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Background/purpose: Dental anxiety is prevalent and may result in the avoidance of periodontal therapy and maintenance. This study aimed to explore the impact of non-surgical periodontal treatment (NSPT) on dental anxiety among patients with periodontitis. Materials and methods: In this study, 122 patients with periodontitis participated. The Chinese version of the Modified Dental Anxiety Scale (MDAS) gauged baseline dental anxiety during the initial appointment. Patients receiving non-surgical periodontal treatment (NSPT) in subsequent appointments formed the NSPT group, while those with a delayed NSPT of at least two months constituted the delayed group. In the NSPT group, the second termination questionnaire was administered one month post the last NSPT visit, just before the periodontal re-evaluation. In the delayed group, the second questionnaire was completed before the delayed NSPT initiation. Results: Baseline MDAS scores were comparable between the delay and NSPT groups. However, the NSPT group exhibited lower total scores and scores for each of the five MDAS items at termination compared with the delay group. At baseline, MDAS total scores were inversely associated with age and were lower in males. A reduction in MDAS total scores between observation points was correlated with NSPT, sex, and age after adjustment. Regarding MDAS item 4 (teeth scaled/polished), score reduction consistently correlated with NSPT and age. Conclusion: Participation in NSPT may alleviate dental anxiety, and consequently enhance the patients' conceptiveness to undergo periodontal maintenance or surgery.

Dental anxiety is prevalent and may result in the avoidance of periodontal therapy and maintenance. This study aimed to explore the impact of non-surgical periodontal treatment (NSPT) on dental anxiety among patients with periodontitis. In this study, 122 patients with periodontitis participated. The Chinese version of the Modified Dental Anxiety Scale (MDAS) gauged baseline dental anxiety during the initial appointment. Patients receiving non-surgical periodontal treatment (NSPT) in subsequent appointments formed the NSPT group, while those with a delayed NSPT of at least two months constituted the delayed group. In the NSPT group, the second termination questionnaire was administered one month post the last NSPT visit, just before the periodontal re-evaluation. In the delayed group, the second questionnaire was completed before the delayed NSPT initiation. Baseline MDAS scores were comparable between the delay and NSPT groups. However, the NSPT group exhibited lower total scores and scores for each of the five MDAS items at termination compared with the delay group. At baseline, MDAS total scores were inversely associated with age and were lower in males. A reduction in MDAS total scores between observation points was correlated with NSPT, sex, and age after adjustment. Regarding MDAS item 4 (teeth scaled/polished), score reduction consistently correlated with NSPT and age. Participation in NSPT may alleviate dental anxiety, and consequently enhance the patients' conceptiveness to undergo periodontal maintenance or surgery. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate randomized controlled trials (RCTs), with at least 6 months of follow‐up, on whether professional mechanical plaque removal (PMPR) including supragingival scaling should be performed prior and separately from subgingival scaling and root planning (SRP) in nonsurgical periodontal therapy (NSPT), in terms of clinical and patient‐reported outcomes (PROs) (CRD42020219759). Methods: The MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science electronic databases, as well as grey literature sources, were searched by two independent reviewers up to May 2023. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and GRADE for assessing the certainty of evidence. Random‐effects pairwise meta‐analyses compared the changes in probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BoP) of a stepwise NSPT approach (PMPR prior and separately from SRP) and conventional one‐step NSPT through mean differences (MDs) and associated confidence intervals (95% CI). Results: Two RCTs were included, including data of 77 participants with severe periodontitis. One RCT presents high risk of bias and the other has some concerns. No significant differences were found between the stepwise approach and performing both steps simultaneously for any clinical outcomes, with overall very low certainty on evidence. No adverse effects were detected and there was no data on PROs. Conclusions: There is very‐low certainty evidence of no significant difference on PPD and BoP reductions and CAL gain between supragingival scaling performed prior and separately from SRP and conventional one‐step NSPT. [ABSTRACT FROM AUTHOR]

