Surgical Periodontal Treatment Research Articles

Inter-relação entre Dentística Restauradora e Periodontia – relato de caso

Excellence in esthetics has been the aspiration of most patients. However, to reach their expectations, it is necessary that the dentist has multidisciplinary knowledge. The objective of this paper is to report a clinical case of an anterosuperior aesthetic rehabilitation involving Periodontics and Restorative Dentistry. A 22-year-old male patient reported as main complaint gingival smile and multiple diastema. Previous periodontal surgical treatment was planned to increase the clinical crown, and then anatomy corrections on anterior elements, both idealized from digital flow. With the 3D model, a mock-up was performed, which assisted both in periodontal surgery and previous visualization of the esthetics for closing the diastemas. It was concluded that the proposed treatment corresponded to the patient’s expectations according to esthetic improvement, both dental and periodontal.

Local drug delivery drugs and systems

Periodontal disease is a multifactorial disease that affects the supporting tissues resulting in destruction of supporting structure. Non surgical periodontal treatment has been a cornerstone in the management of periodontics. Local drug delivery system is the application of anti microbial or anti infective agent that would target pathogenic micro organisms by delivering it at the base of the pocket yielding a stable and good clinical outcome along with mechanical debridement. So aim of this review article is to focus upon the local drug delivery systems in the management of periodontics.

Referral pattern of periodontal disease among general dental practitioners in iraq

Objectives: To evaluate the type of “periodontal treatment” performed by general dental practitioners and the referral patterns of periodontists in Iraq. Material and methods: A total of 201 general dentists were asked to complete a self-administered questionnaire consisting of nine questions regarding periodontal treatment and the referral patterns of periodontists. Results: The study showed that 91.1% of general dental practitioners (GDPs) performed “phase-I therapy”, and most of them done “scaling”. Regarding surgical periodontal therapy, only 12.9% of them performed surgical periodontal therapy, half of the GDPs did gingivectomy, and less than 30% performed crown lengthening. When evaluating maintenance therapy after periodontal treatment, it was found that 77.9% of the GDPs scheduled appointments for patients in the maintenance phase, 49.4% of them after one month, 24.7% after three months, and 15.6% after six months. Using TRUF analysis, most general dentists believed that the patient and periodontal factors were responsible for the recurrence of periodontal disease. Conclusions: There is still a lack of awareness of periodontal surgical procedures among the “general dental practitioners”. Thus, it is essential to increase the comprehension of periodontal treatment among general dentists.KEYWORDS Periodontal treatment; Phase-I therapy; Surgical periodontal treatment; General dental practitioner; Referral pattern Attitude.

Clinical outcomes following periodontal surgery and root surface decontamination by erythritol-based air polishing. A randomized, controlled, clinical pilot study

AimTo evaluate the outcomes following surgical periodontal treatment and root surface decontamination by means of air polishing using an erythritol powder or conventional mechanical root debridement.Material and methodsThirty systemically healthy patients (44.38 ± 8.2 years old, 11 smokers, 19 women) diagnosed with periodontitis stages III–IV were included. Each patient, with one single-rooted tooth, with one probing pocket depth (PD) ≥ 6 mm associated with horizontal bone loss, was treated by means of simplified papilla preservation flap (SPPF) and randomized to either test treatment (careful removal of the calculus with the tip of a blade, air polishing of the root surfaces with erythritol) or to the control group (scaling and root planing with hand curettes, ultrasonic instruments). PD, clinical attachment (CAL), bone sounding (BS), and radiographic bone level (BL) were evaluated at baseline and 12 months postsurgically.ResultsTwenty-seven patients completed the 12-month follow-up (test: n = 14, control: n = 13). In both groups, statistically significant improvements were obtained (p < 0.05, mean CAL gain/PD reduction: test, 2.50 ± 1.60 mm/3.00 ± 0.96 mm; control, 2.85 ± 1.21 mm/3.38 ± 1.12 mm). No statistically significant differences were observed between the groups for any of the investigated parameters (p < 0.05).ConclusionWithin their limits, the present results indicate that the use of air polishing with an erythritol powder during periodontal surgery may represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.Clinical relevanceThe use of air polishing with an erythritol powder during periodontal surgery appears to represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.

