Significant Reduction In Plaque Index Research Articles

Locally delivered coconut oil in nonsurgical therapy of stage II and III grade B periodontitis: A randomized controlled clinical trial

Abstract Background and aim The study aims to evaluate and compare the effect of scaling and root debridement alone versus the use of topically applied coconut oil as adjunctive to scaling and root debridement in the treatment of Stage II and III Grade B periodontitis. Patients and methods Thirty-six patients with stage II and III Grade B periodontitis were randomly allocated to two groups. Group I (Control group) patients were treated with scaling and root debridement alone. Group II (Study group) of scaling and root debridement with a topically applied coconut. Clinical parameters including Plaque index (PI), Gingival index (GI), Probing depth (PD), and Clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. Biochemical parameters evaluated tumor necrosis factor-alpha (TNF-α) level at baseline, 1- and 2-months using enzyme-linked immunosorbent assay (ELISA). Results The results revealed that there was a significant reduction in PI, GI, PD, and CAL in the study group following the use of coconut oil as adjunctive to scaling and root debridement when compared with scaling and root debridement alone. Also, the study group showed a statistically significant decrease in the mean levels (TNF-α) than the control group at 1 and 2 months with (P < 0.05). Conclusions The use of coconut oil as adjunctive to scaling and root debridement may improve the healing outcomes in terms of clinical parameters such as PI, GI, PD, and CAL as well as the reduction of TNF-α levels in crevicular fluid in patients with Stage II and II grade B periodontitis.

Comparative Evaluation of Subgingivally Delivered Tetracycline Fibers and Aloe Vera Gel as an Adjunct to Scaling and Root Planing in Treatment of Chronic Periodontitis: A Randomized Controlled Clinical Trial

ABSTRACT Introduction: Comprehensive mechanical debridement, like scaling and root planing (SRP), combined with proper plaque control, is the primary nonsurgical approach for managing periodontitis. However, it may not always eliminate infection due to inadequate debridement or inaccessible areas. For this, various chemotherapeutic allopathic and herbal local drug delivery (LDD) agents as adjuvants have been used with SRP for management of chronic periodontitis. Methodology: A randomized controlled clinical trial was conducted, comprising 60 sites from 20 patients. Each patient received three treatment modalities assigned to different quadrants SRP with normal saline irrigation, SRP with LDD of tetracycline fibers, and SRP with LDD of 100% pure aloe vera gel. Clinical parameters were assessed at baseline, day 7, and 3 months postoperatively. Results: The addition of 100% pure aloe vera gel and tetracycline fibers (Periodontal Plus ABTM) with SRP significantly improved the probing pocket depth (P < 0.05) compared to SRP with saline irrigation. Additionally, the tetracycline group showed significant reductions in plaque index (P < 0.05) and highly significant reductions in modified sulcular bleeding index (P < 0.001) compared to the saline group. Conclusion: Aloe vera gel with SRP shows comparable effectiveness to tetracycline fibers in managing chronic periodontitis, suggesting it as a cost-effective herbal alternative.

Effectiveness of the Education Program on Using Iodine Mouthwash on Dental and Oral Health in Adolescents: An Intervention Study in the Adolescent Community in Batusangkar City, Indonesia

Poor oral health in adolescents is a significant public health problem in Indonesia. Iodine-based mouthwash has been proven effective in reducing plaque and gingivitis, but its use is not optimal among adolescents. This study aims to evaluate the effectiveness of an educational program on the use of iodine-based mouthwash on dental and oral health among adolescents in Batusangkar City. This research is an experimental study with a pre-post test design involving 150 adolescents aged 12-18 years in Batusangkar City. Participants were randomly divided into an intervention group (receiving an educational program and iodine mouthwash) and a control group (receiving an iodine mouthwash). Plaque index, gingival index, and knowledge about dental and oral health were measured before and after the intervention for 6 months. Data analysis was carried out using paired t-tests and independent t-tests. There was a significant reduction in plaque index and gingival index in the intervention group after 6 months of intervention (p < 0.05). The increase in knowledge about dental and oral health was also significant in the intervention group (p < 0.05). There were no significant differences between the two groups at the start of the study. The educational program on the use of iodine-based mouthwash is effective in improving dental and oral health among adolescents in Batusangkar City. This program can be recommended as part of efforts to prevent dental and oral diseases in adolescents.

