Significant Reduction In Probing Pocket Depth Research Articles

Efficacy of Scaling and Root Planing with and without Adjunctive Use of Diode Laser or 1% Ornidazole Gel as Local Drug Delivery in the Management of Chronic Periodontitis: An Experimental Study

Background: Chronic periodontitis is a prevalent inflammatory disease affecting the supporting structures of the teeth. Scaling and root planing (SRP) is a conventional non-surgical therapy. However, adjunctive treatments like diode lasers and local drug delivery systems (e.g., 1% Ornidazole gel) have been proposed to enhance treatment outcomes. This study aimed to assess the efficacy of SRP alone and combined with diode laser or 1% Ornidazole gel as adjunctive therapies for managing chronic periodontitis. Materials and Methods: This experimental study included forty five individuals of both gender aged between 27 and 60 years diagnosed with chronic periodontitis and having pocket depths >4 mm in different quadrants of the mouth were selected and divided equally into three groups as Group-I (treated with SRP only), Group-II (treated with SRP and diode Laser application of 1.5 w, 980nm,30sec continuous wave), Group-III (treated with SRP and Application of 1% Ornidazole gel, as local drug delivery). Clinical parameters including gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) were recorded at baseline and after 1 month of treatment. Statistical analysis was performed to compare the outcomes among the three groups.Results: All groups exhibited significant improvement in periodontal health, with reductions in GI, PPD and improvements in CAL. The intra-group comparison of all three groups from baseline to one month showed a statistically significant reduction in GI, PPD and CAL. In contrast, the intergroup comparison between Group I (SRP only) and Group II (SRP+Diode laser) showed statistically non-significant results in PPD and CAL. A statistically significant reduction in PPD and CAL was observed in Group III (SRP+ 1% Ornidazole gel) compared to Group I and Group II.Conclusion: Adjunctive use of diode laser and 1% Ornidazole gel enhances the efficacy of SRP in treating chronic periodontitis. Both modalities offer clinical benefits over SRP alone, with the 1% ornidazole showing marginally better results. when used as an adjunct to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Further research with a larger sample size and longer follow-up is needed to validate these findings.

Efficacy of Rose Bengal-Mediated Antimicrobial Photodynamic Therapy as an Adjunct to Scaling and Root Planing on Clinical and Microbiological Parameters in the Management of Chronic Periodontitis: A Single-Blinded, Randomized Controlled Clinical Trial.

Aim: The study aims to assess the efficacy of rose bengal (RB)-mediated antimicrobial photodynamic therapy (a-PDT) as an adjunct to scaling and root planing in the management of chronic periodontitis patients in terms of clinical parameters like gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and microbiological parameters like total microbial count, total red complex organism count, Porphyromonas gingivalis count, Treponema denticola count, and Tannerella forsythia count. Materials and Methods: In this randomized controlled clinical trial, a total of 30 patients were recruited who met the inclusion criteria. The participants were randomly allocated into group A with scaling and root planning (SRP) alone and group B with SRP + a-PDT. The clinical and microbiological parameters were measured at baseline and at 3-month follow-up. Intergroup and intragroup comparisons were performed using independent t test and paired t test, respectively. Value of p < 0.05 was considered as statistically significant. Results: At 3-month follow-up, group B treated with SRP + a-PDT showed statistically significant reduction in GI (0.58 ± 0.20) and PPD (1.81 ± 0.32 mm), gain in CAL (0.73 ± 0.04 mm), and reduction in total microbial count [2.80 ± 0.08 × 104 colony forming unit (CFU)], total red complex count (0.29 ± 0.14 × 102 CFU), P. gingivalis count (0.43 ± 0.13 × 102 CFU), T. denticola count (0.61 ± 0.04 × 102 CFU), and T. forsythia count (0.59 ± 0.04 × 102 CFU) as compared with group A (p < 0.05). Conclusion: RB-mediated a-PDT as an adjunct to SRP was significantly more effective in improving GI, PPD, and CAL and in reducing microbial count as compared with SRP alone in the management of chronic periodontitis.