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Objectives: The primary aim of this study was to compare the anesthetic efficacy of the intraseptal anesthesia (ISA) obtained with three doses of 4% articaine with 1:100,000 epinephrine (4%Ar + Ep) for scaling and root planing (SRP), using a computer-controlled local anesthetic delivery system (CCLADS). The secondary aims were to compare the clinical anesthetic parameters in relation to different jaw regions and examine the possible influence of sex and smoking habits on them. Materials and methods: SRP under ISA obtained with different doses (0.1 ml, 0.2 ml, and 0.3 ml) of 4%Ar + Ep was performed in 360 patients. The success rate, onset, duration of soft tissue anesthesia, and the anesthetic field widths were recorded by pinprick testing. Results: The anesthesia success was high (90–95%). The onset was immediate. The duration and anesthetic field widths showed a dose-related significance, however, without a consistent sex-related or smoking-related significance. The multiple logistic regression analysis revealed a twofold higher chance of anesthesia success by increasing the dose and increased bleeding on probing-related and female sex-reduced probability of anesthesia success. Conclusions: ISA obtained with 0.3 ml of 4%Ar + Ep delivered by a computer-controlled local anesthetic delivery system provided a high anesthetic success and the adequate clinical anesthetic parameters for SRP in all regions of both jaws. Clinical relevance: ISA obtained with 4%Ar + Ep provides an effective anesthesia for SRP. The anesthetic success rate may be reduced in the presence of gingival inflammation and in females as well. The study was registered in a Clinical Trials database (NCT04392804, registration date May 9, 2020). [ABSTRACT FROM AUTHOR]

Objective: This systematic review aims to assess the available literature on the clinical efficacy of hand versus power-driven instruments for subgingival instrumentation during surgical periodontal therapy (ST). Materials and methods: A search of the literature was carried out on MEDLINE via Ovid, Embase, Web of Science, the Cochrane Database, LILACS, and Scopus. RCTs comparing the use of powered instruments (test) to hand scalers (control) for subgingival instrumentation in terms of changes in probing pocket depth (PPD) after surgical periodontal treatment were included and screened in duplicate. Descriptive synthesis of the data and risk of bias assessment were undertaken. Results: Four RCTs met the inclusion criteria and were included in this systematic review. ST in all studies was performed by means of open flap debridement. Gracey curettes were the most commonly used hand instruments, while sonic and ultrasonic devices were used in the test group. Sites with initial PPD ≥ 6 mm had pocket reduction ranging from 2.93 to 4.89 mm in the control group and from 2.77 to 3.86 mm in the test group. All studies found no significant difference between the different types of instruments/devices in terms of PPD reduction. Conclusions: Despite the limited number of studies, both manual and power-driven instruments appear to be effective in reducing PPD after surgical treatment of periodontitis. Clinical relevance: Based on the findings of this systematic review, the clinician may make a decision whether to use manual or powered instruments during ST on a case-by-case basis and considering other factors, such as the risk of creating high concentrations of aerosols. [ABSTRACT FROM AUTHOR]

Introduction: The goals of periodontal therapy include preventing illness, slowing or stopping disease development, replacing lost periodontal tissues, and preserving the therapeutic outcomes. The apical repositioning of the gingival edge during traditional periodontal surgery exposes the root surface to the oral cavity and reduces pocket depth. It may lead to attachment loss, Gingival Recession (GR). It is also commonly recognised that periodontal surgery causes pain and suffering. Laser assisted periodontal therapy has been the subject of study in an effort to address these drawbacks. Aim: To compare the efficacy of diode laser as an adjunct to Open Flap Debridement (OFD) with that of OFD alone in the management of chronic periodontitis patients. Materials and Methods: This randomised clinical trial with split mouth study design will be conducted in Periodontics Department at Sharad Pawar Dental College, Wardha, Maharashtra, India, for a duration of six months. Thirteen patients (26 quadrants) with generalised chronic periodontitis patients will be selected. The Probing Pocket Depth (PPD) ≥5 mm after phase I therapy will be included in this split mouth study. Diode laser (920 nm) will be used as an adjunct to OFD (test) as compared with conventional flap surgery (control). Clinical parameters like Plaque Index (PI), Papillary Bleeding Index (PBI), PPD, Relative Attachment Level (RAL) and Relative Gingival Marginal Level (RGML) and GR will be recorded at baseline and six months post-therapy. Visual Analogue Scale (VAS) will be used to determine patient discomfort intraoperatively and after one week. A questionnaire for patient-based outcomes will be administered after period of six months postsurgery and response will be recorded. Student's paired t-test will be used for comparing the treatment groups at baseline and six months. [ABSTRACT FROM AUTHOR]

