Significant Probing Depth Reduction Research Articles

The Effect of Peri-Implant Therapy on the Expression of Th17-Related Cytokines in Patients with Peri-Implant Mucositis and Peri-Implantitis: A Prospective Longitudinal Study.

Background/Objectives: Cytokines related to the Th17 response have been associated with peri-implant diseases; however, the effect of peri-implant therapy on their modulation remains underexplored. To evaluate the effect of peri-implant therapy on the expression of cytokines related to the Th17 response in the peri-implant crevicular fluid (PICF) (GM-CSF, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-12 (p70), IL-17A, IL-21, IL-23, and TNF-α) of partially edentulous patients with peri-implant disease (PID). Methods: Thirty-seven systemically healthy individuals presenting with peri-implant mucositis (PIM) (n = 20) or peri-implantitis (PI) (n = 17) were treated and evaluated at baseline (T0) and three months after therapy (T1). Clinical parameters (probing depth (PD), clinical attachment level (CAL), plaque index, and bleeding on probing index (BoP), were evaluated. The PIM group underwent non-surgical therapy, while the PI group received a surgical approach. PICF was collected with absorbent paper strips and analyzed with a multiplex assay. Results: Eighty-eight implants were treated in 37 patients (56 in the PIM group and 32 in the PI group). After therapy, significant reductions in PD, CAL, plaque index, and BoP were observed in the PIM group (p < 0.05). In the PI group, significant reductions in PD, CAL, and BoP were noted (p < 0.05). The PIM group showed a significant reduction of IL-17A and TNF-α after therapy, while the PI group showed a significant reduction of IL-1β, IL-6, and TNF-α (p < 0.05). Conclusions: The peri-implant therapy for patients with PID reduced the expression of cytokines related to the Th17 response in PICF.

Efficacy of Antibiotic Versus Probiotics as Adjuncts to Mechanical Debridement for the Treatment of Peri-Implant Mucositis

ABSTRACT Background: Peri-implant mucositis, an inflammatory condition affecting the soft tissues surrounding dental implants, is commonly treated with mechanical debridement. The efficacy of adjunctive therapies, such as antibiotics and probiotics, in enhancing treatment outcomes remains a topic of interest. Materials and Methods: A randomized controlled trial was conducted with 60 patients diagnosed with peri-implant mucositis. Patients were divided into three groups: group A (mechanical debridement alone), group B (mechanical debridement plus antibiotics), and group C (mechanical debridement plus probiotics). Clinical parameters, including probing depth (PD), bleeding on probing (BOP), and plaque index (PI), were recorded at baseline, 1 month, and 3 months post treatment. Statistical analysis was performed using ANOVA and post-hoc tests to compare the efficacy between groups. Results: At 1 month, group B showed a significant reduction in PD (mean reduction of 2.1 mm) and BOP (mean reduction of 40%) compared to group A (mean reduction of 1.2 mm in PD and 25% in BOP) and group C (mean reduction of 1.8 mm in PD and 35% in BOP). At 3 months, group C exhibited sustained improvement in PI (mean reduction of 50%) and BOP (mean reduction of 45%) compared to group B (mean reduction of 45% in PI and 40% in BOP) and group A (mean reduction of 30% in PI and 20% in BOP). Conclusion: Both antibiotics and probiotics as adjuncts to mechanical debridement demonstrated efficacy in the treatment of peri-implant mucositis. Antibiotics showed a more pronounced immediate effect, while probiotics provided sustained improvements over a longer period.

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 &lt; 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.

