Root Planing Research Articles

Effect of Scaling and Root Planing in Conjunction with Antimicrobial Therapy on Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients.

Scaling and root planing with systemic doxycycline had an effect on blood glucose levels in type 2 diabetes patients, according to the results of a glycosylated hemoglobin assay. The trial was conducted to determine whether periodontal therapy affected blood sugar regulation as a result of this finding. A total of 60 people with type 2 diabetes (diabetes mellitus not caused by insulin deficiency) were split into three groups. Group I (control group) consists of patients who are only taking an oral anti-diabetic medication. Patients on an oral anti-diabetic drug plus scaling and root planing make up group II. Patients on an oral anti-diabetic drug, scaling, root planing, and doxycycline constitute Group III. The patients were re-evaluated for glycated hemoglobin levels and periodontal status using the clinical parameters of gingival index by Loe and Silness and clinical attachment level at baseline, 30th, 60th, and 90th day. Compared with group II, the findings showed a statistically significant decrease in glycated hemoglobin values (p =0.001) and improvements in clinical attachment level (p =0.022, 0.05) and gingival index (p = 0.009.,01) in group III. In the control group (group I), no such finding was made. The average gingival index, however, increased statistically significantly (p = 0.032, 0.05). Various studies have been showing the benefits of non-surgical periodontal therapy as a benefit for improving the overall glycemic status of the patient. Non-surgical mechanical periodontal therapy combined with systemic administration of antimicrobials such as doxycycline enhances the metabolic status of type 2 diabetes mellitus patients better than non-surgical mechanical periodontal therapy alone.

Impact of nonsurgical and antibiotics treatment on periodontitis

Abstract Background: Periodontitis is one of the most prevalent chronic inflammatory noncommunicable and multifactorial diseases. Objectives: The present study was aimed to detect the effect of systemic antibiotics as disjunctive to nonsurgical treatment of generalized periodontitis (grade I and grade II) on the bacterial count and clinical periodontal parameters. Materials and Methods: Subgingival plaque samples were collected from 40 patients with generalized periodontitis, 20 patients were treated with scaling and root planning only, and 20 patients were treated with a combination of ciprofloxacin 500 mg and metronidazole 500 mg with scaling and root planning. Moreover, 20 samples were collected from healthy patients as a control group. Specific periodontal pathogen genes for Tannerella forsythia (BspA, CIpB genes) were identified using real time polymerase reaction (RT-PCR). Results: In this study, 120 samples were detected for the presence of T. forsythia by RT-PCR technique, and the specific ClpB, and BspA primers’ genes were used for the amplification of a fragment of these genes for the identification of T. forsythia. The results showed that the presence of ClpB and BspA in all (100%). BspA and ClpB showed a decrease but non-significant differences before and after treatment, whereas the periodontal parameter, probing pocket depth, plaque score, and bleeding on probing showed a significant decrease after treatment except clinical attachment lose showing a non-significant difference. Conclusion: Clinical treatment (scaling and root planning) is often helpful in the treatment of generalized periodontal disease (grade I and grade II) without the need for antimicrobial therapy as soon as possible.

Assessment of Outcome of Oral Supplementation of Vitamin D3 as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Type II Diabetes Mellitus - A Randomized Controlled Clinical Trial.

Both diabetes and periodontitis affect millions of people worldwide and Vitamin D insufficiency may create a conducive environment for the progression of diabetes and periodontal disease. The aim of the study was to assess the outcome of oral supplementation of Vitamin D3 in patients with Type 2Diabetes Mellitus with generalized chronic periodontitis, as an adjuvant toscaling and root planing. A total of 92 patients, including 46 each in non-diabetic and diabetec group. Clinical parameters including Plaque Index (PI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), levels of Vitamin D in serum, and Fasting Blood sugar were assessed at the baseline. SRP was finished for each participant in the trial. Following SRP, the first 25people in each group got 60,000 IU of oral vitamin D3 granules once a week for eight weeks, while the remaining 21 subjects from each group did not. At the conclusion of the 8th week following interventions, all the indicators were reviewed. Following SRP and Vitamin D supplementation there was a measurably critical reduction in every one of the periodontal clinical indicators in both groups. In both groups, there was a statistically significant rise in serum vitamin D levels. In addition to SRP, vitamin D supplementation shows promise as a host immunomodulatory drug in the management of periodontitis, particularly in patients with diabetes mellitus.