Introduction: The goals of periodontal therapy include preventing illness, slowing or stopping disease development, replacing lost periodontal tissues, and preserving the therapeutic outcomes. The apical repositioning of the gingival edge during traditional periodontal surgery exposes the root surface to the oral cavity and reduces pocket depth. It may lead to attachment loss, Gingival Recession (GR). It is also commonly recognised that periodontal surgery causes pain and suffering. Laser assisted periodontal therapy has been the subject of study in an effort to address these drawbacks. Aim: To compare the efficacy of diode laser as an adjunct to Open Flap Debridement (OFD) with that of OFD alone in the management of chronic periodontitis patients. Materials and Methods: This randomised clinical trial with split mouth study design will be conducted in Periodontics Department at Sharad Pawar Dental College, Wardha, Maharashtra, India, for a duration of six months. Thirteen patients (26 quadrants) with generalised chronic periodontitis patients will be selected. The Probing Pocket Depth (PPD) ≥5 mm after phase I therapy will be included in this split mouth study. Diode laser (920 nm) will be used as an adjunct to OFD (test) as compared with conventional flap surgery (control). Clinical parameters like Plaque Index (PI), Papillary Bleeding Index (PBI), PPD, Relative Attachment Level (RAL) and Relative Gingival Marginal Level (RGML) and GR will be recorded at baseline and six months post-therapy. Visual Analogue Scale (VAS) will be used to determine patient discomfort intraoperatively and after one week. A questionnaire for patient-based outcomes will be administered after period of six months postsurgery and response will be recorded. Student’s paired t-test will be used for comparing the treatment groups at baseline and six months.

Objective This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis.Methods The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted. Results A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI（-0.45, -0.2）, P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI（-0.40, 0.10）,P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05).Conclusion aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.

Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and nonsmokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.

Objectives: Evaluating the efficiency of combined air polishing and Nd:YAG laser application in addition to scaling and root planning (SRP) in treatment of periodontal pockets of stage III grade C periodontitis patients was the aim of this clinical trial. Materials and methods: Twenty-four systemically healthy, stage III grade C periodontitis patients were recruited for this clinical trial. In this split-mouth study, the quadrants were randomly allocated to either SRP with combined air polishing (erythritol/chlorhexidine powder) and Nd:YAG laser (2 W, 200 mJ/pulse, 10 Hz) therapy (test group) or SRP alone (control group). A masked examiner recorded clinical parameters such as plaque index (PI), gingival index (GI), bleeding on probing (%) (BOP %), probing depth (PD), and clinical attachment level (CAL) on periodontal charts at baseline, 1 month and 3 months after treatment. Results: The clinical parameters had significantly reduced 1 and 3 months after treatment compared to baseline for both study groups (p < 0.05). Considering PI, GI, and BOP (%) parameters, there were no significant differences between the study groups at any time points (p > 0.05). While PD and CAL reductions were similar in study groups for moderately deep pockets (5 to 6 mm) (p > 0.05), PD and CAL reductions were significantly greater in test group compared to control group for deep pockets (PD ≥ 7 mm) (p < 0.05). Conclusions: The present clinical trial demonstrated that SRP with combined application of air polishing and Nd:YAG laser may be advantageous in sites where mechanical debridement alone cannot access, such as deep pockets in the short term. Long-term, well-designed future studies including clinical, biochemical, and microbiological analyses are needed to determine the effectiveness of this procedure. Clinical relevance: SRP with combined application of air polishing and Nd:YAG laser provided more reductions in probing depth and clinical attachment level parameters in deep pockets compared to SRP alone. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. Methods Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe. Results For sites of 40.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). Conclusion When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

Background. Periodontal disease is a chronic polymicrobial infectious condition. Non-surgical treatments, including scaling and root planing (SRP) with or without adjunctive treatments, are among the recommended treatment options for this condition. This study investigated the effect of probiotic supplementation in the form of mouthwash with SRP on periodontal indices in patients with stage III grade A generalized periodontitis. Methods. Thirty-six patients were randomly assigned to two groups (n=18) and received SRP treatment along with a placebo in one group and probiotic supplementation in the other. After SRP, the test group used daily probiotics for 20 days. The control group subjects were treated only with SRP and placebo mouthwash. Periodontal indices were determined at three time intervals: at baseline and after one and three months. The data were analyzed using SPSS 17. P

Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of Nd: YAG laser therapy adjunct to subgingival scaling and root planning (SRP) for treating severe chronic periodontitis. Methods We selected patients with severe chronic periodontitis whose teeth were distributed in 4 quadrants of the mouth, with probing depth (PD) of 5-8mm, attachment loss (AL)≥5mm and bleeding on probing (BOP). These teeth were randomly divided into three groups: SRP group, SRP+L group (Nd: YAG laser after SRP treatment), and L+SRP group (SRP after Nd: YAG laser treatment). We recorded parameters including BOP, PD and AL of the three groups at baseline and 8 weeks after treatment and made statistical analysis. Results At 8 weeks after treatment, BOP, PD and AL of the three groups were improved than those in the baseline (P<0.05). BOP positive percentage of SRP+L group and L+SRP group significantly reduced compared with SRP group (P<0.05). PD of SRP+L group significantly decreased compared with SRP group and L+SRP group (P<0.05), for sites with PD=7mm, SRP+L group was significantly decreased compared with SRP and L+SRP groups (P<0.05). AL of SRP group significantly decreased compared with SRP+ L group and L+SRP group (P<0.05). Conclusion Severe periodontal treatment with Nd:YAG laser adjunct to SRP is more effective in reducing BOP and PD, and for deeper pockets PD is significantly decreased in SRP+L group, but there is no advantage in the improvement of AL. [ABSTRACT FROM AUTHOR]

Aim: Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non‐surgical periodontal therapy. Materials and Methods: Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non‐smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non‐surgical periodontal therapy. Meta‐regressions were conducted to evaluate correlations between outcomes and other contributing factors. Results: Seventeen studies were included. The post‐treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: −0.33 mm, 95% confidence interval (CI): [−0.49, −0.17], p <.01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: −0.20 mm, CI: [−0.39, −0.02], p <.01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups. Conclusions: Smoking negatively impacts clinical responses to non‐surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non‐smokers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this article was to perform a systematic review on the effectiveness of local adjuvant therapies in the treatment of aggressive periodontitis (AgP), now reported as periodontitis grade C. Materials and methods: The authors selected randomized clinical trials of AgP patients who received local therapy as adjuvants to non-surgical periodontal with a duration of at least 90 days. Seven databases were searched up to January 2020. The gain in clinical attachment level (CAL) and reduction of probing depth (PD) were the outcomes of interest. Results: Of the 3583 studies found, only five articles were included in the qualitative analysis. Among the substances analyzed, only 1.2 mg of simvastatin gel (SMV) (1.2 mg/0.1 ml), 1% of alendronate gel (ALN) (10 mg/ml), and 25% metronidazole gel (MTZ) (Elyzol@) showed a significant decrease in the probing depth when compared with their respective control groups. The gain CAL was shown using 1.2 mg SMV gel (1.2 mg/0.1 ml) and 1% ALN gel (10 mg/ml). Conclusion: Although 1.2 mg SMV gel (1.2 mg/0.1 ml), 1% ALN gel (10 mg/ml), and 25% MTZ gel (Elyzol) have shown better results, local therapies adjuvant to SRP the data found were limited. Future clinical studies with appreciable methodological quality should be conducted. Clinical relevance: Despite some benefits of local delivery therapy, up to now, it has not been possible to prove the efficacy of local therapy as an adjunct to standard treatment of AgP (periodontitis grade C). [ABSTRACT FROM AUTHOR]

