.50 mm (p = 0.001), index plaque 0.01 (p = 0.94) and gingival index − 0.11 mm (p = 0.02). Between chlorhexidine gel and other antimicrobials showed a mean difference in probing depth of 0.40 mm (p = 0.30), plaque index of 0.20 mm (p = 0.0008) and gingival index of -0.04 mm (p = 0.83) after one month. Chlorhexidine chips were more effective on the gingival index than other antimicrobials after three months. The other antimicrobials were more effective than chlorhexidine chips on probing depth after one and three months, and than chlorhexidine gels on plaque index after one month.

Superhydrophobic Tipped Antimicrobial Photodynamic Therapy Device for the In Vivo Treatment of Periodontitis Using a Wistar Rat Model.

Limited options exist for treatment of periodontitis; scaling and root planing (SRP) are not sufficient to eradicate P. gingivalis and the resulting inflammatory disease. Chlorhexidine (CHX), used as an adjuvant to SRP, may reduce bacterial loads but leads to pain and staining, while evidence for its efficacy is lacking. Antibiotics are effective but can lead to drug-resistance. The rising concern of antibiotic resistance limits the future use of this treatment approach. This study evaluates the efficacy of a novel superhydrophobic (SH) antimicrobial photodynamic therapy (aPDT) device as an adjuvant to SRP for the treatment of periodontitis induced in a Wistar rat in vivo model relative to CHX. The SH-aPDT device comprises an SH silicone rubber strip coated with verteporfin photosensitizer (PS), sterilized, and secured onto a tapered plastic optical fiber tip connected to a red diode laser. The superhydrophobic polydimethylsiloxane (PDMS) strips were fabricated by using a novel soluble template method that creates a medical-grade elastomer with hierarchical surface roughness without the use of nanoparticles. Superhydrophobicity minimizes direct contact of the PS-coated surface with bacterial biofilms. Upon insertion of the device tip into the pocket and energizing the laser, the device generates singlet oxygen that effectively targets and eliminates bacteria within the periodontal pocket. SH-aPDT treatment using 125 J/cm2 of red light on three consecutive days reduced P. gingivalis significantly more than SRP-CHX controls (p < 0.05). Clinical parameters significantly improved (p < 0.05), and histology and stereometry results demonstrated SH-aPDT to be the most effective treatment for improving healing and reducing inflammation, with an increase in fibroblast cells and extracellular matrix and a reduction in vascularization, inflammatory cells, and COX-2 expression. The SH-aPDT approach resulted in complete disease clearance assessed 30 days after treatment initiation with significant reduction of the periodontal pocket and re-formation of the junctional epithelium at the enamel-cementum junction. PS isolation on a SH strip minimizes the potential for bacteria to develop resistance, where the treatment may be aided by the oxygen supply retained within the SH surface.

Impact of supragingival scaling on the outcomes of subgingival instrumentation completed after 1 week: a split-mouth randomized clinical trial.

To investigate the impact of supragingival scaling on the clinical outcomes of subgingival instrumentation completed after 1 week. In 27 patients with Stage II and Stage III periodontitis, pairs of contralateral quadrants were randomly assigned into test group 1 (single sitting scaling and root planing) and test group 2 (supragingival scaling followed by subgingival instrumentation after 1 week). Periodontal parameters were recorded at baseline, 2, 4, and 6 months; Gingival crevicular fluid vascular endothelial growth factor (VEGF) estimation was done at baseline in both groups and 7 days after supragingival scaling in test group 2. At 6 months, significantly better improvement in test group 1 at sites with periodontal probing depth (PPD) > 5 mm; (∆PPD = 2.32 mm vs 1.41 mm, P = .001; ∆clinical attachmen level [CAL] = 2.34 mm vs 1.39 mm, P = .001) was observed. Supragingival scaling resulted in significant reduction in gingival crevicular fluid VEGF (42.46 to 27.88 pg/site) after 1 week. Regression analysis explained 14% variance in VEGF to baseline PPD at sites with PPD > 4 mm; and 21% variance in CAL improvement to VEGF at sites with PPD > 5 mm. The percentage of sites with PPD = 5 to 8 mm reaching the clinical endpoint was 52% and 40% for test group 1 and test group 2, respectively. Better results were noticed in bleeding on pocket probing-positive sites in both groups. The sites with PPD > 5 mm where supragingival scaling was followed by subgingival instrumentation after 1 week resulted in less favourable treatment outcomes. (Clinical trial registry NCT05449964).

Anti-infective Efficacy of Mechanical Debridement with Adjunctive Modalities on Clinical and Cytokine Parameters in Treatment of Chronic Periodontitis: Randomized Controlled Clinical Trial.

Periodontal debridement involves conventional scaling and root planing (SRP) along with variant forms of adjunctive therapies. In the present clinical trial, we investigated if the adjunctive use of HybenX gel or diode laser along with SRP could provide a favorable outcome for the treatment of chronic periodontitis. The present study involved 60 subjects diagnosed with chronic periodontitis who were randomly assigned as test groups (laser or HybenX) or control group (SRP alone). The primary outcomes of the clinical trial were pocket probing depth (PPD) and clinical attachment level (CAL), which was evaluated at baseline and at third-month time interval. Additionally, secondary outcomes included estimation of reduction in inflammatory mediators interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in gingival crevicular fluid using enzyme-linked immunosorbent assay at baseline and third-month intervals. Normality determination was checked using Shapiro-Wilk test. Since the data was not normally distributed, nonparametric tests were applied. The comparison of clinical parameters between the groups was analyzed with Kruskal-Wallis test. Wilcoxon sign rank test was used to compare the pairwise comparison of clinical parameters among the groups from baseline to third-month follow-up. The inflammatory mediators at various time points were compared using a One-way analysis of variance test, and the inflammatory mediators in each study group were compared using a paired t-test. Both the test groups demonstrated a decrease in PPD and CAL. However, the HybenX group exhibited statistically significant reduction at the end of the third-month study interval compared to the laser group and SRP alone. Further, the secondary outcome IL-1β and TNF-α analysis exhibited statistically significant reduction in all the groups posttherapy. The adjunctive application of HybenX gel yielded an advantage compared to laser and SRP for the treatment of chronic periodontitis. Adjunctive use of the oral tissue desiccant (HybenX gel) combined with SRP improved the periodontal pocket disinfection process and enhanced tissue healing devoid of adverse effects.

A comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Twelve-month results of a multicenter, randomized, controlled study.

The purpose of this publication is to report on the 12-month clinical and radiographic results comparing the surgical use of the Er,Cr:YSGG laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. Fifty-three adult subjects (29 females and 24 males; 19-73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n=27) or MIST (n=26). Fifty subjects completed the study. Recession (REC), probing depth (PD), clinical attachment level (CAL), treatment time, and standardized radiographs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4-6weeks following SRP, and 6 and 12months following surgical therapy. Radiographic results were compared to baseline at 6 and 12months following surgical therapy. The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.7 mm (p=0.05), PD with a non-inferiority margin of 0.7mm (p=0.05), and REC with a non-inferiority margin of 0.4mm (p=0.05). Standardized radiographs suggest similar bone fill of 1.14±1.73mm for MIST and 1.12±1.52mm for ERL. This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST at 12 months in terms of clinical outcomes and similar to MIST in terms of radiographic bone fill for the surgical treatment of intrabony defects.