Tooth autotransplantation with adjunctive application of enamel matrix derivatives using a digital workflow: A prospective case series

ObjectivesDigital protocols and bioactive materials may reduce complications and improve tooth autotransplantation (ATT) success and survival rates. This prospective study assesses the performance of a fully digital autotransplantation protocol of close-apex molars with the adjunctive application of Enamel Matrix Derivatives (EMD). MethodsTwelve adult patients with 13 hopeless molar teeth were replaced with autotransplantation of closed apex third molars. Outcomes, including success and survival rates, clinical, endodontic, radiographic, patient-reported outcome measures (PROMs), and digital image assessments, were conducted over a two-year follow-up period. ResultsSurvival and success rates were 100% and 91.2%, respectively, with no progressive inflammatory or replacement root resorption (ankylosis) except for one tooth presenting radiographic furcation involvement. A significant probing depth reduction of 2.4 ± 2.58 mm and CAL gains of 2.8 ± 3.03 mm were observed in transplanted teeth compared to the hopeless receptor teeth. Radiographic bone levels remained stable throughout the study period (-0.37 ± 0.66 mm), and digital image assessments showed minimal alveolar ridge width changes (-0.32 to -0.7 mm) and gingival margin changes (-0.95 to -1.27 mm) from baseline to last visit. PROMs indicated very high patient satisfaction. ConclusionThe use of a digital ATT protocol with adjunctive use of EMD in closed-apex third molars demonstrated promising short-term high success and survival rates. Additionally, this type of therapy adequately preserves the dimensions of the alveolar ridge in the receptor site. Clinical significanceThis is the first prospective clinical study examining the effect of a digital tooth autotransplantation protocol combined with the application of EMD. It demonstrates that this approach is an effective treatment for replacing hopeless teeth and also validates the digital assessment of ATT alveolar ridge preservation at the recipient site.

Impact of surface chemical treatment in surgical regenerative treatment of ligature-induced peri-implantitis: A canine study.

Implant surface decontamination is a critical step in peri-implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature-inducted peri-implantitis. Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri-implantitis. The peri-implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration. Thirty-five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl-treated sites demonstrated reosseointegration with direct bone-to-implant-contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls (p<0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50±1.24mm at baseline to 4.46±1.70mm at 6-months postsurgery (p=0.006). CHX-treated sites demonstrated a nonsignificant reosseointegration of 26% (p>0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p>0.05). Titanium implants with peri-implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.

Assessing the Impact of Smoking Cessation Interventions on Periodontal Health and Gingival Inflammation in Smokers with Periodontitis

ABSTRACT Background: Smoking is a well-established risk factor for periodontitis, a chronic inflammatory disease of the oral cavity. While smoking cessation has been linked to improved overall health, its specific impact on periodontal health and gingival inflammation in individuals with periodontitis remains less explored Materials and Methods: We conducted a prospective cohort study involving 200 smokers diagnosed with periodontitis. Participants were divided into two groups: Group A received comprehensive smoking cessation interventions, including counseling and pharmacotherapy, while group B continued smoking without intervention. Periodontal health was assessed through clinical parameters, including probing depth (PD) and clinical attachment level (CAL), at baseline and 6 months post intervention. Gingival inflammation was evaluated using the Gingival Index (GI). Results: After 6 months, group A exhibited a significant reduction in mean PD (from 4.5 mm to 3.2 mm) and CAL (from 5.0 mm to 3.5 mm) compared to group B. Conversely, group B showed no significant change in these parameters. The GI score significantly decreased in group A (from 2.8 to 1.2) but remained unchanged in group B. Furthermore, group A demonstrated a higher rate of smoking cessation (72%) compared to group B (14%) Conclusion: Smoking cessation interventions play a crucial role in improving periodontal health and reducing gingival inflammation in smokers with periodontitis. The observed reductions in PD, CAL, and gingival inflammation highlight the potential benefits of smoking cessation on oral health outcomes in this high-risk population.