Combined Treatment of Peri-Implantitis in Patients with Type 2 Diabetes Mellitus

Objective: To evaluate the outcome of combined therapy of peri-implantitis in patients with type 2 diabetes mellitus. Methods: Study included 46 patients with type 2 diabetes mellitus diagnosed peri-implantis. 24 implants with early peri-implantitis, 18 implants with moderate peri-implantitis. The diagnostic parameters used for assessing peri-implantitis include clinical indices, Probing Pocket Depth (PPD), Bleeding on Probing (BOP), peri-implant radiography, data at the re-examination were retrospectively compared to baseline data. Patients underwent treatment with HbA1c levels &lt;7.2% or less than 154 mg/Dl. Results: A statistical significant reduction in both PPD and BOP were seen at all-time points as compared with the baseline clinical measurements. Stable clinical measurements PPD and BOP were demonstrated after 1 year the initial treatment, remaining stable during the following three years. The mean BOP in patients before treatment of peri-implantitis was 2.5 ± 0.31, after 6 months treatment month treatment 0.6 ± 0.1. The mean PPD in patients before treatment of peri- implantitis was 5.2 ± 0.24, after 6-month treatment pocket was 3.2 ± 0.1. Conclusion: Conservative treatment with systemic antibiotics, pocket elimination was an effective therapy in peri-implant mucositis and еarly periimplantitis, when peri-implantitis category moderate surgical treatment combined conservative therapy effective method in patients with type 2 diabetes mellitus.

Comparative evaluation of the effectiveness of concentrated growth factor alone and in combination with diode laser application in the treatment of intrabony periodontal defects: A clinical and radiographic split-mouth study.

Applying autologous growth factors and diode laser in periodontal therapy enhances fibroblast-mediated new attachment and osteoblastic differentiation. Hence, this study compared and evaluated the effectiveness of concentrated growth factor (CGF) alone and with diode laser application in managing intrabony periodontal defects. Ten patients with stage III periodontitis were included in this study. All the patients underwent an open flap debridement (OFD) procedure followed by CGF membrane placement in the intrabony defect in site A, whereas, in site B, after OFD, all the patients underwent diode laser irradiation before CGF membrane placement. Plaque and gingival bleeding index (PI & GBI), PPD, and clinical attachment level (CAL) were evaluated at baseline and 3 and 6 months later. Bone fill (BF), BF%, bone crest changes (BCC), and BCC% were assessed radiographically at six months postoperatively. Significant reductions in PI and GBI scores, probing pocket depth (PPD), and CAL gain were observed at both sites 3 and 6 months from baseline. A significant reduction in PPD and CAL gain was noted between sites, which were higher in site B than in site A with a mean difference of 0.70±0.05 mm and 1.30±0.18 mm, 0.90±1.89 mm at 3 and 6 months, respectively. Radiographic measurement showed better BF, BF%, BCC, and BCC% at both sites at six months, which were higher at site B than at site A but statistically insignificant. The combination of CGF and diode laser application has demonstrated successful and promising results in terms of regeneration, improving the clinical and radiographic parameters.

Effect of Air Polishing on the Treatment of Peri-Implant Diseases: A Systematic Review and Meta-Analysis.

Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.

Effects of enamel matrix derivative in nonsurgical periodontal therapy on pro-inflammatory profiles, microbial environment and clinical outcome: a randomized clinical trial

