Therapy Of Chronic Periodontitis Research Articles

The Interplay Between Diabetes and Oral Health: A Comprehensive Bibliometric Analysis of Clinical Trials (1967-2024).

Recognizing the complex interaction between diabetes and oral health is crucial, considering the increasing worldwide prevalence of these conditions. This bibliometric analysis delves into the extensive body of literature concerning the impact of diabetes on oral health, utilizing data retrieved from PubMed. The publishing trends indicate a growing research interest in the field over time, with notable peaks and declines. Coauthorship analyses of authors and institutions illuminated collaborative networks within the research community. Two departments at Ahvaz Jundishapur University of Medical Sciences in Iran, namely the Department of Periodontology within the School of Dentistry and the Diabetes Research Center within the Health Research Institute, demonstrated the highest total link strength. The co-occurrence analysis of keywords also unveiled thematic clusters, reflecting research focus areas and evolving trends. The analysis of topic trends highlighted persistent research interests in topics, such as type 2 diabetes mellitus, glycated hemoglobin, periodontitis, and therapy for chronic periodontitis, with shifts in therapeutic modalities investigated. The thematic map suggests that dental implants and tumor necrosis factor-alpha are emerging terms in the field that have gained more traction recently. Furthermore, the analysis of scientific production by country indicated varied contributions, with Brazil leading in publication output. Analysis of collaboration among corresponding authors' countries identified Italy exhibiting substantial international collaboration, while most of the countries primarily produced single-country publications. This comprehensive analysis provides insights into the multifaceted landscape of research on diabetes and oral health, emphasizing ongoing efforts to understand and address the complex interplay between these conditions.

Necroptosis has a crucial role in the development of chronic periodontitis.

Periodontitis is a non-communicable chronic inflammatory disease that affects the entire periodontium and its severe types cause irreparable destruction. The purpose of this study was to determine the type of cell death in chronic periodontitis (CP) with the expression of receptor-interacting protein kinase (RIPK) type1 and RIPK3 genes. This cross-sectional study was carried out from September 2019 to 2020. The samples (38 participants) were divided into two groups: 20 recently diagnosed CP patients and 18 healthy individuals. Participants' data was collected in the periodontology Department, Dental school, Mashhad University of Medical Sciences and sent to the Immunology Lab for assessment of RIPK1 and RIPK3 expressions using quantitative real time-PCR. The study sample consisted of 30 females (78.9%) and 8 males (21.1%) with a mean age of 34±5 years. The expression of the genes of interest in CPs exhibited an opposite pattern. Although, RIPK3 gene expression was significantly greater in CP patients compared to the control group (P=0.024), the expression of RIPK1 decreased (p<0.001). Moreover, no significant correlation was observed between age and gender with these molecules in CPs. The RIPK3 selectively contributes to necroptosis, therefore, it seems that RIPK3-mediated necroptosis is involved in chronic periodontitis. RIPK1 also participates in necroptosis, but mostly in apoptosis. Therefore, necroptosis as an unprogrammed inflammatory cell death induced by pathogenic damages seems to be another mechanism complicated in periodontitis and could be used as a novel target for CP therapy.

THERAPY OF PERIODONTITIS WITH VASCULAR ENDOTHELIAL GROWTH FACTOR BASED ON HYDROGEL: IMMUNOHISTOCHEMICAL CHARACTERISTICS

Regeneration of lost periodontal tissues is the ultimate goal of periodontal treatment. One of the promising approaches to stimulating periodontal regeneration is the use of hydrogels and various growth factors that contribute to the colonization of the scaffold with fibroblast populations, followed by the formation of mature connective tissue of the periodontal ligament. Patients with chronic generalized periodontitis of mild and moderate severity (n=70, age 49-69 years) were treated in the Department of maxillofacial surgery of the UKB No. 4. Treatment was carried out with a preparation from a complex of bioresorbable carbohydrates and recombinant human vascular endothelial growth factor (VEGF-A). The biopsy material was taken immediately before the introduction of the drug into the periodontal pocket and 14 days after the procedure. Prior to treatment, pronounced chronic inflammation with a predominance of lymphocytes, moderate edema and divergence of the fibers of the stromal component were noted in the gum preparations, signs of chronic moderate active inflammation were observed. After treatment, collagen fibers constructed from type III collagen and type I collagen were found in the structured fibers of the intercellular substance, which is characteristic of the formed connective tissue. Thus, the therapy of chronic periodontitis with a hydrogel with VEGF-A is a promising direction for further research, since it has the potential to influence not only stimulating the regeneration of periodontal tissues, but also the effect of local anti-inflammatory treatment.