Perception of general dental practitioners towards periodontal practice and referral profile: A survey study

The speciality of periodontology has been evolved with leaps and bounds in all aspects ranging from advances in diagnostic aids to use of growth factors and periodontal regeneration techniques in treatment, thus making speciality per se reach new heights. Moreover, with development of technology, periodontal treatment is freely accessible to general dental practitioners. However, knowledge of periodontal diagnosis and treatment is usually limited to undergraduate level and most of times private practice deals only with chief complaint of patient. Evaluate the knowledge and perception of general dentists towards periodontal treatment.The study involved a survey for 50 practicing general dentists having their clinics in Hubli-Dharwad city with qualification of Bachelor of Dental Surgery only. A pre-tested close ended questionnaire was distributed comprising of 20 questions and knowledge, perception levels were assessed. Percentage-wise distribution of responses to various questions was used. Although 90.4% of general dentists did believe in the success of periodontal treatment and did recommend their patients to undergo various periodontal treatment procedures, 88.5% of the dentists performed most of periodontal surgeries and phase I therapy on their own. 78% of dentists referred cases to specialist only for grafting, ridge augmentation and dental implant procedures. About 71.2% of dentists considered gingival health for prosthetic considerations and 94.2% of them did evaluate periodontal condition before referring case for orthodontic treatment. It was noted that 84.6% of dentists followed up periodontal cases as a part of maintenance phase and 57.7% of them did attend CDE program regarding consequences periodontal disease progression and its treatment outcomes in past 1 year. In this study, dentists reported rendering nonsurgical and surgical periodontal therapy on a wide scale. Majority of dentists did attend CDE programs on periodontology and have gained knowledge about periodontal disease and its current treatment modalities. Although dentists do have good perception on success of periodontal treatment, majority of nonsurgical and surgical periodontal treatment was performed by general dentists on their own. Thus the need of the hour is to establish a proper periodontal referral relationship among the general dentists of Hubli-Dharwad. Although dentists do have good perception on success of periodontal treatment, majority of nonsurgical and surgical periodontal treatment was performed by general dentists on their own. Thus the need of the hour is to establish a proper periodontal referral relationship among the general dentists of Hubli-Dharwad city.

Dental Surgery in an Asplenic Patient

Nonsurgical endodontic treatment is a highly predictable treatment option in most cases, but surgery may be indicated for teeth with persistent periradicular pathosis unresponsive to it. The persistence of infection usually, but not always, indicates reduced immunological resistance. In such scenario, the clinician should be vigilant and find out the source of immunological incompetence before implementing treatment. Following splenectomy, individuals have an elevated risk of infection, in particular to encapsulated bacteria, Gram-negative pathogens such as Capnocytophagia carnimorsus and Bordetella holmesii, and intra-erythrocyte parasites such as malaria and babesia. After splenectomy, there are alterations in cell counts, cell quality, and immunological responses. Initially, after splenectomy, a reactive thrombocytosis and leukocytosis is observed. Splenectomized individuals are at risk to, overwhelming bacterial sepsis (overwhelming postsplenectomy infection). The complications are now infrequent because of pneumococcal vaccinations, prophylactic penicillin, and prompt medical attention at the first sign of fever. This case presents relevant management of a periradicular lesion in a 32-year-old male who has undergone splenectomy because of idiopathic thrombocytopenic purpura. The tooth was first endodontically treated that was followed by periodontal and periapical surgical treatment.

Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study.

While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients’ perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.

Use of Biomaterials for Periodontal Regeneration: A Review

BACKGROUND: Management of bone periodontal defects, destruction, and loss of the alveolar bone is considered a challenge for modern periodontal regeneration and implant dentistry. Numerous of biomaterials are being used in periodontal regenerative treatment.&#x0D; AIM: This study aims to know the characteristics of biomaterials and their efficiency in periodontal surgical treatment as regenerative therapy.&#x0D; METHODS: A systematic review of the literature considering reviews, clinical studies, original papers, and articles from electronic data has been used.&#x0D; RESULTS: Different biomaterials such as Straumann® Emdogain®, Geistlich Bio-Oss®, MIS 4MATRIX – Bone Graft, Platelet-rich fibrin (PRF), Mis Bone-4MATRIX, and PRF are being used for periodontal regeneration treatment, hence revealing more effective outcomes when combined. PRP together with conventional grafting procedures may be a beneficial treatment approach, guided tissue regeneration with bioabsorbable membranes in combination with Bio-Oss are stable on a long-term basis.&#x0D; CONCLUSION: Biomaterials being used in periodontal surgical treatment have the different regenerative ability. The combined use of biomaterials might result in a better clinical outcome. There are also a number of other biomaterials used to treat periodontal regeneration, but generally all have the same ability and the same molecular structure as highlighted in this literature review.