Evaluation of dental plaque reduction using microcurrent-emitting toothbrushes in orthodontic patients: a randomized, double-blind, crossover clinical trial

This study aimed to compare the effectiveness of microcurrent-emitting toothbrushes (MCTs) and ordinary toothbrushes in reducing the dental plaque index (PI) and dental caries activity among orthodontic patients. The evaluation was performed using a crossover study design involving 22 orthodontic patients randomly assigned to the MCT or ordinary toothbrush groups. The participants used the designated toothbrush for 4 weeks and had a 1-week wash-out time before crossover to the other toothbrush. PI (Attin’s index) and dental caries activity were measured at baseline and at the end of each 4-week period. Additionally, patients completed questionnaires to assess patient satisfaction for “freshness in mouth” and “cleansing degree.” The results showed that the MCT group had a significant reduction in PI (p = 0.009), whereas the ordinary toothbrush group did not (p = 0.595). There was no significant difference in the dental caries activity between the two groups (p > 0.05). Patient satisfaction assessment revealed that 65% patients in the MCT group had more than “fair” experience of freshness, in contrast to 50% of patients in the ordinary toothbrush group. Satisfaction with cleansing degree was similar in both groups. Overall, these findings suggest that MCTs are more effective in reducing dental PI than ordinary toothbrushes.

Combined Efficacy of Advanced Oral Hygiene Aids and Active Reminders in Maintaining the Oral Hygiene of Patients with Fixed Orthodontic Appliances: A Randomized Clinical Trial

Objectives To evaluate the efficacy of water irrigating devices, powered toothbrushes, and active repeated oral hygiene reminders on oral hygiene of fixed orthodontic patients. Materials and Methods This was a randomized, examiner-blind clinical trial involving fixed orthodontic appliance patients. Patients were recruited within six months of bonding on both the arches. Eighty patients were randomly assigned to four groups; groups 1 and 3 subjects received standard oral hygiene procedures and used manual orthodontic toothbrushes, and subjects in groups 2 and 4 used powered toothbrushes and water irrigators for oral hygiene maintenance during the study period. In addition, repeated oral hygiene reminders via SMS were sent to subjects in groups 1 and 2, whereas groups 3 and 4 subjects received only oral motivation. The principal investigator assessed the plaque index (PI) and gingival index (GI) at baseline (T0) and after 2, 4, 8, and 12 weeks, that is, T1, T2, T3, and T4, respectively. Results Group 2 and group 4 subjects showed statistically significant reduction in PI ( p < .001) and GI ( p < .001) scores at the end of study interval; however, the magnitude of decrease was less in group 4 in comparison to group 2. Intergroup comparisons between group 1 versus group 3 and group 2 versus group 4 were made to evaluate the efficacy of reminders. Statistically significant reduction was observed in group 2 as compared to group 4 at T4 ( p < .001) when compared to T1 ( p < .87). Conclusion Using powered toothbrushes and oral irrigators resulted in a statistically more significant reduction in plaque and gingivitis scores than conventional procedures. Active reminders had a catalytic effect in improving the oral hygiene.