ObjectivesThis study aimed to evaluate the impact of enamel matrix derivative (EMD) application following subgingival instrumentation of residual pockets in periodontitis patients on inflammatory host response, microbiological composition, and clinical outcome.MethodsIn this double-blinded randomized controlled trial, a total of 22 patients with generalized periodontitis stage III or IV presenting with ≥ 6 mm probing pocket depth (PPD) at re-evaluation after initial periodontal therapy were included. Participants were randomly allocated at a 1:1 ratio to subgingival instrumentation with (EMD +) or without (EMD-) non-surgical EMD application into the pocket. PPD, clinical attachment level (CAL), bleeding on probing (BoP), plaque index (PI), as well as a panel of pro-inflammatory cytokines and periodontal pathogen count in the gingival crevicular fluid (GCF) of the respective sites were evaluated at baseline (T0) and six months afterwards (T1).ResultsBoth treatment groups showed a significant PPD reduction (EMD + 1.33 ± 1.15 mm, p < 0.001; EMD- 1.32 ± 1.01 mm, p < 0.001) as well as CAL gain (EMD + 1.13 ± 1.58 mm, p < 0.001; EMD- 0.47 ± 1.06 mm, p = 0.005) from T0 to T1. While no intergroup differences for PPD reduction were observed, CAL gain was higher in EMD + sites compared to EMD- (p = 0.009). No essential effects on cytokine expression as well as bacterial count were detected.ConclusionsApplication of EMD as an adjunct to subgingival instrumentation of residual pockets yielded benefits regarding CAL gain; however, effects on PPD reduction, inflammatory cytokines, and bacterial count were negligible.Trial registrationClinicalTrials.gov (NCT04449393), registration date 26/06/2020.Clinical relevanceBased on the obtained results, additional non-surgical EMD application compared to subgingival instrumentation alone showed no clinically relevant effects on treatment outcome and underlying biological mechanisms.

Comparing the Effectiveness of Conventional and Microsurgical Access Flap Techniques in Managing Horizontal Bony Defects in Chronic Periodontitis Patients: A Clinical and Radiographic Study

Abstract Objective Periodontal microsurgery is descendant of conventional periodontal surgery to reduce surgical trauma, improve wound healing, and enhance patient compliance. This study compared the efficacy of conventional and microsurgical access flap in the management of horizontal bony defects in chronic periodontitis patients. Materials and Methods Eight pairs of contralateral horizontal bone defects in chronic periodontitis patients were randomly allocated to control group and test group. Microsurgical access flap was carried out in test group under magnification, while control group received conventional access flap. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), relative attachment level (RAL), and relative gingival marginal level (RGML) were recorded at baseline, 3 months, and 6 months. Wound healing index (WHI) was evaluated after 1 week, 2 weeks, and 4 weeks. Pain perception was evaluated using visual analog scale (VAS) post-surgery and after 24 hours. Radiographic defect depth was measured at baseline and after 6 months. Statistical Analysis The statistical analysis was done by SPSS statistical software. The intragroup comparison was done by repeated measures analysis of variance. The intergroup difference between both groups was done by Student's t-test. The descriptive statistics for VAS and WHI was done by Wilcoxon signed rank test. The mean difference between clinical parameters from baseline to follow-up intervals was calculated by post-hoc least significance difference analysis. Results There was significant reduction in PI, GI, PPD, and RAL within both the groups (p &lt; 0.05). There was increase in RGML within both the groups from baseline to 6 months (p &lt; 0.05). In the intergroup comparison, test group showed better WHI and better pain perception (VAS) compared to control group (p &lt; 0.05). No difference was found between both the groups in terms of radiographic defect depth (p &gt; 0.5). Conclusion Both the procedures were effective in improving the clinical parameters but the microsurgical group showed better results in terms of wound healing and less postoperative pain. Both procedures showed no significant effect on radiographic defect depth.

Photodynamic Therapy with Tolonium Chloride and a Diode Laser (635 nm) in the Non-Surgical Management of Periodontitis: A Clinical Study.

This study aimed to evaluate the efficacy of photodynamic therapy (PDT) using tolonium chloride and a 635 nm diode laser as an adjunct to non-surgical periodontitis treatment, specifically scaling and root planing (SRP) alone. A total of 32 patients with a pocket probing depth > 5 mm were included in the study. Among them, 16 patients underwent SRP alone (control group), and the remaining 16 patients received SRP along with PDT (study group). The PDT procedure utilized a 635 nm diode laser (Smart M, Lasotronix, Poland) and tolonium chloride. Clinical periodontal parameters, such as the plaque index (PI), bleeding on probing (BOP), gingival recession (GR), probing pocket depth (PPD), and clinical attachment loss (CAL), were assessed before treatment (T0) and at 3 months after treatment (T3). At T3, both groups demonstrated a significant reduction in the PI, BOP, PD, and CAL compared to T0. The SRP + PDT group displayed a significant reduction in PPD (3.79 mm ± 0.35) compared to the SRP alone group (4.85 mm ± 0.42) at T3. Furthermore, the SRP + PDT group exhibited a significant reduction in CAL (5.01 ± 0.81) compared to the SRP group (5.99 ± 1.08) at T3. Within the study's limitations, it was concluded that PDT, with tolonium chloride and a 635 nm diode laser, significantly contributed to the non-surgical treatment of periodontitis.