Eficácia do laser de diodo de alta potência como coadjuvante à instrumentação mecânica de bolsa profunda em paciente com periodontite estádio III, grau C e generalizada

ABSTRACT Periodontitis is an inflammatory clinical condition caused by dysbiotic biofilm that results in progressive destruction of periodontal attachment and can lead to tooth loss if left untreated. Objective: To evaluate the clinical efficacy of high-power diode laser as an adjunct to mechanical instrumentation in periodontal pockets of a patient with generalized, stage III, grade C periodontitis. Methods: 126 sites of a patient were examined at the Clinical Research Laboratory (LabClin) of the Federal University of Campina Grande (UFCG), where the parameters of probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP) were evaluated at the beginning of the study and after 3 and 6 months of basic therapy. All sites received non-surgical periodontal treatment which corresponds to scaling and root planing (SRP) and coronary polishing. The deep periodontal pockets with PD ≥ 5 mm, received the adjuvant therapy with diode laser light. Results: There was a significant improvement of periodontal parameters of PD, CAL and BoP in all treated sites. In those with PD ≥ 5 mm, the results were similar, with statistically significant reduction of PD, CAL and BoP before and after treatment. After 6 months, all periodontal pockets with PD ≥ 5mm were reduced to values lower than 3. Conclusion: The irradiation of deep pockets with high-power diode laser proved to be effective as adjuvant therapy to SRP in patients with generalized, stage III, degree C periodontitis.

Comparison between Hyaluronic Acid and Chlorhexidine in the treatment of Orthodontically induced gingival enlargement: A randomized controlled trial

Introduction: The study aimed to assess and compare the effectiveness of chlorhexidine and hyaluronic acid when used as an adjuvant to professional mechanical plaque removal (PMPR) in the treatment of orthodontically induced gingival enlargement. Methods: The study conducted was a randomized controlled clinical trial involving 45 patients. The patients will be categorized into 3 groups; control group receiving conventional PMPR, study 1 group receiving PMPR and chlorhexidine (CHX), and study 2 group receiving PMPR and hyaluronic acid (HA). Probing depth (PD), Gingival overgrowth index (GOI), gingival bleeding index (GBI), and plaque index (PI), will be recorded at baseline, 1 month, 2 months, and 4 months’ post therapy. A bivariate analysis was conducted to evaluate the parameters in function of the three study groups, and to evaluate the changes in PD and GBI between baseline, month 1, month 2 and month 4 in the three study groups. Results: A significant reduction in probing depth and gingival bleeding was observed in the three groups (p 0.05). The change in PD, PI, GBI and GOI was more in Group 1 and Group 2 than in the control group. Hyaluronic acid demonstrated the same effect of chlorhexidine. Conclusions: HA is just as effective as CHX in treating gingival enlargement. Based on the acceptance of HA by patients generally and the negative effects of CHX, HA may be a potential alternative to CHX.

Adjunctive effect of collagen membrane coverage to L-PRF in the treatment of periodontal intrabony defects: a randomized controlled clinical trial with biochemical assessment

BackgroundThe innovation of leukocyte platelet-rich fibrin (L-PRF) has added enormous impact on wound healing dynamics especially the field of periodontal regeneration. The release of growth factors (GF) is thought to improve the clinical outcomes in infrabony defects. The aim of this study was to evaluate the clinical effect of covering L-PRF contained infrabony defects with collagen membranes (CM), and to compare their GF release profile to uncovered L-PRF defects and open flap debridement (OFD).MethodsThirty non- smoking patients with infrabony pockets participated to be randomly assigned to OFD group (n = 10), L-PRF group (n = 10), or L-PRF protected CM group (n = 10). Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and the radiographic defect base fill (DBF) were measured at baseline and at 6 month following surgical intervention. Gingival crevicular fluid samples were obtained on days 1, 3, 5, 7, 14, 21 and 30 days following surgery for the Platelet Derived Growth Factor-BB (PDGF-BB) and Vascular Endothelial Growth Factors (VEGF) release profile evaluation.ResultsFor all patients, a statistically significant (P ≤ 0.05) reduction in PI, GI, PD and CAL were reported throughout the study period. Differences between the three treatment modalities were not statistically significant. PRF + CM showed a statistically significant DBF compared to OFD and L-PRF groups at follow up. Quantitative analysis of PDGF-BB and VEGF levels demonstrated a statistically significant (P < 0.001) decline between measurement intervals for all groups with no statistically significant differences between the three groups.ConclusionWithin the limitations of this study, L-PRF coverage with CM may augment defect base fill through its mechanical protective effect without enhancement in the release profile of VEGF and PDGF. The non-significant intergroup differences question the validity of the claimed extra physiologic concentration of GF offered by L-PRF harvests.Trial registrationThe present study was registered at ClinicalTrials.gov (NCT05496608), (11/08/2022).