Influence of herbal medicine in periodontics

ABSTRACT The nonsurgical treatment for periodontitis includes scaling and root planning and the use of antimicrobial agents. Patients with periodontitis are now being treated with supplementary antimicrobials as a result of a growing understanding of the infectious nature of periodontal diseases. The use of herbs in the treatment of periodontitis is growing as an adjunct to nonsurgical modes of treatment, either in single herb or polyherbal therapy.

The effect of ozone gel as adjunct treatment in patients of periodontitis according to bleeding on probing and platelet-activating factor (A split-mouth randomized controlled clinical trial)

Materials and methods: total sample composed of 58 periodontal pockets was divided into two groups. The control group had 28 periodontal pockets treated with scaling and root planning only, while the test group had 30 periodontal pockets treated with scaling and root planning and ozone gel. Two applications of the gel were applied at baseline and one month after the treatment .platelet activating factor (biomarker) and clinical parameters of bleeding on probing are measured at baseline, after one month, and after three months. In the second visit of periodontal therapy (after one day), GCF samples were obtained from patients by gently inserting periocol paper into the selected depth of the pocket when resistance was encountered. The periocol paper was then left in position for 30 seconds before being removed and weighed on a chemical balance. Each paper strip was placed in a tube keeping o.3ml of buffer phosphate saline, then transferred and stored at -40C. Calculated the difference between the weight of periocol paper before and after exudate absorption of gingival crevicular fluid. After sample storage for five minutes, the samples were centrifuged at 13,000 rpm.
 Results: Test sites showed a greater reduction in bleeding on probing and there was a significant difference in the first month only when compared to control sites (Fisher exact=0.010) but no significant difference at three months. The platelet-activating factor was reduced significantly by ozone gel in the first month with only a p-value (0.000) but no significance at one and three months.
 Conclusion: In comparison to SRP alone, treatment with ozone gel as an adjuvant therapy yields no statistically significant improvement after three months.

The Effects of Curcumin Gel Against Tannerella Forsythia (Clinical and Microbiological study)

Aim of the study: To determine the effects of curcumin gel on Tannerella forsythia.
 Materials and methods: Eleven individuals were chosen with probing pocket depths of more than or equal to 5 mm. Scaling and root planing (SRP) were done on entire mouth, then curcumin and placebo gel were applied. At baseline and third visit (after one month), bleeding on probing (BOP), probing pocket depth (PPD), and relative attachment levels (RAL) were measured with a collection of subgingival plaque. The real-time polymerase chain reaction method has been used for bacterial analysis.
 Results: There was a substantial lessening in the bacterial outcomes, PPD and RAL when comparing the curcumin with the placebo group, while the difference was not significant with respect to BOP. On intra-group comparison, only the test group showed a significant decrease in bacterial count, BOP, and RAL, while both groups showed a significant reduction in PPD.
 Conclusion: Curcumin gel has an antimicrobial impact on T.Forsythia and a significant effect on improving BOP, PPD, and RAL.

Pain Assessment and Need for Analgesics after Scaling and Root Planing in Patients with Stage II and Stage III Periodontitis.