Evaluation of The Efficacy of Topically Applied Melatonin Gel as Adjunctive Therapy in Chronic Periodontitis; Randomized Control Trail

Evaluation of The Efficacy of Topically Applied Melatonin Gel as Adjunctive Therapy in Chronic Periodontitis; Randomized Control Trail

To Explore and Analyze the Safety and Clinical Efficacy of Periocline-Assisted Periodontal Basic Therapy on Chronic Periodontitis.

Objective This study aimed to investigate and analyse the clinical efficacy and safety of periocline-assisted periodontal foundation in the therapy of chronic periodontitis. Methods From May 2018 to January 2021, 108 patients with chronic periodontitis were treated at our institution and randomly assigned equally to either the control or the experimental group. The plaque index (PLI), sulcus bleeding index (SBI), probing depth (PD), and periodontal attachment level (AI) were evaluated before and after periodontal basic therapy in the control group and periocline as an adjunct in the experimental group. Lactobacillus (LB) and Porphyromonas gingivalis (PG) concentrations in saliva were measured before and after therapy, and adverse responses during treatment were noted. Results The levels of PLI, SBI, PD, and AI in the two groups were significantly lower in both groups at 1 and 3 months posttreatment compared to baseline; the levels of PLI and SBI were higher, and the levels of PD and AI were lower at 3 months after treatment compared to 1 month after treatment; compared with the control group at 1 month and 3 months after treatment, the levels of PLI, SBI, PD, and AI in the experimental group were lower than those in the control group (P < 0.05). The LB level was higher and the PG level was lower in both groups compared to baseline at 1 and 3 months posttreatment. The LB level was higher and the PG level was lower at 3 months posttreatment compared to 1 month after treatment. Compared with the control group at 1 month and 3 months after treatment, the LB level was higher, and the PG level was lower in the experimental group (P < 0.05). No significant adverse effects were observed in either group during the treatment period. Only 1 patient in the experimental group had mild gastrointestinal reactions, mainly nausea, without obvious neurological symptoms or abnormal blood changes, which did not affect the treatment. Conclusion Periodontal fundamental therapy with perioclines may be a potential treatment for persistent periodontitis. It improves the primary clinical indicators, increases dysbacteriosis control, and has a strong safety profile. It could effectively control the development of clinical symptoms of periodontitis and reduce tissue destruction, with obvious clinical treatment effects. It could be used as the first choice for topical treatment of chronic periodontitis. It is recommended for further study by a wide range of researchers.

Evaluation of the Efficacy of Topically Applied Melatonin Gel as Adjunctive Therapy in Chronic Periodontitis; Randomized Control Trail

Evaluation of the Efficacy of Topically Applied Melatonin Gel as Adjunctive Therapy in Chronic Periodontitis; Randomized Control Trail

Detection and quantification of pathogenic microorganisms in patients with chronic periodontitis before and after treatment with chlorhexidine digluconate

The aim of this study was to evaluate the efficiency of chlorhexidine digluconate solution (CHX) as an adjunct to nonsurgical therapy (NPT) of patients with chronic periodontitis (CP), by analyzing the presence and quantity of periopathogenic microorganisms in subgingival biofilm. DNA was extracted from the subgingival biofilm obtained from 40 patients with CP divided into two groups (NPT+CHX and NPT alone as control) at baseline and 2 months after the therapy. The presence of selected periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, E. corrodens, T. denticola, and T. forsythia) was determined by polymerase chain reaction (PCR), while total bacterial load was assessed by quantitative PCR. The incidence of microorganisms decreased following treatment, both with NPT+CHX and NPT alone, but without reaching statistically significant difference in the NPT group. In the NPT+CHX group, a significant reduction of prevalence of two species: T. denticola (P = 0.008) and T. forsythia (P = 0.016), as well as of total microorganism count (P = 0.002) was observed two months after treatment. In conclusion, the present findings support the use of CHX as adjunctive therapy in CP.