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.&#x0D; 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.&#x0D; 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.&#x0D; Conclusion: Curcumin gel has an antimicrobial impact on T.Forsythia and a significant effect on improving BOP, PPD, and RAL.

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.

Comparative evaluation of locally delivered probiotic paste and chlorhexidine gel as an adjunct to scaling and root planing in treating chronic periodontitis: A split-mouth randomized clinical trial.

Introduction:The etiological factors of periodontal diseases are the habitation of dysbiotic bacteria, absence of beneficial bacteria, and susceptibility of the host. Irresolute pattern in the periodontal diseases pathogenesis leads to the evolution of novel antimicrobial therapy.Objective:The objective of the study is to assess and compare the competency of locally delivered probiotic paste with chlorhexidine gel as a supplement to scaling and root planing (SRP) in chronic periodontitis patients.Materials and Methods:A split-mouth randomized controlled trial was designed on 10 systemically healthy participants having chronic periodontitis at three distinct quadrants with 5–6-mm pocket depth. The sites in each participant were randomly selected for Group A (negative control), Group B (positive control), and Group C (test). In Group A, only SRP, Group B – SRP + chlorhexidine local drug delivery (LDD), Group C – SRP + probiotic LDD were done, respectively. Gingival index (GI) and bleeding index (BI) were determined at baseline, 3rd, 6th, and 9th weeks, whereas probing pocket depth (PPD), Russell's periodontal index, and clinical attachment level were checked at baseline and after 9 weeks.Results:It shows a significant reduction in GI, BI, PPD, and gain of CAL in probiotic LDD group.Conclusion:Nowadays, since microbes are rapidly developing resistance to antibiotics, the development of probiotics is a boon for the treatment of periodontal diseases. Diseases of the periodontium are not restricted to the oral cavity alone but also have strong systemic effects. Hence, probiotics give a natural and promising choice of therapy to establish both good oral and systemic health.

Does the use of omega-3 fatty acids as an adjunct to non-surgical periodontal therapy provide additional benefits in the treatment of periodontitis? A systematic review and meta-analysis.

This review aimed to assess the impact of dietary omega-3 fatty acids as an adjunct to non-surgical periodontal treatment when compared with periodontal treatment alone on periodontal clinical parameters of periodontitis patients. We included only randomized clinical trials (RCTs) with at least 3-months follow-up of non-surgical periodontal therapy, in combination with dietary omega-3 fatty acids. The MEDLINE, EMBASE, and LILACS databases were searched for articles published up to October 2021. Random-effects meta-analyses were conducted to determine the change in clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BOP), and gingival index (GI) after therapy. Of the eight hundred eighty-four potentially relevant papers retrieved from the electronic databases, 10 RCTs were selected for qualitative analysis, and of these, 8 RCTs were included in meta-analysis. RCTs showed a significant PPD reduction/CAL gain associated with the use of omega-3 fatty acids. The pooled estimates revealed significant overall PPD reduction of 0.42mm (95% CI 0.15, 0.68) and CAL gain 0.58mm (95% CI 0.24, 0.92). In individuals with periodontitis, the use of omega-3 fatty acid dietary supplementation as an adjunct to non-surgical periodontal treatment can provide additional benefits in CAL gain and PPD reduction, compared with non-surgical periodontal treatment alone.

The granulation tissue preservation technique in regenerative periodontal surgery-a randomized controlled clinical trial.