Background and Objectives: The most common treatment procedure for periodontitis and gingivitis is scaling and root planing, which is perceived as a painful dental treatment. The current study aimed to assess pain perception and analgesics consumption after scaling and root planing (SRP) in patients with stage II and stage III periodontitis. Materials and Methods: Before starting the SRP, all the periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL), were measured. The anxiety level of the patients was also assessed using the modified dental anxiety scale (MDAS) questionnaire. Pain perception of the patients was recorded with the visual analog scale (VAS) after performing the SRP. Patients were asked to mark their pain level on the VAS sheet after two hours, four hours, eight hours, 24 h, and 48 h after the periodontal treatment. The following cut-off points were used for the pain intensity in the VAS: 0 = no pain, 1-4 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain. Patients were advised to take analgesics if the pain was intolerable. Multivariate logistic regression was performed to conduct the association of all dependent variables and the pain perception of patients. A nonparametric Friedman test was conducted to assess pain perception at different times. Results: A total of 52 patients including 32 males and 20 females participated in the current study, with a mean age of 43.10 ± 12.33 years. Multivariate analyses showed that MDAS and analgesic consumption is significantly associated with pain perception. Other clinical variables are not associated with pain perception. The Friedman test exhibited that pain perception is significantly associated (p < 0.05) with time. Conclusions: Analgesic consumption and anxiety level are significantly associated with pain perception after SRP treatment.

Micro-CT evaluation of the effect of various ScRp instrumentation methods on cement loss, porosity and micro-crack formation.

The purpose of this study was to compare the effectiveness of three different instruments on cement loss, porosity and micro-crack formation, which was not evaluated before, following scaling and root planning (SRP) using micro-computed tomography (micro-CT). In this experimental study, 30 single-rooted extracted human teeth were used and divided into three groups. All the teeth were scanned with micro-CT before and after SRP. Group 1: SRP was performed with Gracey curettes, Group 2: SRP was performed by using an ultrasonic device, and Group 3: SRP was performed by using diamond burs. Cement loss from the root surface, porosity, and micro-crack formation in the root dentine were analysed. Micro-CT is used for qualitative and quantitative analysis of samples. The obtained data were analysed statistically (p < 0.05). Minimum cement loss following SRP was detected with ultrasonic scaler (26.98 mm3), whereas the highest was created by diamond burs (96.20 mm3) (p < 0.05). The total porosity values after SRP were 0.278%, 0.334% and 0.252% for Groups 1, 2 and 3, respectively. Although Group 3 had the least porosity values, there was no statistically significant difference between the groups. The highest micro-crack formation was seen in Group 2 and the lowest was in Group 1 with a significant difference (p < 0.05). More cement loss was observed with diamond burs. Ultrasonic devices appear to be a viable alternative to instrumentation with curettes. However, ultrasonic devices should be used carefully because of micro-crack formation since the micro-crack resulting from instrumentation with hand instruments is the least of all.

UJI EFEKTIVITAS EKSTRAK ETANOL DAUN JAMBU BIJI MERAH (Psidium guajava L.) DALAM MENGHAMBAT PERTUMBUHAN BAKTERI Porphyromonas gingivalis PENYEBAB PERIODONTITIS

Background: Chronic periodontitis is a disease of the oral cavity that is often complained by almost the entire population of the world. Prevalence Porphyromonas gingivalis in chronic periodontitis, which reached 96.2%. Mechanical treatment that can be given are scaling, root planing, curettage, and administration of antibiotics. Red guava leaves (Psidium guajava L.) can act as an antibacterial because it contains several active compounds such as tannins, flavonoids and saponins.Method: This study was a laboratory experimental study with a post-test only group design. The red guava leaf extract sulution concentrations used were 2%, 5%, 10%, 15% and 20%. The Phorpyromonas gingivalis bacteria were the dependent variable in this study.Results: Ethanol extract of red guava leaves concentrations of 2%, 5%, 10%, 15% and 20% is effective in inhibiting the growth of bacteria Porphyromonas gingivalis, with 20% having the largest inhibition zone.Conclusion: Based on this research, it can be concluded that the higher the concentration of the ethanol extract of red guava leaves (Psidium guajava L.) used, the larger the diameter of the inhibition zone formed.

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

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

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

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

Is Probiotic an Alternative to Systemic Antibiotics in treating Chronic Periodontitis?