Background. Periodontal disease is a chronic polymicrobial infectious condition. Non-surgical treatments, including scaling and root planing (SRP) with or without adjunctive treatments, are among the recommended treatment options for this condition. This study investigated the effect of probiotic supplementation in the form of mouthwash with SRP on periodontal indices in patients with stage III grade A generalized periodontitis. Methods. Thirty-six patients were randomly assigned to two groups (n=18) and received SRP treatment along with a placebo in one group and probiotic supplementation in the other. After SRP, the test group used daily probiotics for 20 days. The control group subjects were treated only with SRP and placebo mouthwash. Periodontal indices were determined at three time intervals: at baseline and after one and three months. The data were analyzed using SPSS 17. P<0.05 was considered statistically significantd. Results. There were significant differences in BOP levels in both the test and control groups between different intervals, with no significant difference between the groups. The significance of changes in the CAL and PI indices were similar to those in BOP. There were significant differences in PD levels between the groups after one and three months using the mouthwash. There were also significant differences between the PD values at different intervals in both groups. Conclusion. This study's results showed that probiotic supplementation as a mouthwash, along with SRP, had a positive effect on periodontal indices in patients with stage III and grade A generalized periodontitis. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the effect of the subgingival application of 0.8% hyaluronic acid (HA) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Twenty patients with chronic periodontitis were recruited to participate in a study and divided to Group 1 (G1) treated with 8% hyaluronic acid gel as an adjunctive to scaling and root planning (HARP) and Group 2 (G 2) treated with scaling and root planning only. Plaque index (PL.I) Gingival index (G.I) and bleeding on probing (B.O.P) were evaluated pretreatment (baseline) (1st visits), one week (2nd visits), and 4 weeks (3rd visit) posttreatment. Subgingival plaque sample were taken for microbiologic analysis at baseline and 4 weeks posttreatment. Intragroup comparison result between visits for Group 1showed that there was highly significant different for BOP, CFU, and no significant different for PLI and GI between 2nd and 3rd visit. For G 2, there was highly significant different for GI and significant for PLI and BOP, and non-significant different CFU, between 2nd and 3rd visit. Intergroup comparison for clinical parameter and bacteriological result between visits Showed that there was highly significant different in1st visit for PLI, BOP and CFU in 3 rd visit. It can be conclude that the local application of hyaluronic acid gel (0.8%) in conjunction with scaling and root planning have a beneficial effect on clinical periodontal parameter and may prevent recolonization of periodontal pathogens in patients with chronic periodontitis. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis was to evaluate the effects of metronidazole and amoxicillin in combination with mechanical therapy for the treatment of aggressive periodontitis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Record of Systematic Reviews (CRD42018111595). The research was performed using PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library databases till December 2019 and included randomized clinical trials that analyzed whether the use of systemic metronidazole and amoxicillin improved the treatment response in patients with aggressive periodontitis. Altogether, 137 articles were identified and 4 studies were selected after applying the inclusion and the exclusion criteria. No statistically significant difference was observed in the clinical attachment level between the use of systemic antibiotics combined with scaling and root planning (SRP) and SRP without antibiotics (p = 0.52, mean deviation [MD]: 0.21, 95% confidence interval [CI]: −0.04–0.46). There was a statistically significant difference in the probing depth between the use of systemic antibiotics with SRP and the use of SRP alone (p = 0.02, MD: 0.40, 95% CI: 0.02–0.78). Gain in the clinical attachment level was not significantly higher when systemic antibiotics were used with SRP compared to SRP without antibiotics in the treatment of aggressive periodontitis. However, a statistically significant difference was observed in reduction in the probing depth. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate and correlate the effect of non surgical periodontal therapy on homocysteine levels in patients with chronic periodontitis. Methods: Fifty participants were enrolled in the study (n=50) in the age range of 20-45 yrs. Each patient was examined using a mouth mirror and UNC-15 graduated periodontal probe. After recording the clinical parameters & indices (CAL, OHI-S, GI), venous blood was drawn from the antecubital vein and transferred to a vial and centrifuged to isolate the plasma, which was then sent for evaluation of plasma homocysteine level. Non-surgical therapy was performed which consisted of scaling and root planing (SRP). After 90 days, the patient was re-evaluated for clinical parameters and the readings were recorded again. Blood samples were sent for analysis of post treatment plasma homocysteine levels. Results: The plasma Hcy level in periodontitis subjects during pre treatment was 20.7± 3.4 µmol/L which was significantly higher. Post therapy levels reduced to 14.7± 2.2 µmol/L. The OHI's and GI were also significantly reduced after post therapy. Conclusion: An inflammatory condition like chronic periodontitis is significantly associated with elevated plasma homocysteine levels. However, no significant change was seen in the plasma homocysteine levels between males and females. Periodontal intervention shows statistically significant improvement in plasma homocysteine values. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients. Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p