Evaluación comparativa de enjuague bucal con peróxido de hidrógeno y clorhexidina sobre los niveles de interleucina-1ß salival en pacientes con diabetes mellitus tipo 2 y periodontitis crónica: ensayo clínico controlado aleatorio

Introduction: Periodontal inflammation causes dysbiosis and change in the microbiota. Nonsurgical periodontal therapy (NSPT) helps in removal of plaque and restoring periodontal health. Various adjunctive therapy like use of mouthwash helps in maintenance of periodontal health and reducing inflammatory load. Materials and Methods: A total of 108 subjects diagnosed with type 2 diabetes mellitus and periodontitis were divided into three groups: Group 1 received NSPT and rinsing with 0.2% chlorhexidine mouthwash for 3 months, Group 2 received NSPT and rinsing with 1.5% hydrogen peroxide mouthwash for 3 months, Group 3- received NSPT only (control group). The clinical parameters measured included Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP) and probing (PD) at baseline, 1, 2, 3 months follow up. Salivary interleukin 1βlevels were measured at baseline and 3 months interval. Results: Group 1, 2 and 3 showed significant reduction in PI, GI, BOP and PD at 1 and 3 months follow up (p<0.05). However, Intergroup comparison of clinical parameters showed significant reduction in group 1 and 2 when compared with group 3 (p<0.05). Salivary interleukin 1-β levels showed significant reduction from baseline to 3 months in all the three groups and intergroup comparison didn’t show any significant changes, (p>0.05). Conclusions: Hydrogen peroxide mouthwash as an adjunct to NSPT can be considered as a safe and effective measure to reduce periodontal inflammation in type 2 diabetes mellitus patients with chronic periodontitis.

Efficacy of Ozonated Olive Oil Gel in the Management of Peri-Implant Mucositis.

Peri-implant mucosistis is similar to gingivitis, the former affects the mucosa around implants without bone loss. The aim of this study was to determine the effectiveness of ozonated olive oil gel in the management of peri-implant mucositis. A randomized controlled clinical trial was conducted among 50 patients with peri-implant mucositis within the age group of 25-50 years. They were randomly divided into two groups with 25 participants in each group based on the intervention [Group A (Ozonated olive oil gel), Group B (Chlorhexidine gel)]. Silness and Loe plaque index (PI) and Loe and Silness gingival index (GI) were recorded at baseline and after 4 weeks. Paired t-test and independent t-test was used to test the significance. Within the groups, there was a statistically significant reduction in PI and GI from baseline (P < 0.05). However, the difference in PI and GI between both the groups was statistically insignificant (P > 0.05). Ozonated olive oil gel was equally effective to chlorhexidine gel in the management of peri-implant mucositis.

Comparative evaluation of plaque removal efficacy and quantitative analysis of &lt;em&gt;Streptococcus mutans&lt;/em&gt; in saliva after using nylon and charcoal bristles toothbrushes in children: A clinico-microbiological study

Background: Dental biofilms are the primary aetiologic factors in the 2 most prevalent oral diseases, dental caries and periodontal disease. Among all oral hygiene methods available, mechanical plaque removal with a toothbrush is the primary mode of maintaining good oral hygiene.Objectives: Comparative evaluation of plaque removal efficacy and quantitative analysis of Streptococcus mutans in saliva after using nylon and charcoal bristles toothbrushes in children.Method: Forty healthy children aged 8-10 years having decayed-missing-filled-tooth (DMFT) score less than 5 were randomly allocated into two groups, one using charcoal bristles and the other using nylon bristles toothbrush. Loe &amp; Silness Plaque Index was recorded along with saliva sample collection for Streptococcus mutans count before and after using the respective toothbrushes for 1 week.Results: A significant reduction in plaque index was observed in each group with a non-significant reduction in Streptococcus mutans CFU. However, the comparison between the two groups was not statistically significant.Conclusions: This randomised, parallel, singleblinded clinical study demonstrated that both nylon and charcoal bristles toothbrushes significantly enhanced plaque control but there was no significant difference in the two methods. There was no significant reduction in Streptococcus mutans CFU.

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.

Comparative evaluation of the clinical and radiographic efficacy of 0.05% zoledronate gel as local drug delivery system in treating intrabony defects in stage III grade B periodontitis patients with and without type-2 diabetes mellitus-A randomized split-mouth clinical trial.