IL-6, a Therapeutic Target and Omega-3 PUFA, a Host Modulator in Chronic Periodontitis

Periodontitis is a common multifactorial inflammatory disease with gradual loss of supportive tissues around the teeth which eventually leads to decrease in the quality of life. Blocking Interleukin-6 (IL-6), a multifunctional cytokine with pro-inflammatory properties has demonstrated therapeutic efficacy in inflammatory diseases like Rheumatoid arthritis, SLE and multiple sclerosis. Host immune response, the underlying cause for this progressive disease is targeted by Host modulatory therapy (HMT), an emerging treatment modality. Omega-3 polyunsaturated fatty acids (ώ 3 PUFAs), one of the relatively safe HMTs, reduces tissue destruction, stabilizes or even regenerates the periodontium through its anti-inflammatory &amp; immunoregulatory properties. ώ 3 PUFAs are essential for the synthesis of eicosanoids which are involved in anti-inflammatory, antiplatelet aggregatory, vasodilation, vasoconstriction, immune response, cell growth and proliferation. The key factor examined and extrapolated in this study is the anti-inflammatory property of ώ 3 PUFA. The aim of the study was to evaluate the immunological and clinical response to ώ 3 PUFA supplementation therapy in chronic periodontitis by measuring the inflammatory cytokine, IL-6 levels in serum. In this open label exploratory study, 40 patients with a Female: Male ratio of 4:1were enrolled and assessed clinically by measuring Oral Hygiene Index-Simplified (OHI-S), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and their serum for IL-6 levels. Subsequently 300 mg (concentration of EPA 180/DHA120) of ώ 3 PUFA was prescribed twice daily for 3 months and periodically reviewed to assess their IL-6 levels and periodontal status. IL-6 levels which were at a maximum mean of 10.2 pg/ml prior to treatment, showed a gradual and notable reduction to 2.3 pg/ml at the end of the study following ώ 3 PUFA supplementation therapy. The coefficient of variation R2 and ANOVA showed statistically significant periodic variation in biomarker IL-6 and in all clinical measurements at all time intervals. ώ 3 PUFA adjunctive therapy significantly reduces the inflammatory cytokine (IL-6) levels and causes noteworthy improvement of the most relevant clinical parameters (OHI-S, PPD, CAL). Hence ώ 3 PUFA can be recommended as a dietary supplementation and a safe host modulatory treatment in chronic periodontitis.

Periodontal P eriodontal Parameters and Anti-Car ameters and Anti-Cardiolipin Antibodies F diolipin Antibodies Following ollowing Periodontal Ther eriodontal Therapy in Chr y in Chronic Periodontitis eriodontitis

Anti-cardiolipin (anti-CL) antibodies are autoantibodies which are directed against cell membrane phospholipids. A significant number of periodontitis patients showed positive for anti-CL antibody. Objective: This study aimed to determine the periodontal parameters and anti-CL antibodies levels before and after non-surgical periodontal therapy in chronic periodontitis. Methods: This cross-sectional study had been carried out at Periodontal Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Thirty five chronic periodontitis (CP) and 39 non-periodontitis (NP) patients underwent clinical periodontal examination at baseline. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), and clinical attachment loss (CAL) were measured. Scaling and polishing was performed and blood samples were taken for IgG and IgM anti-CL antibodies analysis. Re-evaluation was performed four weeks after initial therapy. CP patients were re-examined, all periodontal parameters were recorded and blood samples were taken for reassessment of IgG and IgM anti-CL antibodies. Results: Significant difference means of PI (p=0.001), GI (p=0.000), PPD (p=0.000) and, CAL (p=0.000) were found between CP and NP groups. All periodontal parameters were significantly reduced (p≤0.05) after four weeks of therapy. The mean levels of IgG and IgM anti-CL antibodies at baseline were significantly higher in CP than NP group (IgG=4.46 vs 3.22, p=0.002; IgM=3.28 vs 2.57, p=0.019). No significant difference of the median levels of IgG (p=0.82) and IgM anti-CL antibodies (p=0.35) following therapy. Conclusion: All periodontal parameters were significantly reduced following periodontal therapy. Higher level of Anti-CL antibodies in CP indicates stimulation of autoantibodies production by periodontal infection. Nonetheless no significant changes of this anti-CL antibodies levels despite significant reduction of the clinical parameters after periodontal therapy