Background: Sometimes, a combination of mechanical and chemical treatment provides good recovery such as metronidazole (MTZ) and hyaluronic acid (HA) topically that have recently been recognized as an adjunct therapeutic measure for periodontitis. Aims and Objectives: The objective is to estimate and compare the potential benefits of the effect of MTZ and HA gels on the clinical periodontal parameters. Materials and Methods: Chronic periodontitis patients were volunteered to partake in this research. They classified into three groups; 10 patients received root surface debridement (RSD) and 0.2% HA gel was additionally applied subgingival in test sites as the first group, the second group (10 patients) received RSD and MTZ gel was also added subgingival in test sites, and the last group consisting of 10-patient management with RSD alone. At the first visit, plaque index, gingival index, and periodontal pocket depth (PI, GI, and PPD) were recorded subsequently, and this represents 1st record which was done before periodontal treatment, while the 2nd record for indices was taken after 7 days. Results: Intragroup analysis of all the clinical periodontal parameters showed high significant (HS) results between baseline and 1 week at P < 0.01. In addition, on intergroup analysis, the results were significant at a second visit for GI and HS for PPD and not significant for PI. Conclusion: Local applications of MTZ and (0.2%) HA gels as an auxiliary to conventional periodontal therapy have a useful impact on clinical periodontal parameter during 7 days in chronic periodontitis patient. [ABSTRACT FROM AUTHOR]

Background: The etiology of periodontal diseases is multifactorial including both systemic and local causes. Local factors such as grooves on root surfaces contribute a great deal to the causation of periodontal diseases. Materials and Methods: Proximal radicular grooves were studied in 150 extracted maxillary and mandibular anterior teeth. Periodontal attachment loss was measured after staining the root surfaces with 0.1% toluidine blue stain. The relationship of the presence and absence of grooves with periodontal attachment loss was also studied. Results: The prevalence of proximal root grooves was found to be 86.67%. The prevalence of grooves on maxillary teeth was 43.42% and on mandibular teeth was 56.67%. A greater loss of attachment was present on grooved surfaces than on nongrooved surfaces. Conclusion: The proximal radicular grooves present as one of the major etiological factors in periodontal diseases.

Objectives: This study was performed to investigate the efficacy of using glycine powder air-polishing (GPAP) or antiseptics (chlorhexidine, CHX) adjunctively to scaling and root planing (SRP) in the treatment of periodontitis. Methods: In this trial, 90 patients (between 28 and 80 years old) who had at least three teeth with 3- to 7-mm periodontal pockets were ıncluded from the Department of Periodontology. The patients were divided into three groups randomly. In the control group, ultrasonic instrumentation was performed with distilled water and hand instrumentation. In the CHX group, ultrasonic instrumentation was performed with CHX and hand instrumentation. In the GPAP group, in addition to SRP with ultrasonic performed with distilled water and hand instrumentation. GPAP was performed for 10 s per periodontal pocket using a Perio-Flow device. All treatments were performed in one session. Resuls: The scores of plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), and clinical attachement level (CAL) were decreased in all groups after 1 month, and the results were statistically significant in intergoup comparisions. PI and CAL scores were statistically significant in intragroup comparisions in GPAP group. Altough GI, PD, and BOP scores were lower in the GPAP group than CHX and control group, the differences after 1 month were not statistically significant. Conclusion: Within the limits of this study, it was seen that SRP was effective alone in the treatment of periodontitis. However, using a CHX with ultrasonic devices has little beneficial effects on periodontal parameters when compared with control and GPAP groups. GPAP groups was found more effectively in PI and CAL scores. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of hormone replacement therapy(HRT) on periodontal treatment outcomes in a group of postmenopausal women with periodontitis. Materials and Methods: 23 post-menopausal chronic periodontitis patients were included in this study. The test group(n=11) consisted of women who started HRT with this study and received conjugated estrogen and medroxyprogesteron. The control group(n=12) was women not taking any HRT or supplement therapy. Study groups received the same periodontal treatment. All subjects examiend by recording the following: plaque index (PI), sulcus bleeding index (SBI), periodontal pocket depth (PD) and relative attachment level (RAL) from 6 sites in each tooth. Measurements were recorded at the baseline, 1 month, 3 months, and 6 months following periodontal treatment. Serum estrogene level and bone mineral density was recorded at baseline and 6 months following periodontal treatment. Results: The GI change was greater in the control group. There wasn’t significant difference by means of PD, the attachment gain was significantly greater in the HRT receiving group. Conclusion: HRT seems to have a positive effect on periodontal treatment outcomes.