ObjectivesTo investigate if the application of the granulation tissue preservation technique (GTPT) in regenerative therapy of infrabony periodontal defects results in more clinical attachment level (CAL) gain and more radiographic bone gain (RBG) than the conventional resective approach 12 months after surgery.Materials and methodsForty patients exhibiting at least one infrabony defect with a probing pocket depth (PPD) ≥6 mm and a radiographic infrabony component (INFRAX‐ray) ≥3 mm were randomly treated with the GTPT (test group) or the double‐flap approach with resection of the defect‐filling granulation tissue (control group). Enamel matrix derivatives were applied in both groups. Clinical and radiographic parameters were recorded at baseline (t0), 6 months (t1), and 12 months (t2) after surgery. The primary outcome variable was CAL gain between t0 and t2.ResultsWhen all patients were considered, ΔCALt0–t2 did not differ significantly between the two groups (p = .160). Significant PPD reduction (test group: 4.38 ± 1.36 mm; control group: 4.06 ± 2.38 mm), CAL gain (test group: 3.75 ± 1.24 mm; control group: 2.88 ± 2.09 mm), and RBG (test group: 3.06 ± 1.74 mm; control group: 3.27 ± 2.19 mm) were achieved at t2 in both groups. Using multivariate linear regression, PPDt0 and group were identified as variables with the greatest influence on ΔCALt0–t2. PPDt0 and INFRAX‐ray were identified as variables with the greatest influence on RBGt0–t2. Patients with a defect angle >22° showed significantly more CAL gain in the test group (t0–t1: 3.08 ± 1.38 mm; t0–t2: 3.62 ± 0.96 mm) than in the control group (t0–t1: 1.77 ± 1.54 mm; t0–t2: 2.18 ± 1.83 mm).ConclusionsRegarding all patients, the study failed to show significant differences between the test and control groups. However, the GTPT appears to lead to more CAL gain in noncontaining infrabony defects.

Effectiveness of Tetracycline Drugs in the Non Surgical Treatment of Peri-implantitis: A Systematic Review and Meta-analysis

Introduction: Peri-implantitis is a significant factor affecting the success rate of oral reconstruction. Hence, it is vital to prevent it. To control peri-implant disease, non surgical treatment is the first line of defense. While peri-implant mucositis can be entirely treated, there are unforeseen repercussions for the treatment of peri-implantitis, according to many studies using non invasive approaches. Aim: To investigate the clinical effects of the tetracycline group of medications in the treatment of non surgical peri-implantitis. Materials and Methods: Electronic bibliographic databases PubMed (MEDLINE), EBSCO, Cochrane database, Clinical trial registry, DOAJ, Google Scholar, and Manual reference searches were performed for articles published January 2010 to August 2021. Total five Randomised Controlled Trials (RCTs) were selected. Three reviewers independently performed the data extraction using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting. The risk of bias was assessed with the ROB-2 tool and the quality of evidence was determined with the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A quantitative meta-analysis was performed to compare the reduction in Bleeding On Probing (BOP), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). Results: In the overall analysis, BOP and PPD, was statistically reduced in the tetracycline drugs compared to the tetracycline groups. When comparing experimental and control groups, the mean reduction in BOP was -9.71 mm, (95% CI: -11.74 to -7.68), The random-effects model showed a statistically significant difference Z=9.40 (p-value&lt;0.00001). The mean PPD was reduced by -1.18 mm in the experimental groups compared to the control groups (95 % CI: -2.35 to -0.02). The CAL gain was -0.98 mm from 3.23 to 1.28 mm in the experimental group which was statistically non significant. The minocycline revealed statistically significant mean difference in BOP (mean difference was -0.72 (95 % CI: -6.84, -3.24 mm but non significant difference reduction in PPD (p-value &gt;0.05). High heterogenicity was reported in all analyses. Conclusion: The non surgical treatment with the tetracycline medication group resulted in a significant clinical reduction in BOP and PPD without a significant change in CAL when compared to other non surgical therapies. The minocycline has resulted in clinical decreases in BOP except PPD. Longterm randomised controlled trials are needed to assess the efficacy of treatments that do not prevent further bone loss, implant survival rates, and oral health-related quality of life standards.