Semelil as Adjunctive Therapy in Chronic Periodontitis: A Preliminary Randomized Controlled Clinical Study.

Host modulation therapy is recently employed to improve periodontal treatments outcome. This randomized controlled clinical trial aimed to evaluate the effects of Semelil (ANGIPARS) as an adjunct to non-surgical treatment in patients with chronic periodontitis. Forty-four healthy subjects with moderate to severe chronic periodontitis were enrolled in the study. After completion of phase I periodontal therapy, including oral hygiene instruction, scaling, and root planing, the patients were randomly divided into two groups to receive capsules of Semelil (test) or placebo (control), consuming two capsules a day for three months. Clinical parameters (probing depth [PD], clinical attachment level [CAL], modified sulcular bleeding index [MSBI], modified gingival index [MGI], and plaque index [PI]) and biochemical parameters (interleukin-1β [IL-1β], 8-hydroxy-2-deoxyguanosine [8-OHdG]), and lipid peroxidation [LPO]) were measured at baseline and after completion of treatment. Twenty-five patients completed the study: 15 in the test group and 10 in the control group. All clinical and biochemical parameters were significantly improved from baseline to the final measurements in both groups (p < 0.001). The changes were more pronounced in the test group in comparison to the control group. However, the differences between the groups were significant only for MGI, MSBI, PD, and CAL (p < 0.05). Semelil may reveal promising results as an adjunctive treatment for chronic periodontitis.

Levels of interleukins in patients with chronic kidney disease and periodontitis: A systematic review

Aim: To systematically review the in vivo clinical studies available in the literature evaluating the effect of interleukin (IL) in patients with chronic kidney disease (CKD) and chronic periodontitis (CP). Materials and Methods: A search was initially performed using Scopus, PubMed, and Web of Science databases published from the year 2003 to 2020. Among the keywords used in the search were “periodontal diseases,” “interleukin,” “chronic kidney diseases,” and “inflammation.” After relevant articles were found, a critical assessment was made to select those that met the criteria for the systematic review. Among the inclusion criteria needed for the papers were randomized clinical trials, longitudinal clinical trials, clinical studies, no sample size limits, and only English language articles. Case reports, conference abstracts, and unpublished data were excluded for this study. Result: Based on the keywords, 16 of the relevant articles were listed and seven of them were selected for a systematic review. Conclusion: After reviewing the articles based on their results and conclusion, it can be concluded that serum IL level increased significantly in patients with CKD and CP and periodontal therapy can significantly reduce the level of serum IL. Moreover, the effect of modern periodontal therapy in CKD and CP is still unknown and inflammatory gene expression profile in patients with CKD will still need to be evaluated within different populations.

Effect of probiotics as a complement to non-surgical periodontal therapy in chronic periodontitis: a systematic review.