This 6-month randomized split-mouth and placebo-controlled clinical trial aimed to evaluate the clinical and radiographic efficacy of adjunctive use of 0.05% zoledronate (ZLN) gel as local drug delivery to scaling and root planing (SRP) in stage III, grade B periodontitis patients with and without controlled type-2 diabetes mellitus (DM). A total of 120 infrabony sites were divided into two groups: Group-1 (non-diabetic periodontitis) and Group-2 (periodontitis +DM). A total of 60 sites in each group were randomized to receive treatment with SRP+placebo gel (control) or SRP+0.05% ZLN gel (test). Plaque index (PI), modified sulcus bleeding index (mSBI), pocket probing depth (PPD), and relative attachment levels (RAL) were assessed at baseline, 3 and 6 months, and digital intraoral periapical and cone-beam computed tomography imaging were used to measure the linear and percentage reduction of intrabony defect depth (DD, DDR%) after 6 months. Group-1 showed significant reduction in PI (0.56±0.15 and 0.52±0.19 from 0.67±0.17), mSBI (0.7± 0.60 and 0.47± 0.57 from 0.9±0.48), PPD (4.6± 0.85 and 3.43 ± 0.63 from 6.5±1.04) and gain in RAL (7.03±0.85 and 5.93 ± 0.69 from 8.9±1.09) in the ZLN-treated sites than the placebo sites and also from Group-2 sites after 3 and 6 months, respectively. A significant reduction in DD of 28.79% in Group-1 and 22.20% in Group-2 at ZLN sites was seen compared to placebo sites of both groups. ZLN gel applied subgingivally in infrabony pockets resulted in significant clinical improvements evident by probing depth reduction and gain in attachment levels along with radiographic evidence of more bone fill seen in non-diabetic patients compared to diabetic periodontitis patients.

Effect of interproximal home oral hygiene on clinical parameters and inflammatory biomarkers in patients receiving periodontal maintenance.

The purpose of this 6-week, single-blinded, randomized clinical trial was to determine if the use of an interproximal brush, with or without a tracking device, is more effective than an oral irrigator in improving interproximal probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and inflammatory markers. Seventy-six patients with Stages III-IV, Grade B periodontitis and a 5-7mm posterior interproximal PD with BOP were randomized: (1) interproximal brush alone (IB; n=26), (2) interproximal brush with tracking device (TD; n=23), (3) oral irrigator (OI; n=27). Participants used devices once daily for 6weeks. Clinical measurements (PD, CAL, PI, BOP, GI) and gingival crevicular fluid (GCF) samples were collected at baseline and 6weeks. All groups showed a significant reduction in PD and CAL (≥1.1mm, p<0.0001) and improvement in BOP (≥56%, p<0.0001) and GI (≥82%, p<0.001) at the experimental site with no differences among groups. The IB and IB+TD groups showed a significant reduction in PI (≥0.9, p ≤ 0.01). Interleukin (IL)-1β was reduced in all groups (p=0.006), but IB+TB more than OI (p ≤ 0.05). IL-10 was reduced among all groups (p=0.01), while interferon-gamma significantly increased (p=0.01) in all groups. IB and OI improved clinical parameters of PD and CAL and reduced inflammatory markers (BOP, GI, GCF IL-1β). IB had better interproximal plaque reduction. Tracking did not significantly improve clinical parameters compared with the IB and OI groups, suggesting future modifications are needed.

Clinical efficacy of green tea, aloe vera and chlorhexidine mouthwashes in the treatment of dental biofilm induced gingivitis: A multi-arm, double-blinded, randomized controlled clinical trial.