Aim: to assess the clinical efficacy of three treatment modalities (Lactobacillusreuteri (L. reuteri) + Scaling and root planning (SRP), broad spectrum antibiotics+ SRP and SRP alone) and to compare their efficacy in the treatment of Chronic periodontitis. Methods: Sixty systemically healthy participants (20 Group A, 20 Group B and 20 Group C), clinically diagnosed with CP were enrolled. All patients underwent SRP. Adjunctive Amoxicillin and metronidazole were given thrice and twice daily respectively for 7 days to the Group A participants. Adjunctive probiotic wasgiven twice daily for 3 months to the Group B participants whereas, no adjunctive was provided to the participants of Group C. Results: Statistically significant improvement was observed in the participants of each group A, B and C for every clinical parameter i.e., plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD) and clinical attachment level (CAL) gain on each follow-up visit. However, Group A and Group B exhibited superior results than Group C. Conclusion: Treatment of CP with SRP along with adjunctive modalities improves clinical periodontal outcomes as compared to SRP alone. However, two adjunctive modalities i.e., systemic antibiotics and L. reuteri are comparable in efficacy. Keywords: chronic periodontitis; probiotics; lactobacillus reuteri; dental scaling; antibiotics

Evaluation of different local drug delivery systems in the management of chronic periodontitis: A comparative study

Periodontal disease is an immune-inflammatory disease affecting the soft tissues and alveolar bone and surrounding periodontal tissues. The standard treatment involves scaling and root planing (SRP) which removes the sub gingival microbial deposits effectively and the gingival health is maintained. Sometimes the treated areas may show regrowth of the microorganisms and the non-surgical periodontal treatment alone cannot eliminate the micro-organisms in mild periodontitis cases due to the difficulty in reaching the subgingival areas which are deeper and in complex root morphologies. So now a days the non-surgical periodontal treatment combined with the use of systemic antimicrobial agents and host modulating agents has shown to use effectively in the treatment of periodontal diseases.All the patients who were diagnosed with chronic periodontitis underwent initial therapy i.e., full-mouth scaling and root planing. Then the oral hygiene instructions were given to the patients and were recalled after 1 week (baseline visit). A total of 20 patients who met the inclusion criteria and showed satisfactory condition after the initial therapy with persistent periodontal pockets were included in this study. They were randomly assigned into two groups i.e., Group-A: metronidazole gel (metrogyl) and Group B: tetracycline fibre groups with 10 patients in each group. The periodontal clinical parameters like plaque index (PI), gingival index (GI) and periodontal pocket depth (PPD) were evaluated at the baseline visit before the application of local drug delivery and 15 and 30 days after the local drug delivery application.The mean plaque scores were reduced from 1.41±0.04 at baseline to 1.04±0.14 at 30 days. Likewise in Group-B the mean PI scores reduced from 1.50±0.10 at baseline to 1.25±0.18 at 30 days. The mean gingival index scores reduced from 1.41±0.04 at baseline to 1.01±0.04 at 30 days. Likewise in Group-B mean GI Scores reduced from 1.36±0.03 at baseline to 0.99±0.06 at 30 days. The mean PPD scores were reduced from 5.65±0.12 at baseline to 3.15±0.10 at 30 days in Group-A. Likewise in Group-B mean PPD scores reduced from 5.68±0.06 at baseline to 3.26±0.10 at 30 days. This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered metronidazole gel and tetracycline fibers.

Association of vitamin D in individuals with periodontitis: an updated systematic review and meta-analysis