Use of Curcumin-Loaded Polyvinylpyrrolidone in Conjunction With Surgical Treatment of Intrabony Periodontal Defects ‘Controlled Clinical and Biochemical Study’

IntroductionOne of the major problems with curcumin topical therapy is its bioavailability in the gingival crevicular fluid in order to induce predictable effects. This study was conducted in order to evaluate the release pattern of curcumin in the gingival crevicular fluid from polyvinylpyrrolidone (PVP) as a sustained release vehicle. Clinical impact of curcumin-loaded (PVP) in conjunction with surgical treatment of intrabony periodontal defects was also evaluated. MethodsTwenty-four patients having stage II or stage III, grade A periodontitis, were included in the study. Patients were divided into two groups: group I: periodontal defects were treated by open flap debridement alone; group II: defects were treated by open flap debridement followed by application of curcumin-loaded (PVP) (2%curcumin). Clinical parameters were recorded 3 and 6 months postoperatively. Radiographic measurements were recorded 6 months postsurgically. The release profile of curcumin was performed using high-performance liquid chromatography. Curcumin availability was reported for up to 30 days. ResultsClinical results demonstrated statistically significant reduction in probing depth and gain in clinical attachment level for group II sites compared to group I. Gradual release of curcumin was detected in a descending manner over 14 days. Radiographic examination from baseline to 6 months showed a statistically significant bone fill in group II compared to that of group I. ConclusionsThe use of curcumin-loaded PVP in association with open flap debridement of intrabony periodontal defects leads to prolonged curcumin availability associated with a significant reduction in probing depth, gain in clinical attachment level, and bone fill compared to open flap debridement alone.

Clinical and radiographic peri-implant outcomes with riboflavin loaded Poly-L-glycolic acid nanoparticles incorporated in aloe-vera gel treating peri-implantitis in chronic hyperglycemic patients

AimThe objective of the current study was to compare the effectiveness of antimicrobial photodynamic therapy (PDT) versus Poly-L-glycolic acid nanoparticles loaded riboflavin incorporated in aloe vera gel (PGA/RF/AV) on periimplant parameters and bacterial counts in chronic hyperglycemic patients having periimplantitis. MethodsOne hundred and two diabetic patients undergoing mechanical debridement (MD) were equally divided into three groups: Group 1: PGA/RF/AV+ MD, Group 2: PDT + MD, and Group 3: MD alone. Periimplant parameters [Bleeding on probing (BoP), probing depth (PD), plaque index (PI), marginal bone level (MBL)] were recorded in all three groups. Periimplant plaque samples were studied to record the levels of Tannerella forsythia (Tf) and Porphyromonas gingivalis (Pg). The recordings were taken at baseline, 3 months and 6 months post treatment. ResultsAll three groups showed a reduction in severity of periimplantitis measured in terms of PD, PI, MBL and BoP. A statistically significant reduction in PD, PI and MBL was found in patients in Group 2 whereas participants of Group 1 were found to have a significant decrease in BoP. A statistically significant decline in the numbers of both the bacterial species was seen in Group 2 at the three-month follow-up whereas at the six-month follow-up, a statistically significant reduction was observed in treatment Group 2 in the levels of Tf species only. ConclusionRiboflavin-loaded nanocarrier incorporated in aloe vera gel showed greater clinical efficacy than PDT alone in the treatment of periimplantitis in chronic hyperglycemic individuals.

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 hyaluronic acid in the treatment of periodontal intrabony defect: a systematic review and meta-analysis.