This multi-arm, randomized, double-blinded, controlled clinical trial was designed to evaluate the clinical efficacy of 0.5% green tea (GT), 0.2% chlorhexidine (CHX) and aloe vera (AV) mouthwash as compared to the control (CNT) group (scaling and polishing alone with no mouthwash) in the management of dental biofilm induced gingivitis among 18-40-year-old patients. Sixty patients with generalized dental biofilm-induced gingivitis were randomly allocated to four study groups (n=15 each) for treatment, namely Group GT, Group CHX, Group AV and Group CNT after scaling and polishing were administered to all the patients. Plaque index (PI), gingival index (GI) and sulcular bleeding index (SBI) were recorded at baseline, 14th and 21st day. PI, GI and SBI at various time intervals (baseline, 14th and 21st day) showed high statistically significant differences within the group (p < 0.01). Among these, the maximum percentage change was found in the CHX group followed by GT when evaluated from baseline to 21st day. The least percentage change was found in the AV group for PI and GI while the CNT group showed the least percentage change for sulcular index when evaluated from 14th to 21st day. Inter-group results showed high statistically significant differences (p < 0.01) for PI and GI when evaluated between baseline to 14th day and baseline to 21st day. SBI also showed statistically significant differences (p < 0.05) when evaluated between baselines to 14th day and baseline to 21st day. Green tea mouthwash displayed a significant reduction in plaque index, gingival index and sulcular bleeding index. 0.5% green tea catechin has equivalent anti-plaque efficacy as 0.2% chlorhexidine gluconate and can be considered a potent alternative to prevent and treat gingival diseases.

Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis

The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica-based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM). Patients with and without medically diagnosed T2DM were included. Patients' medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica-based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01. Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores. In the short term, NSPT with 0.12% CHX or S persica-based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.

Non-surgical periodontal therapy with adjunct photodynamic therapy for the management of periodontal inflammation in adults using nicotine-free electronic-cigarette: A randomized control trial

ObjectiveThe aim was to assess the effect of non-surgical periodontal therapy (NSPT) with adjunct photodynamic treatment (PDT) for the management of periodontal inflammation in young electronic cigarette (E-cig) users. MethodsPatients with periodontal inflammation were included. Patient demographics and information related to E-Cig usage were recorded. Scores of plaque index (PI), bleeding index (BI), clinical attachment loss (AL) and probing depth (PD) recorded at baseline and at 3-months’ follow-up. Patients were randomly divided into test (NSPT + PDT) and control groups (NSPT) alone. Sample-size estimation was done using data from a pilot investigation and group comparisons were done. Correlation between periodontal parameters and duration of E-cig use was assessed using regression analysis models. Group-comparisons were done using the Mann Whitney U test; and logistic regression was done to correlate periodontal parameters with age, gender, frequency of vaping, number of puffs inhaled and oral hygiene maintenance protocols. Level of significance was set at P<0.01. ResultsTwenty-three and 23 individuals were randomly allocated to the test- and control-group, respectively. At baseline, PI, BI and PD were comparable in all patients. There was a significant reduction in PI (P<0.01), BI (P<0.01) and PD (P<0.01) in the test and control groups at 3-months’ follow-up when compared with their respective baseline scores. At 3-months’ follow-up, there was no significant difference in PI, BI and PD among patients in the test and control groups. There was no clinical evidence of clinical AL among patients in the test- and control groups at baseline and at 3-months’ follow-up. ConclusionIn the short-term, PDT is as effective as NSPT for the management of periodontal inflammation in young E-Cig users.

Efficacy of 0.2% chlorhexidine gluconate and 0.1% octenidine dihydrochloride mouth rinses in patients with plaque induced gingivitis: Double blinded randomised case control study.