The total oxidant status and total antioxidant capacity of saliva in patients with chronic periodontitis before and after non – surgical periodontal treatment

Objective: The aim of this study was to measure the total oxidant status (TOS) and total antioxidant capacity (TAOC) levels in the saliva of patients with chronic periodontitis, before and after non – surgical periodontal treatment (NSPT). In addition, we aimed to investigate the correlation between salivary TOS, TAOC levels and periodontal parameters. Materials and Method: This longitudinal study included 12 patients diagnosed with chronic periodontitis. The periodontal parameters (PlI, GI, PPD, CAL, BOP) and unstimulated saliva of the patients were evaluated at baseline and eight weeks after NSPT. The salivary TAOC and TOS levels were measured using assay kits according to the manufacturer's instructions. Results: At eight weeks after NSPT, the saliva TOS levels were lower and the saliva TAOC levels were higher significantly, compared to those at baseline (p &lt;0.05). A correlation between TAOC and PPD at eight weeks after NSPT was found (p &lt;0.05). Conclusion: The periodontal parameters and oxidative stress biomarkers improved after NSPT when compared to baseline. However, more studies are in need to confirm the correlation between oxidative stress biomarkers and periodontal parameters.

Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis.

Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review.

Interdisciplinary Approach in Periodontology - A Mini-Review and A Report of Two Complex Cases

Increasing life expectancy, higher quality of biomaterials used in dentistry and the rapid evolution of clinical procedures, has led to more demanding patient requests and more complicated treatment choices. Such complex cases require holistic management, which frequently mandates clinicians to cooperate in a multidisciplinary approach, in order to fulfil therapeutical objectives and to provide successful treatment concerning functional rehabilitation and aesthetical enhancement. Periodontology cannot be practised in isolation but has to be combined with other fields of dentistry, since periodontal diseases are quite prevalent and affect oral health in various ways. It is evident that these interactions and interrelationships between periodontology practice and other dental fields, such as endodontics, prosthodontics and orthodontics are quite crucial so as the utmost care to be delivered. Combined endodontic-periodontal lesions, adult orthodontics, especially in patients having been treated for periodontitis, prosthetic restoration and dental implant placement in patients with history of periodontitis are some challenging treatment modalities that may require interdisciplinary approach. In the first case reported, non-surgical as well as surgical periodontal treatment and periodontal health stabilization created the proper background for successful orthodontic treatment to be applied in a patient with severe chronic periodontitis. In the second case, periodontal therapy and surgical lengthening of the clinical crowns, with respect to biological width fundamentals, provided more favourable conditions in order a patient with alternative passive eruption and gummy smile to be restored prosthetically.

The Effect of Platelet Rich Fibrin (PRF) and Bone Graft (Carbonate Apatite) Applications on Platelet Derived Growth Factor-BB Post Flap Surgery in Patients with Chronic Periodontitis

Chronic periodontitis characterized by a periodontal pocket over 5 mm, alveolar bone resorption accompanied by tooth mobility, requires periodontal surgical treatment. Conventional surgical treatment can not achieve the regeneration of periodontal tissue and thus requires regenerative procedures, such as with the addition of PRF. PDGF-BB is a growth factor that plays an important role in wound healing. Developments in additional bioactive ingredients in surgical procedures are used to regulate inflammation and increase the speed of the healing process. The purpose of this study was to determine the effect of PRF and bone graft (carbonate apatite) on PDGF-BB levels post-surgical flap in patients with chronic periodontitis. The experimental study with open label and consecutive sampling was conducted on 10 subjects of chronic periodontitis who received surgical flap treatment with bone graft and PRF; and 10 subjects without PRF. GCF samples were collected immediately before surgery and 7 days post flap surgery for examination of PDGF-BB levels by ELISA method. The data were calculated statistically by Mann-Whitney test (p &lt;0.05). The results showed that the mean difference of PDGF-BB level in PRF group was 9.44 pg/ml (-1.20 – 37.79 pg/ml) with p value (0.013) and Non-PRF group was 7.97 pg/ml (-6.62 - 44.42 pg/ml) with p value (0.059). The p value in the PRF group &gt; 0.05 means a significant increase in PDGF-BB levels on the 7th day post flap surgery. Examination of PDGF levels, especially PDGF-BB, should be done in each healing phase of the wound from the inflammatory phase to the maturation and remodeling phase, for example on the 3rd, 7th, 14th and 28th days when PDGF levels approach zero and the healing process it's almost over, referring to the results of Alzahrani's research (2018) and also Matsuoka and Grotendorst (1989) which showed higher levels of PDGF-BB and VEGF in GCF on days 1, 3, 7 and 14 after surgery with minimally invasive surgery (MIS) technique. The conclusions of this study showed that the application of Platelet Rich Fibrin (PRF) and bone graft had an effect on the level of Platelet Derived Growth Factor (PDGF-BB) post-surgical flap in patients with chronic periodontitis, and elevated levels of PDGF-BB post-surgical flap with PRF application higher than surgical flap without the PRF application. Increased levels of PGDF-BB in the group applied to the PRF were higher than those that were not applied PRF, although statistically significant differences were not found, there was a tendency for the healing process of the PRF group to be better than the Non PRF group.

Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life

Statement of the Problem: Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose:This study sought to compare patients’ perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method:A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results:38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion: Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.

The Effects of Non -Surgical Periodontal Treatment on The Severity of Erectile Dysfunction

The Effects of Non -Surgical Periodontal Treatment on The Severity of Erectile Dysfunction

Comparison of mast cell counts between the patients with moderate and severe periodontitis.

Background The role of mast cells in periodontal tissue degradation has been established. These cells can be efficient in the etiology of periodontitis by participating in gingival homeostasis and releasing cytokines and enzymes, resulting in connective tissue matrix breakdown. Therefore, the aim of this study was to compare the mast cell counts between patients with moderate and severe periodontitis. Methods This case‒control study was performed on 15 subjects with severe periodontitis and 15 subjects with moderate periodontitis, who needed periodontal surgical treatment. Incisional biopsies were provided during periodontal surgery. Afterward, the mean counts of mast cells were determined after toluidine blue staining of the samples. Finally, data were analyzed with SPSS. Results The results of this study showed that mast cell counts in severe periodontitis cases were lower than those in moderate periodontitis. However, there were no statistically significant differences between the two groups (P=0.611). In addition, the mean mast cell counts in males and females did not show a statistically significant difference (P=0.231), although the count was higher in female subjects. Conclusion Based on the results, no statistically significant differences were found in mast cell counts between subjects with severe periodontitis and those with moderate periodontitis.

Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis.

To evaluate the potential added benefit of the topical application of hyaluronic acid (HA) on the clinical outcomes following non-surgical or surgical periodontal therapy. A systematic search was performed in Medline, Embase, Cochrane, Web of Science, Scopus and Grey literature databases. The literature search was preformed according to PRISMA guidelines. The Cochrane risk of bias tool was used in order to assess the methodology of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between the treatment and controls were estimated using the random-effect model for amount of bleeding on probing (BOP), probing depth (PD) reduction and clinical attachment level (CAL) gain. In order to minimize the bias and to perform meta-analysis, only randomized clinical studies (RCTs) were selected. Thirteen RCTs were included: 11 on non-surgical periodontal treatment and two on surgical periodontal treatment. Overall analysis of PD reduction, CAL gain and BOP reduction in non-surgical therapy with adjunctive HA presented WMD of - 0.36mm (95% CI - 0.54 to - 0.19mm; p < 0.0001), 0.73mm (95% CI 0.28 to 1.17mm; p < 0.0001) and - 15% (95% CI - 22 to - 8%; p < 0.001) respectively, favouring the application of HA. The overall analysis on PD and CAL gain in surgical therapy with adjunctive HA presented WMD of - 0.89mm (95% CI - 1.42 to - 0.36mm; p < 0.0001) for PD reduction and 0.85mm (95% CI 0.08 to 1.62mm; p < 0.0001) for CAL gain after 6-24months favouring the treatment with HA. However, comparison presented considerable heterogeneity between the non-surgical studies and a high risk of bias in general. Within their limits, the present data indicate that the topical application of HA may lead to additional clinical benefits when used as an adjunctive to non-surgical and surgical periodontal therapy. However, due to the high risk of bias and heterogeneity, there is a need for further well-designed RCTs to evaluate this material in various clinical scenarios. The adjunctive use of HA may improve the clinical outcomes when used in conjunction with non-surgical and surgical periodontal therapy.