Randomized, controlled clinical trial to evaluate efficacy of sticky bone and concentrated growth factor in the management of intrabony defects: 12 months follow-up study

Platelet derivatives are enriched growth factors that ameliorate various cellular processes in regeneration. The present clinical trial aimed to evaluate and compare the effects of sticky bone and concentrated growth factors (CGFs) in the treatment of intrabony osseous defects by cone-beam computed tomography (CBCT). The study included 20 patients having 40 intrabony defects. 20 sites each were included in both test group (Sticky bone) and Control group (CGF alone). The clinical parameters including probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline and 6 and 12 months posttherapy. The radiographic parameters including the depth, mesiodistal (MD), and the buccolingual (BL) width of the defect to assess the amount of bone fill were examined at baseline and after 12 months using CBCT. Twelve months posttherapy clinical results indicated a significant reduction of PPD and gain in CAL in both the study groups. Similar observations were recorded with CBCT radiographic parameters where the intrabony defect depth and MD defect width for the test group and control group significantly reduced after 12 months' posttherapy (P < 0.0001). However, no significant reduction in BL defect width was observed in control group (P = 0.577) in contrast to the test group (P = 0.028) after 12 months' posttherapy. Intrabony defects treated with sticky bone showed improved clinical and radiographic parameters indicative of enhanced periodontal regeneration as compared to CGF alone treated sites.

Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone-A randomized, feasibility parallel-arm clinical trial.

A brush made of chitosan has shown to be an effective and harmless device for non-surgical treatment of mild to moderate peri-implantitis. To date, no study has evaluated the use of a chitosan brush in the non-surgical treatment of residual pockets in periodontal treatment. Seventy-eight patients with periodontitis were included in this multicenter, randomized, examiner-blind clinical trial of 6 months duration. Patients with residual probing pocket depth (PPD) of ≥5mm and ≤7mm following previous active periodontal treatment were included. Patients were assigned either subgingival treatment with curettes (control) or an oscillating chitosan brush (test). Changes in bleeding on probing (BoP) and PPD between baseline and terminal evaluation at 6 months were evaluated. A significant reduction in both PPD and BoP was seen within both groups. There was no significant difference in BoP between test and control groups after 6 months, but the reduction in PPD was significantly improved in the test group (P≤0.01). The combined outcome of no BOP and PPD ≤4mm was significantly better in the test group (P≤0.01). No adverse reactions were seen. Treatment of residual periodontal pockets (PPD=5 to 7mm) with a chitosan brush disclosed equal or better clinical results as compared to regular curettes. This study supports that a chitosan brush can be used for subgingival biofilm removal and soft tissue curretage in the treatment of periodontitis.

Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study.

Simple SummaryRegeneration of the wounded/lost tissues post-surgery often requires a meticulous treatment plan. The present study assessed the use of a collagen membrane to aid in the regeneration of lost periodontal tissues following extraction of the tooth. The results show that the collagen membrane promoted wound stabilization, as indicated by improvement in all assessed clinical parameters. Thus, collagen membrane can be used regularly in clinical practice post-extraction to augment wound healing.The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.

Management of Grade II Furcation Defect in Mandibular Molars with Allograft and Alloplastic Bone Graft: A Clinico- Radiographic Study

Aim: The present study was carried out to compare clinically and radiographically the efficacy of regenerative potential of Demineralizedfreeze-dried bone allograft (DFDBA) and Bioactive glass putty (Novabone© dental putty) in mandibular grade II furcation defects. Methods: In 34 Patients, 60 mandibular grade II furcation defects were treated using DFDBA and Bioactive glass putty. 30 furcations were treated using DFDBA, while bioactive glass putty was used to treat remaining 30 furcation defect. Clinical parameters evaluated were Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative vertical attachment level (RVAL), Relative horizontal attachment level (RHAL) at baseline, 3 months and 6 months. Radiographic parameters recorded were linear measurement of defect depth and bone density in gray scale at baseline and 6 months. Results: Both the group showed significant reduction in mean (P≤0.05) GI, PI, PPD, RVAL and RHAL at 6 months. Group I showed greater reduction in PPD. Radiographic evaluation showed significant (P≤0.05) reduction in defect depth and increase in bone density in both groups. Conclusions: Bioactive glass putty showed comparable regeneration to that of DFDBA in the treatment of mandibular grade II furcation defect. Additional putty consistency of bioactive glass makes it easier and more convenient to use.