This systematic review aimed to evaluate the effects of hyaluronic acid (HA) alone or in combination with any bone substitute for the treatment of intrabony defects (IBDs). Six databases were searched up to April 2022 to find randomized clinical trials comparing the clinical effects of open flap debridement (OFD) + HA versus OFD alone (first group) or OFD + HA + bone substitutes versus OFD + bone substitutes (second group) in the treatment of IBDs with a follow-up of at least 3months. Random effects models of mean differences were used to determine the clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill (RBF). Of the 276 studies identified, 6 were included in the qualitative synthesis, and 5 in the meta-analyses. The meta-analyses in the first group showed a statistically significant differences for CAL gain (mean difference [MD]:1.00; 95% confidence interval [CI]:0.65 - 1.35; n = 2) and PD reduction (MD: 0.76; 95%CI: 0.34 - 1.17; n = 2) favoring HA + OFD at 6months. However, in the second group, the meta-analyses did no show additional effect of HA in association with bone substitute was demonstrated for either CAL gain (MD: 0.57; 95%CI: - 0.30 - 1.43; n = 2) or PD reduction (MD: 1.05; 95%CI: - 0.38 - 2.47; n = 2) but did show significant differences for RBF (MD: 0.57; 95%CI: 0.15 - 0.99; n = 2) at 12months. Compared with OFD alone, local application of HA in the treatment of IBDs provided a significant CAL gain and PD reduction at 6months. However, its combination with bone substitutes showed no statistically significant differences at 12months. The use of OFD + HA improves the CAL and PD in the treatment of IBDs compared to OFD only after 6months of follow-up. These results are not maintained after 12months.

Efficacy of subgingival minocycline hydrochloride delivery as an adjunct to non-surgical mechanical debridement for the treatment of peri-implantitis in patients with type-2 diabetes mellitus.

The aim was to assess the efficacy of subgingival minocycline hydrochloride (MH) delivery with non-surgical mechanical debridement (NSMD) for treating peri-implantitis in patients with type-2 diabetes mellitus (DM). Type-2 diabetic and non-diabetic patients with peri-implantitis were included. In the test-group, patients underwent NSMD with a single session of MH delivery. In the control-group, patients underwent NSMD alone. Hemoglobin A1c (HbA1c), modified plaque-index (mPI), modified gingival index (mGI), probing-depth (PD) and crestal bone loss (CBL) were measured at baseline and at 6-month follow-up. Level of significance was set at p<0.01. Thirty type-2 diabetic and 30 healthy individuals with peri-implantitis were included. There was a significant reduction in mPI (p<0.01), PD (p<0.01) and mGI (p<0.01) at 6 months among patients with and without type-2 DM in the test and control groups. There was no significant difference in peri-implant parameters in all patients at the 6-month follow-up. There was no significant difference in HbA1c and CBL among patients with and without type-2 DM in the test and control groups when baseline values were compared with those at 6 months of follow-up. A single application of subgingival MH delivery is as effective as NSMD alone for the treatment of peri-implantitis in type-2 diabetic patients.

The Tunnel Wall Approach and Enamel Matrix Derivative to Cover Exposed Roots and Improve Clinical Attachment Levels in Cairo Class III Defects Associated with an Intrabony Lesion in the Anterior Area: Three Cases.

These case reports present a surgical technique to improve the clinical attachment level and cover the exposed root surface in Cairo Class III situations associated with a one- to two-wall combined intrabony defect in the anterior area. The tunnel wall approach combined previously described concepts and placed a CTG into a modified tunnel-type flap through a vertical releasing incision. The CTG acted both as a buccal soft tissue wall to stabilize the blood clot and as a space maintainer to coronally move the tissue. The decontaminated root surfaces were treated with enamel matrix derivative, and a bone filler material was placed from the bottom of the intrabony defect up to the cementoenamel junction to support the proximal soft tissue architecture. Healing of the four presented sites was uneventful. Clinical measurements up to 12 months showed significant probing depth reduction, clinical attachment gain, and coverage of the buccal recession in each case. Papilla improvement was reported in three cases. Radiographic examinations confirmed intrabony defect healing and the presence of embedded bone filler material in the soft tissue above the bone crest. The tunnel wall approach seems to be a valuable option to safely enhance the clinical attachment level and cover the exposed root in Cairo Class III situations associated with a one- to two-wall combined intrabony defect in the anterior area.