Aims: The study aims at making a comparative study of two commercially available mouth rinses, 0.2% chlorhexidine gluconate and 0.1% octenidine dihydrochloride for assessing their efficacy as an antiplaque agent in patient with plaque induced gingivitis.&#x0D; Methods and Material:&#x0D; In double-blinded experimental study forty-five patients with dental plaque induced gingivitis, divided into 3 groups of 15 patients each, were advised 0.2% chlorhexidine gluconate (CHX) and 0.1% octenidine dihydrochloride (OCT) and distilled water as a mouth rinses respectively. Clinical parameters viz, Plaque Index, Modified Gingival Index and Gingival Bleeding Index were assessed (day 0, 5,10 and15). Microbial count was also assessed from the collected plaque samples (at day 0 and on day 15). Antimicrobial susceptibility test was also done.&#x0D; Statistical analysis used: One- way ANOVA with post hoc test using Tukey, Paired- t test, Mann-Whitney U test, The Kruskal-Wallis test, Wilcoxon signed-rank test&#x0D; Results:&#x0D; There was significant difference in mean plaque index between the different groups. There was a significant reduction in plaque index for 0.2% CHX The mean modified gingival index was higher in group belonging to 0.1% OCT compared to 0.2% CHX that was statistically significant (p = 0.005). Similarly, the mean gingival bleeding index was significantly higher in group belonging to 0.1% OCT compared to 0.2% CHX (p = 0.005). On day 15 change in the microbial count was statistically significant for 0.2% CHX (p = 0.026).and 0.1% OCT (p = 0.001).&#x0D; Conclusions:&#x0D; The antimicrobial and antiplaque efficacy (in vivo and in vitro) of 0.1% octenidine dihydrochloride containing mouth rinse was comparatively higher than that containing 0.2% chlorhexidine gluconate thereby demonstrating the former's potential usefulness in controlling plaque and gingivitis.

Determination of efficacy of curcumin and Tulsi extracts as local drugs in periodontal pocket reduction: A clinical and microbiological study.

Background:The aim of our study is to assess the effectiveness of Curcumin and Tulsi in the control of periodontal parameters when delivered in the form of local drug delivery (LDD) agents.Methods:Curenext gel® and Tulsi gel were used as the two LDD agent. A split mouth randomized clinical trial was carried out in 15 patients. Three sites in different quadrants were assigned treatment modality of scaling and root planing (SRP) alone, SRP with LDD of curcumin and SRP with LDD of Tulsi extract, respectively. Clinical parameters Probing Pocket Depth, Clinical Attachment Level, Plaque Index, Gingival Index, and modified Sulcus Bleeding Index were recorded and subgingival plaque sample collected for N-benzoyl-L-arginine-p-nitroanilide (BAPNA) assay on baseline followed by LDD with extracts in the assigned group. The parameters were recorded at baseline and on 30th day postoperatively. Unpaired and Paired-'t' test were used for intergroup and intragroup comparison of recorded clinical and microbiological parameters.Results:All the treatment modalities showed statistically significant reduction in clinical and microbiological parameters on intragroup comparison. Intergroup comparison showed statistically significant reduction in Plaque Index in curcumin group and BAPNA assay in Tulsi group when compared to SRP.Conclusion:Both the herbs were effective in improving periodontal parameters and may develop as an alternative to currently used LDD agents in near future.

Functionally graded membrane: A novel approach in the treatment of gingival recession defects.

Background:Guided tissue regeneration has recently been advocated in re-constructing soft-tissue dimensions in recession defects. Advancement in nanotechnology has led to increased zest for approaches such as electrospinning of biologically active; nanofibrous functionally graded regenerative membranes for periodontal tissue engineering. A functionally graded membrane (FGM) had been tailored by incorporating chitosan and nano-hydroxyapatite over Amnion membrane and used in gingival recession defects.Study Design:It was single-blind, randomized controlled study. Split-mouth study was conducted in nine patients and 22 sites with recession defects were selected. Sites were divided into Group A (Amnion membrane with coronal advanced flap) and Group B (FGM with coronal advanced flap).Materials and Methods:Sites were assessed clinically by recording plaque index (PI), gingival index (GI), vertical recession defect depth (VRDD), relative clinical attachment level (CAL), and width of keratinized tissue at baseline, 3–6 months; and radiographically by recording linear bone growth by dentascan at baseline and 6 months.Result:Both groups showed statistically significant reduction in PI, GI and VRDD, and CAL and nonsignificant reduction in width of keratinized tissue at 3 and 6 months postoperatively. Group A showed statistically significant linear bone growth at 6 months. Group B also showed gain in linear bone growth at 6 months; however, result was statistically nonsignificant.Conclusion:FGM had shown favorable results by enhancing bone growth while preventing the gingival tissue downgrowth.