BackgroundThere are differences in vitamin D levels between periodontitis and healthy individuals, but the effect of vitamin D on periodontitis is controversial. The purpose of this Meta-analysis is twofold: (1) compare vitamin D levels in individuals with or without periodontitis; (2) assess the effects of vitamin D supplementation during scaling and root planing (SRP) on periodontal clinical parameters in individuals with periodontitis.MethodsA systematic search was conducted in five databases (PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library), published from the database inception to 12 September 2022. The Cochrane Collaboration Risk of bias (ROB) assessment tool, the risk of bias in non-randomized studies of intervention (ROBINS-I) tool, the Newcastle–Ottawa Quality Assessment Scale (NOS), and Agency for Healthcare Quality and Research (AHRQ) were used to evaluate randomized controlled trial (RCT), non-RCT, case–control study, and cross-sectional study, respectively. Statistical analysis was performed using RevMan 5.3 and Stata 14.0 software, with weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence intervals (CI) as the effect measures, and heterogeneity was tested by subgroup analysis, sensitivity analysis, Meta-regression.ResultsA total of 16 articles were included. The results of Meta-analysis showed that periodontitis was associated with lower serum vitamin D levels compared to normal population (SMD = -0.88, 95%CI -1.75 ~ -0.01, P = 0.048), while there was no significant difference in serum or saliva 25(OH)D levels between periodontitis and normal population. Additionally, the Meta-analysis showed that SRP + vitamin D and SRP alone had a statistically significant effect on serum vitamin D levels in individuals with periodontitis (SMD = 23.67, 95%CI 8.05 ~ 32.29, P = 0.003; SMD = 1.57, 95%CI 1.08 ~ 2.06, P < 0.01). And SRP + vitamin D could significantly reduce clinical attachment level compared to SRP alone (WMD = -0.13, 95%CI -0.19 ~ -0.06, P < 0.01), but had no meaningful effect on probing depth, gingival index, bleeding index, respectively.ConclusionThe evidence from this Meta-analysis suggests that the serum vitamin D concentration of individuals with periodontitis is lower than that of normal people, and SRP along with vitamin D supplementation has been shown to play a significant role in improving periodontal clinical parameters. Therefore, vitamin D supplementation as an adjuvant to nonsurgical periodontal therapy has a positive impact on the prevention and treatment of periodontal disease in clinical practice.

The increasing importance of the oral microbiome in periodontal health and disease.

Herein, the aim is to discuss the current knowledge of microbiome and periodontal diseases. Current treatment strategies include mechanical therapy such as root planing, scaling, deep pocket debridement and antimicrobial chemotherapy as an adjuvant therapy. Among promising therapeutic strategies, dental probiotics and oral microbiome transplantation have gained attention, and may be used to treat bacterial imbalances by competing with pathogenic bacteria for nutrients and adhesion surfaces, as well as probiotics targeting the gut microbiome. Development of strategies to prevent and treat periodontal diseases are warranted as both are highly prevalent and can affect human health. Further studies are necessary to better comprehend the microbiome in order to develop innovative preventative measures as well as efficacious therapies against periodontal diseases.

Pyogenic granuloma: Clinicopathological and treatment scenario in Rajshahi Medical College Hospital

Background: Oral pyogenic granuloma is a soft-tissue lesion of the oral mucosa. This lesion has a tendency to recur after surgical excision.&#x0D; Materials and Methods: A total of 35 patients underwent surgical excision of pyogenic granuloma in the period from January 2019 to June 2022. Two surgical techniques were used to remove pyogenic granuloma: simple excision with root planing and modified excision with deep curettage.&#x0D; Results: Females (54%) were slightly more predominant than males (46%). The upper and lower jaws were almost equally affected by the lesion with more predilection toward the posterior region. The size of the lesion ranged from 0.5 to 3 cm in diameter with slow-growing rate. Rural residents were more affected (57%) than urban people. The lesion appears clinically as a small red mass with sessile base, and these clinical features were similar in pregnant and nonpregnant women. The recurrence rate was 14.8% and seen only in patients treated by simple excision. Histopathological feature was consistent with inflammatory hyperplastic lesion, and there was no radiographic evidence of bone resorption associated with the lesion.&#x0D; Conclusion: Modified excision with deep curettage prevents the recurrence of the lesion after 1-year follow-up.&#x0D; Central Medical College Journal Vol 6 No 1 January 2022 Page: 39-43

LOCAL ANESTHETICS AND PREGNANCY. A REVIEW OF THE EVIDENCE AND WHY DENTISTS SHOULD FEEL SAFE TO TREAT PREGNANT PEOPLE.