Eeficiency of conventional technique and surgical operating microscope in crown lengthening: An original research

Background: The success of any periodontal therapy always depends on better visual access and, magnification is an important component which provides good hand eye coordination with a better treatment outcome. The aim of our study is to assess the effectiveness of magnification over conventional method while performing surgical crown lengthening and to evaluate the patient comfort level and pain perception over a period of 3 months. Methods -The study was conducted amongst 20 patients, 10 in each group requiring crown lengthening for restorative purpose and was evaluated ever a period of 3 months. Results - During 3months follow up, significant differences were found between the groups for probing depth with mean difference of 1.22±0.6, position of gingival margin as with mean 2.7±1.15 and biologic width with mean difference 2.8±0.42.Regarding patient comfort and patients pain perception it was found low for microscope group with mean difference of 2±0.67 Conclusion – A good visual access is a primary requisite behind the success of any periodontal therapy and it was concluded from our study that there was significant reduction in probing depth and improvement in biologic width, gingival margin.

Efficacy of Er:YAG laser for the peri-implantitis treatment and microbiological changes: a randomized controlled trial.

The aims of this study were to identify the microbiological changes in the periodontal pockets following an Er:YAG laser (ERL) irradiation and mechanical debridement to compare the effectiveness of ERL irradiation to mechanical debridement for peri-implantitis treatment through randomized controlled trials. Twenty-three patients with peri-implantitis lesions were treated in either a test group, ERL set at energy level of 100mJ/pulse, frequency of 10Hz, pulse duration was 100µs, and irradiated by three passages, or a control group, with mechanical debridement using an ultrasonic scaler. An examiner measured the following clinical parameters at different stages (a baseline and at 3- and 6-month post-treatment): probing depth (PD), bleeding on probing (BOP), marginal bone loss (MBL), and anaerobic bacteria counts. Linear regression, with generalized estimation equations, was used to compare the clinical parameters and anaerobic bacterial counts at different stages and between groups. The anaerobic bacterial counts significantly decreased within the control group during the follow-ups. At the 6-month follow-up, both groups showed a significant reduction in PD (test group: mean difference of 0.84mm; control group: mean difference of 0.41mm), and the test group showed a significantly higher PD reduction on the buccal site (1.31mm) compared to that of the control group (0.25mm). Both ERL and mechanical debridement treatments led to significant improvements in PD. When mechanical debridement therapy was used, significant anaerobic bacterial count reductions were observed. Future treatment of peri-implantitis should involve a combination of both of these therapies.

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.

Evaluation of biphasic hydroxapatite and β-tricalcium phosphate as a bone graft material in the treatment of periodontal vertical bony defects - A clinical and digital radiological measurement study.

The present study aimed to evaluate 2 bone graft materials, that is, biphasic hydroxyapatite and β-tricalcium phosphate, in the treatment of periodontal vertical bony defects. In term of attachment level, probing depth and radiographic bone level changes. Also, a new digital method of radiographic assessment was used for measurement of vertical bone defect. Ten subjects with periodontitis and having two or more vertical bony defects were enrolled in the study. Patients were classified randomly into 2 groups. Group I consisted of the experimental site where defect was filled with biphasic hydroxyapatite and β-tricalcium phosphate graft and Group II consisted of control site where only the open flap debridement (OFD) was carried out. Clinical parameters were evaluated at baseline, 3 and 6 months; Radiographs were taken at baseline and 6 months after surgery. Overall, by the end of 6 months, biphasic hydroxyapatite and β-tricalcium phosphate and OFD treatment groups exhibited a significant reduction in probing depth almost by 75% and gain in clinical attachment level at follow-up. In the biphasic hydroxyapatite and β-tricalcium phosphate group, radiographic bone level gain appeared to be greater than in the OFD group. In the present study, biphasic hydroxyapatite and β-tricalcium phosphate have shown promising results and have showed reduction in probing depth, a resolution of osseous defects and gain in clinical attachment level when compared to open flap debridement.

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.