Background To improve the results of the classic periodontal treatment, probiotics have been suggested recently to decrease the number of bacteria and the expression of mediators of inflammation. This systematic review aimed to assess the literature for the effectiveness of different probiotic strains as adjuvants to non-surgical periodontal therapy. Material and Methods The electronic database of MEDLINE (via Pubmed) was searched up to December 2017 for randomised clinical trials in English comparing non-surgical periodontal treatment and probiotics versus periodontal treatment and placebo. The primary outcome investigated was reduction in pocket probing depth. Secondary outcomes were bleeding on probing, plaque index reduction and bacteria counts. Results Nine trials were included. A narrative data synthesis did not result in any major improvement of overall pocket probing depth but moderate pockets from 4 to 6 mm showed larger reductions in study groups, which could decrease the need for surgery. Sites with bleeding on probing and presence of plaque decreased after treatment. For periimplant mucositis, there was a small tendency to better results in the study group. Conclusions With the available data, it is concluded that probiotics may provide an additional benefit to manual debridement in chronic periodontitis. More studies are required on dose, route of administration and strains of probiotics used. Key words:Periodontics, chronic periodontitis, probiotics, periodontal treatment, lactobacillus, streptococcus.

Clinicomicrobiological evaluation of the efficacy of local delivery of moxifloxacin and ibuprofen gel as an adjunct to scaling and root planing in chronic periodontitis patients.

Aims:To evaluate the clinical and microbiological effects of local drug delivery of moxifloxacin and ibuprofen gel as an adjunct to conventional periodontal therapy in chronic periodontitis patients.Subjects and Methods:Twenty patients with moderate-to-severe chronic generalized periodontitis with probing pocket depth (PPD) of ≥5 mm and <8 mm were randomly assigned to one of the following two treatment modalities: scaling and root planing (SRP) group and moxifloxacin and ibuprofen combination gel as an adjunct to SRP group. Clinical parameters include plaque index (PI), gingival index (GI), probing depths and clinical attachment level (CAL) that were recorded at baseline and 1 and 3 months after the treatment, and microbiologic assessment was done using dark-field microscopy.Results:A statistically significant difference in mean PI and GI scores and reduction in PPD and gain in CAL were observed at different study intervals with greater difference in the test group. On microbiological examination, the percentage of cocci increased, while a statistically significant decrease in the mean percentage of bacilli and spirochetes was observed in both groups at given intervals. In-vitro dissolution showed controlled release of both the drugs.Conclusions:Among the two treatment modalities, treatment with moxifloxacin and ibuprofen local delivery as an adjunct to SRP gave superior results in clinical and microbiological parameters compared to SRP group.

The effect of smoking on gingival crevicular fluid peptidoglycan recognition protein-1 level following initial periodontal therapy in chronic periodontitis.

To determine the effect of smoking on peptidoglycan recognition protein (PGRP)-1 levels in gingival crevicular fluid (GCF) in smokers and non-smokers with chronic periodontitis (CP) following initial periodontal therapy. A total of 40 patients with CP (20 smokers (S+CP) and 20 non-smokers (S-CP)) and 40 subjects with healthy periodontium (20 smokers (S+PH) and 20 non-smokers (S-PH)), comprising 80 subjects, were included in this study. Baseline GCF samples were obtained from all subjects, and clinical periodontal measurements were recorded. In patients who had received initial periodontal therapy, GCF samples were obtained and all clinical periodontal measurements were recorded again during the 6th-8th weeks. GCF PGRP-1 levels were analyzed by enzyme-linked immunosorbent assay. At baseline, GCF PGRP-1 levels were significantly higher in both groups with CP than in both groups with healthy periodontium, whereas these levels were significantly lower in S+CP than in S-CP. GCF PGRP-1 levels decreased significantly in both CP groups after periodontal therapy, and this reduction was significantly greater in non-smokers than in smokers. Smoking might have a suppressive effect on GCF PGRP-1 levels in CP. Initial periodontal therapy is effective in decreasing GCF PGRP-1 levels in both smokers and non-smokers with CP.

Novel 20% doxycycline-loaded PLGA nanospheres as adjunctive therapy in chronic periodontitis in type-2 diabetics: randomized clinical, immune and microbiological trial.