Clinical and radiographic effects of ascorbic acid-augmented platelet-rich fibrin versus platelet-rich fibrin alone in intra-osseous defects of stage-III periodontitis patients: a randomized controlled clinical trial

AimTo assess platelet-rich fibrin (PRF) with ascorbic acid (AA) versus PRF in intra-osseous defects of stage-III periodontitis patients.MethodologyTwenty stage-III/grade C periodontitis patients, with ≥ 3 mm intra-osseous defects, were randomized into test (open flap debridement (OFD)+AA/PRF; n = 10) and control (OFD+PRF; n = 10). Clinical attachment level (CAL; primary outcome), probing pocket depth (PPD), gingival recession depth (RD), full-mouth bleeding scores (FMBS), full-mouth plaque scores (FMPS), radiographic linear defect depth (RLDD) and radiographic defect bone density (RDBD) (secondary-outcomes) were examined at baseline, 3 and 6 months post-surgically.ResultsOFD+AA/PRF and OFD+PRF demonstrated significant intragroup CAL gain and PPD reduction at 3 and 6 months (p < 0.001). OFD+AA/PRF and OFD+PRF showed no differences regarding FMBS or FMPS (p > 0.05). OFD+AA/PRF demonstrated significant RD reduction of 0.90 ± 0.50 mm and 0.80 ± 0.71 mm at 3 and 6 months, while OFD+PRF showed RD reduction of 0.10 ± 0.77 mm at 3 months, with an RD-increase of 0.20 ± 0.82 mm at 6 months (p < 0.05). OFD+AA/PRF and OFD+PRF demonstrated significant RLDD reduction (2.29 ± 0.61 mm and 1.63 ± 0.46 mm; p < 0.05) and RDBD-increase (14.61 ± 5.39% and 12.58 ± 5.03%; p > 0.05). Stepwise linear regression analysis showed that baseline RLDD and FMBS at 6 months were significant predictors of CAL reduction (p < 0.001).ConclusionsOFD+PRF with/without AA significantly improved periodontal parameters 6 months post-surgically. Augmenting PRF with AA additionally enhanced gingival tissue gain and radiographic defect fill.Clinical relevancePRF, with or without AA, could significantly improve periodontal parameters. Supplementing PRF with AA could additionally augment radiographic linear defect fill and reduce gingival recession depth.

Effect of locally delivered 0.2% Thymoquinone gel in subjects with Grade C Periodontitis: Clinical, Immunological and Microbiological Assessment

To evaluate the clinical, immunological and microbiological efficacy of local application of Thymoquinone (TQ) gel in subjects with grade C periodontitis. Materials and Methods: Twenty-six individuals of both sexes aged between24 and 37 years, diagnosed as grade C periodontitis with pocket depth ≥5 mm were selected for this study. The patients received a complete prophylaxis including scaling and root planning (SRP) followed by local intrapocket administration of placebo gel in the control group and 0.2% TQ gel in the study group sites. Probing pocket depth (PPD), relative attachment level (RAL), matrix metallo-proteniease-8 (MMP8) concentration ingingival crevicular fluid (GCF) and Aggregatibacter actinomycetecomitans (A.a) count in subgingival plaque were measured and recorded at baseline and 8 weeks postoperatively. Results: At 8 weeks evaluation period, TQ group showed a significant reduction in PPD, RAL, MMP-8 levels in GCF and A.a count in subgingival plaque samples when compared to the placebo group. Conclusion: The results showed more favorable clinical, immunological and microbiological outcomes with topically administered 0.2 % TQ gel when used as an adjunct to nonsurgical periodontal therapy in subjects with grade C periodontitis.