The Effects of Curcumin in the Treatment of Gingivitis: A Systematic Review of Clinical Trials.

Different modalities of treatments are available for management of gingival disease but most have adverse effects. Curcumin has anti-inflammatory properties and can be used for management of various inflammatory processes. This systematic review evaluates the effects of curcumin as an adjuvant to oral hygiene on plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and inflammation in patients with gingivitis. A comprehensive search was conducted using PubMed/MEDLINE, Cochrane, SCOPUS, and Google Scholar. Based on the Population, Intervention, Control, and Outcome (PICO) model, clinical trials which tested the effects of curcumin as an adjunctive product or alone in control of gingival inflammation up until 21 February 2020 with language restrictions were selected. From the 422 papers found, 14 met the eligibility criteria. In most of these studies, curcumin treatment achieved significant reductions in PI, GI, GBI, and microbial colony count and was as effective as chlorhexidine mouthwash, with no serious adverse effects. We conclude that treatment with curcumin for gingivitis is safe as a natural herbal compound and is as effective as chlorhexidine mouthwash.

Role of Probiotics for the Treatment of Peri-Implant Mucositis in Patients With and Without Type 2 Diabetes Mellitus.

This study hypothesized that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for the treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type 2 diabetic and nondiabetic patients over a 12-month follow-up period. Patients with and without type 2 diabetes were included. PM patients were categorized into 2 groups based on the treatment procedure: (1) nonsurgical + PT and (2) nonsurgical MD alone. Demographics and education statuses were recorded. Gingival index (GI) and plaque index (PI), crestal bone loss (CBL), and probing depth (PD) were measured at baseline and after 6 and 12 months. Significant differences were detected with P < .01. The hemoglobin A1c level was significantly higher in patients with diabetes at all time durations than in patients without type 2 diabetes (P < .001). Baseline GI, PI, PD, and CBL were comparable in all groups. In patients with type 2 diabetes, there was no difference in PI, GI, PD, and CBL at 6- and 12-month follow-up. In patients without type 2 diabetes, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01) at 6-month and 1-year follow-up as compared with baseline. In patients without type 2 diabetes, MD with or without adjunct PT reduced soft-tissue inflammatory parameters in patients with PM.

Assessment of Antiplaque and Anti-Gingivitis Efficacy of Mouthwashes Prepared from Neem and Mango Extracts.

Objectives:This study aimed to determine the minimum inhibitory concentration (MIC) of mouthwashes prepared from neem and mango extracts against Streptococcus mutans (S. mutans) in vitro. Their taste acceptability and effects on plaque index (PI), gingival index (GI) and salivary pH were also evaluated and compared with chlorhexidine (CHX) in children.Materials and Methods:Dry extracts of neem and mango twigs were prepared and their MIC against S. mutans was determined. The effective MIC was used to prepare mouthwashes from the two extracts. Three parallel groups of children (n=30) used either neem, mango or 0.2% CHX mouthwash for 21 days. The PI and GI were recorded at baseline and at 7 and 21 days. The salivary pH and taste acceptability were also assessed.Results:The MIC of both extracts was achieved at 25% concentration. There was a significant difference between the GI score of mango group compared with neem and CHX at the three time points (P<0.001). There was no significant difference between the neem and mango groups in PI (P=0.674). There was no significant difference among the three groups in salivary pH either (P=0.817). Intragroup comparison showed significant reductions in PI, GI and salivary pH in all the three groups after 21 days (P<0.001).Conclusion:Neem and mango mouthwashes can be used as effective alternatives to CHX in children.