Surgical Treatment of Periodontal Diseases—a Review of Current Clinical Research

This manuscript reviews the literature concerning the surgical treatment of periodontal diseases focusing on studies published within the last three years (2016–2019). A thorough review of four databases was completed including clinical human research studies and systematic reviews. Several recent studies have focused on evaluating the effects of combining alloplastic materials with autologous platelet-rich products and growth factors. The results of most of these studies are similar to those with traditionally used allografts. New membranes of human, animal, stem cell, or alloplastic origin, used for guided tissue regeneration procedures, perform similarly to the traditionally used resorbable collagen membranes. Addition of pharmacologic agents to regenerative procedures presents moderately favorable results. Tissue engineering and stem cell research are also expanding, although most of these studies are in vitro or in animal models. Newer minimally invasive surgical techniques and equipment that allow for better visibility and less invasive surgical approach have shown favorable results. Finally, systematic reviews conclude that there is lack of evidence to support LASERs as an alternative to more traditional surgical periodontal treatment. The focus of many recent human clinical studies has been to evaluate the combination of alloplastic and xenogeneic materials with autologous platelet-rich products, growth factors, and pharmacologic agents. The results of these combinations are similar to traditionally used allografts. The great variability between study design, materials, and techniques highlights the need for well-designed randomized controlled trials and longitudinal studies.

Effect of non-surgical periodontal treatment on crevicular levels of Chemerin and Fibroblast growth factor 21 in controlled type 2 diabetic and non-diabetic patients both with periodontitis and their glycemic control. A clinical trial

Background: Diabetes mellitus is one of the important host risk factors in periodontal diseases. Many factors were reported not only to play a role in the periodontal inflammation, but also to be associated with the severity of the tissue breakdown such as chemerins which are believed to be involved in a variety of chronic inflammatory conditions including diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is connected with regulation of glucose metabolism and was shown to be increased in patients with obesity and type 2 diabetes mellitus (T2DM). The present study aimed to explore the effect of non –surgical periodontal treatment on the gingival crevicular fluid level of Chemerin and FGF21in both controlled diabetic and non-diabetic patients both suffering from periodontitis and to detect the effects of this treatment on the glycemic control of diabetic patients.Methods: The study was conducted on 2 groups; group (A) included fifteen controlled T2 DM patients suffering from periodontitis, and group (B) included fifteen patients suffering from periodontitis.At baseline, GCF samples were collected from all participants for assessment of Chemerin and FGF 21 levels and 3 months after scaling and root planing (SRP). Samples were analysed using ELISA technique. Blood samples were also collected for assessment of HA1c. Results: Significantly higher levels of Chemerin and FGF21 were found in periodontitis patients with diabetes than in the periodontitis patients without diabetes. After periodontal therapy, there was a significant reduction in the GCF levels of chemerin and FGF21 in both periodontitis groups. All clinical parameters showed a significant improvement after treatment. HbA1c did not correlate significantly with any of the studied adipokines as well as any of the clinical parameters in the diabetic group.Conclusion: Periodontitis and T2DM share the nature of inflammation, with adipokines such as Chemerin and FGF21 involved in the process of inflammation. Chemerin exerts a proinflammatory influence on periodontitis and t2DM, also, FGF21 is a potent metabolic regulator with multiple beneficial effects on periodontitis and diabetes.

Impact of One-Stage Full Mouth Disinfection and Periodontal Surgery on Oral Health-Related Quality of Life.

Statement of the Problem Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited. Purpose This study sought to compare patients' perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment. Materials and Method A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21. Results 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p< 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p< 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. Conclusion Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.

Evaluation of serum albumin concentration in generalized chronic periodontitis patients after surgical periodontal therapy

Introduction: Chronic periodontitis is one of the most prevalent diseases which affect patient's mastication and nutrition. Chronic inflammation of the gingiva also causes loss of serum albumin. Serum albumin is considered as a marker for general health as it has many functions in human body. Protein deficiency also accentuates the destructive effects of local irritants and occlusal trauma. Aims: The aim is to study the effect of surgical periodontal therapy (flap surgery) on serum albumin in chronic periodontitis patients. Subjects and Methods: Fifty participants of generalized chronic periodontitis were selected from the outpatient department. Clinical parameters were recorded at baseline, after 1 month, and 3 months. Venous blood was collected at baseline and 3 months after surgery from the participants to measure serum albumin by the bromocresol green albumin method. Statistical Analysis Used: Effect of surgical periodontal therapy on clinical parameters analyzed using one-way ANOVA (repeated-measures one-way ANOVA) followed by Tukey's multiple comparison tests for intragroup and intergroup comparison. A paired t-test was applied for serum albumin analysis. Results: Serum albumin level increased from baseline to follow-up period after surgical periodontal treatment, i.e., 3 months. This effect was found to be statistically significant ( Conclusion: Surgical periodontal treatment (open flap debridement) has a positive effect on serum albumin level.