Oral health and dental treatment are essential during pregnancy. Despite dental treatment being safe during pregnancy for mother and baby, many dentists are reluctant to treat pregnant people. Previously published FDA and ADA recommendations for the treatment of pregnant people exist. Consensus statements and injectable local anesthetic manufacturers' information exist as well. Yet many dentists continue to demonstrate reluctance and hesitancy to treat pregnant people during all stages of pregnancy and for all routine comprehensive care such as exams, diagnostic radiographs, scaling and root planning, restorative, endodontic, and oral surgical procedures. Local anesthetics are most widely used in dental treatment, and many dental procedures necessitate their use when treating pregnant people. To facilitate dentists... comfort and clinical decision-making in the use of local anesthetics in improving the pregnant population's receipt of dental treatment and care outcomes and to calibrate practices to the current standard of practice aligning with contemporary evidence, this paper will review essential published evidence-based studies, guidelines, resources, and information from national organizations responsible for protecting the public's health.

Effect of Ocimum sanctum L as LDD in periodontal therapy.

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

Positive correlational shift between crevicular antimicrobial peptide LL-37, pain and periodontal status following non-surgical periodontal therapy. A pilot study

BackgroundPeriodontitis has a high prevalence and uncertain recurrence. Unlike the pro-inflammatory cytokine profile, little is known about the anti-inflammatory cytokine and antimicrobial peptide overview following treatment. The present study aimed to evaluate if any of the antimicrobial peptide LL-37, interleukin (IL) 4, 10 and 6 together with the volume of gingival crevicular fluid (GCF) and total protein concentration in GCF could be used as correlative biomarkers for the severity in periodontitis as well as prognostic factors in the management of the disease.MethodsForty-five participants were recruited and allocated to the healthy (15), Stage I-II (15) or Stage III-IV periodontitis (15) group. Along with periodontal examination, GCF samples were obtained at baseline and 4–6 weeks following scaling and root planing (SRP) for the periodontitis groups. GCF samples were analyzed by ELISA kits to quantify LL-37 and IL-4, -6 and − 10. One-way ANOVA followed by Dunnett’s test was used to determine differences among the three groups at baseline. Two-way ANOVA followed by Sidak’s post-hoc test was used to compare between pre- and post-SRP in the two periodontitis groups.ResultsThe amount of GCF volume was significantly correlated to the severity of periodontitis and decreased following SRP, particularly in the Stage III-IV group (p < 0.01). The levels of LL-37, IL-6, and pain and periodontal clinical parameters were significantly correlated to the severity of periodontitis. IL-4 and IL-10 in the periodontitis groups were significantly lower than the healthy group (p < 0.0001) and barely improved following SRP up to the level of the healthy group.ConclusionsWith the limitations of this study, crevicular LL-37 may be a candidate for a biomarker of periodontitis and the associated pain upon probing.Trial registrationThe study was registered in clinical trials.gov, with number NCT04404335, dated 27/05/2020.

Newly identified pathogens in periodontitis: evidence from an association and an elimination study

ABSTRACT We assessed the level of evidence for the presence of new periodontal pathogens by (i) comparing the occurrence of non-classical periodontal taxa between healthy vs. periodontitis patients (Association study); (ii) assessing the modifications in the prevalence and levels of these species after treatments (Elimination study). In the Association study, we compared the prevalence and levels of 39 novel bacterial species between periodontally healthy and periodontitis patients. In the Elimination study, we analyzed samples from periodontitis patients assigned to receive scaling and root planing alone or with metronidazole+ amoxicillin TID/ 14 days. Levels of 79 bacterial species (39 novel and 40 classic) were assessed at baseline, 3 and 12 months post-therapy. All samples were analyzed using Checkerboard DNA-DNA hybridization. Out of the 39 novel species evaluated, eight were categorized as having strong and four as having moderate association with periodontitis. Our findings suggest strong evidence supporting Lancefieldella rimae, Cronobacter sakazakii, Pluralibacter gergoviae, Enterococcus faecalis, Eubacterium limosum, Filifactor alocis, Haemophilus influenzae, and Staphylococcus warneri, and moderate evidence supporting Escherichia coli, Fusobacterium necrophorum, Spiroplasma ixodetis, and Staphylococcus aureus as periodontal pathogens. These findings contribute to a better understanding of the etiology of periodontitis and may guide future diagnostic and interventional studies.