This study evaluated the clinical, microbiological, and immunological results of poly lactic-co-glycolic acid (PLGA) nanospheres containing 20% doxycycline (DOXY) in the treatment of type-2 diabetic patients (DM-2) with chronic periodontitis (CP). A parallel, double-blind, randomized, placebo-controlled clinical trial was conducted in DM-2 presenting severe and generalized CP. All patients received one-stage full-mouth ultrasonic debridement (FMUD) and they were randomly divided into two groups: PLAC (n = 20)-local application of placebo PLGA nanospheres, and DOXY (n = 20)-local application of doxycycline-loaded nanospheres; both in six non-contiguous sites. Clinical, metabolic (fasting plasma glucose level-FPG and glycated hemoglobin-HbA1c), cytokine pattern (multiplexed bead immunoassay) and microbiological assessments were performed at baseline, and 1, 3, and 6months after treatment. Both groups showed clinical improvement in all parameters after treatment (p < 0.05). Deep pockets showed improvements in bleeding on probing-BoP (3 and 6months), PD (at 3months), and CAL gain (at 1 and 3months) favoring DOXY (p < 0.05). The percentage of sites presenting PD reduction and CAL gain ≥ 2mm was higher in DOXY at 3months (p < 0.05). DOXY group exhibited a significant increase in the levels of anti-inflammatory interleukin (IL)-10 and a reduction in IL-8, IFN-y, IL-6, and IL-17 (p < 0.05), significant reduction in periodontal pathogens (p < 0.05), and a lower mean percentage of HbA1C at 3months (p < 0.05). DOXY nanospheres may be considered a potential adjunct to mechanical debridement in the therapy of periodontitis in DM-2, offering additional benefits in deep pockets, improving the cytokine profile, and reducing periodontal pathogen levels. The use of locally applied doxycycline nanospheres may represent an adjunctive therapeutic approach in the treatment of periodontal disease in type-2 diabetic patients, achieving additional benefits in the local modulation of cytokines, microbial reduction, and clinical parameters, especially in deep pockets.

Efficacy of locally-delivered statins adjunct to non-surgical periodontal therapy for chronic periodontitis: a Bayesian network analysis

BackgroundStudies indicate locally-delivered statins offer additional benefits to scaling and root planning (SRP), however, it is still hard to say which type of statins is better. This network meta-analysis aimed to assess the effect of locally-delivered statins and rank the most efficacious statin for treating chronic periodontitis (CP) in combination with SRP.MethodsWe screened four literature databases (Pubmed, Embase, Cochrane Library, and Web of Science) for randomized controlled clinical trials (RCTs) published up to June 2018 that compared different statins in the treatment of chronic periodontitis. The outcomes analyzed were changes in intrabony defect depth (IBD), pocket depth (PD), and clinical attachment level (CAL). We carried out Bayesian network meta-analysis of CP without systemic diseases. Traditional and Bayesian network meta-analyses were conducted using random-effects models.ResultsGreater filling of IBD, reduction in PD, and gain in CAL were observed for SRP treated in combination with statins when compared to SRP alone for treating CP without systemic diseases. Specifically, SRP+ Atorvastatin (ATV) (mean difference [MD]: 1.5 mm, 1.4 mm, 1.8 mm, respectively), SRP + Rosuvastatin (RSV) (MD: 1.8 mm, 2.0 mm, 2.1 mm, respectively), and SRP + Simvastatin (SMV) (MD: 1.1 mm, 2.2 mm, 2.1 mm, respectively) were identified. However, no difference was found among the statins tested. In CP patients with type 2 diabetic (T2DM) or in smokers, additional benefits were observed from locally delivered statins.ConclusionLocal statin use adjunctive to SRP confers additional benefits in treating CP by SRP, even in T2DM and smokers. RSV may be the best one to fill in IBD. However, considering the limitations of this study, clinicians must use cautious when applying the results and further studies are required to explore the efficacy of statins in CP with or without the risk factors (T2DM comorbidity or smoking history).

Adjunctive Use of Chlorhexidine Mouthwash to Nonsurgical Periodontal Therapy May Enhance Periodontal Pocket Depth Reduction

Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: a meta-analysis. da Costa L, Amaral C, Barbirato D, Leao A, Fogacci M.JADA 2017;148(5):308-18. The authors' own institutions. A meta-analysis.

Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects

Background/purposeThe application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. Materials and methodsEighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. ResultsStatistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. ConclusionWithin the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.

A LOW-DOSE LASER (DIODE LASER) APPLICATION REDUCES POCKET PERIODONTAL DEPTH AND CLINICAL ATTACHMENT LOSS

Objective: The initial therapy for chronic periodontitis is scaling and root planing (SRP), followed by non-surgical and surgical therapy. Recently, low-dose laser therapy was mentioned as an adjunctive therapy for periodontitis. This study aims to analyze the effect of degranulation using a low-dose laser (diode laser) after SRP for chronic periodontitis treatment with an attachment loss of ≤5 mm compared to SRP alone.Methods: A split-mouth design of in 158 tooth surfaces divided into two groups. The first group was treated with a low-dose laser (diode laser) after SRP, while the second group was treated with SRP only. Bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) were all examined at baseline and 35 days later.Results: The results were statistically significant differences between the two groups were indicated in terms of PPD (p=0.000) and CAL (p=0.040). No significant difference was identified in terms of BOP.Conclusion: The application of a low-dose laser (diode laser) is effective in reducing PPD and CAL as an adjunct therapy in chronic periodontitis treatment.

Efectos del raspaje y alisado radicular a boca completa con azitromicina sobre los niveles de proteina C reactiva ultra sensible, parametros clínicos y microbiológicos periodontales. Ensayo clinico aleatorizado

RESUMENObjetivo: El propósito de este ensayo clínico controlado aleatorizado simpleciego fue determinar el efecto del raspaje y alisado radicular en una sesión adjunto a azitromicina oral, sobre los niveles de proteína C reactiva ultra sensible y otros biomarcadores sanguíneos, parámetros clínicos y microbiológicos periodontales en pacientes con periodontitis crónica tres meses después del tratamiento.&#x0D; Materiales y Métodos: 49 sujetos con periodontitis crónica participaron en el estudio y fueron asignados aleatoriamente en dos grupos de 27 pacientes, el grupo intervención recibió raspaje y alisado radicular adjunto a azitromicina (RAR+Azi) 500 mg/día por cinco días, y el grupo control recibió raspaje y alisado radicular más placebo (RAR+Pb), ambos tratamiento en sesión única. Los grupos de periodontitisrecibieron un examen periodontal a boca completa, análisis de sangre y cultivos microbiológicos al inicio del estudio y tres meses después del tratamiento. Se incluyó un grupo referencia de 25 pacientes periodontalmente sanos tomando muestras sólo al inicio. La variable principal de desenlace fue la variación de la proteína C reactiva ultra sensible. Las variables de resultado secundarias fueron la variación de trigliceridos, colesterol de alta densidad (HDL), colesterol de baja densidad (LDL), glucosa en ayunas, profundidad al sondaje (PS) y composición microbiana.&#x0D; Resultados: La terapia RAR+Azi no redujo significativamente los niveles plasmáticosde hsPCR, sin embargo, se observó una tendencia positiva (4,33 a 2,99 mg/L). Este grupo obtuvo también una mayor reducción en PS, índice arterial y frecuencia de detección de Porphyromonas gingivalis y Prevotela intermedia en comparación con el grupo RAR+Pb (p-0.05). Los otros parámetros sanguíneos no cambiaron significativamente. En contraste, el grupo control aumentó los niveles de hsPCR después dela terapia y en algunos casos se detectó un aumento de PS.&#x0D; Conclusiones: La terapia de RAR+Azi ofrece a corto plazo beneficios clínicos y microbiológicos comparado a RAR solo. No se encontraron diferencias significativas en los niveles de hsPCR. Es necesariorealizar estudios con mayor tiempo de seguimiento para confirmar o rechazar la hipótesis que el tratamiento periodontal solo o con antibióticos generan efectos enlos niveles de hsPCR y otros marcadores de riesgo cardiovascular.&#x0D; Palabras clave: Periodontitis crónica,proteína C reactiva, azitromicina, ensayoclínico aleatorizado.