Aim: Chronic periodontal disease (CPD) and type 2 diabetes mellitus (T2DM) share common pathogenic pathways involving the cytokine network resulting in increased susceptibility to both diseases, leading to increased inflammatory destruction, insulin resistance, and poor glycemic control. Periodontal treatment may improve glycemic control. The aim of this study was to evaluate the effect of scaling and root planing (SRP) of T2DM patients with CPD on hyperglycemia and the levels of serum interleukin-10 (IL-10). Materials and Methods: Forty-five subjects were divided into three groups comprising 15 subjects each as Group 1 (healthy controls), Group 2 (CPD patients), and Group 3 (T2DM patients with CPD). Plaque index, gingival index (GI), probing pocket depths (PPD), clinical attachment loss (AL), bleeding on probing (BoP), random blood sugar, glycosylated hemoglobin (HbA1C), and serum IL-10 were measured at baseline; SRP was performed on Groups 2 and 3 and the selected parameters recorded again at 6 months. Results: Statistically significant (P < 0.05) differences were observed in the variables at baseline and 6 months after SRP between the three groups using one-way ANOVA. The paired samples t-test for PPD and AL in Group 3 was statistically significant. Group 3 revealed positive correlations between PPD and HbA1C, BoP and IL-10, respectively, at 6 months and a predictable association of HbA1C with PPD and GI, and IL-10 levels with BoP, respectively, at 6 months. Conclusion: Scaling and root planing is effective in reducing blood glucose levels in T2DM patient with pocket depths and effective in elevating systemic IL-10 levels in CPD patients and CPD patients with T2DM.

Background: Bacterial plaque and calculus are accepted etiological agents in the initiation and progression of periodontal disease. Their accumulation and attachment are facilitated by a roughened root surface. The rough calculus surface may not, in itself, induce inflammation in the adjacent periodontal tissues, but may serve as an ideal substrate for subgingival microbial colonization. Many techniques have been used to identify and remove calculus deposits present on the root surface. The purpose of this review is to compile the various methods and their advantages for the detection and removal of calculus. [ABSTRACT FROM AUTHOR]

Honey has been shown to promote tissue healing and used to cure many diseases since ancient times. Nevertheless its effect on periodontal therapy has very limited evidence. The aim of this study was to evaluate the potential complementary effect of Tualang honey applied in adjunct to periodontal therapy. Fourteen chronic periodontitis patients with total number of 94 sites with periodontal pocket of 5mm and above were randomly assigned into control and test groups. Parameters such as plaque score, gingivitis score, pocket depth and clinical attachment loss were recorded. Scaling and root planing were done in all patients followed with honey application into the periodontal pockets of test group. The parameters were reevaluated after six weeks. The periodontal pocket depth and clinical attachment loss were significantly improved after 6 weeks in both groups (P<.05). However, the magnitude of changes in all parameters showed no significant different between control and honey group. Considering limitation of this study, the superior effect of Tualang honey as an adjunct to nonsurgical periodontal therapy was not evidence. Many factors may involve the sustainability of honey in the periodontal pocket. Thus we recommended further investigation to evaluate the effect of honey on periodontal wound healing. [ABSTRACT FROM AUTHOR]

Introduction & Objective: Chronic periodontitis is an inflammatory disease of the tooth supporting tissues by a specific group of microorganisms, leading to progressive destruction of the periodontal ligament. The aim of this study was to evaluate the effect of amoxicillin and metronidazole as an adjunct, after scaling and root planning in reducing pocket depth and clinical attachment loss in chronic periodontitis (moderate to severe) patients. Materials & Methods: In this clinical trial randomized control study, scaling and root planning were performed for 30 chronic periodontitis (moderate to severe) patients.15 patients were given amoxicillin 500 mg and metronidazole 250 mg every 8 hours for 7 days as an adjunct after scaling and root planning, For 15 other patients only scaling and root planning were per-formed. Probing depth and clinical attachment loss were measured in each group in base line and were compared 1 month before and after scaling and root planning. Statistical analysis was done using a paired t-test, ANOVA and by SPSS16 software. Results: Mean pocket depth and clinical attachment loss in the test group compared to control group, 1 month after the intervention was not statistically significant(P=0. 082, P = 0.540). Conclusion: Amoxicillin and metronidazole as an adjunct to scaling and root planning do not have a significant impact on reducing pocket depth and clinical attachment loss over one month after treatment in patients with chronic periodontitis.

Introduction: The present study compared the effects of erbium-doped yttrium aluminium garnet (Er:YAG) laser and hand instrumentation on the attachment of human gingival fibroblast (HGF) cells to periodontally involved root surfaces. Methods: A total of 40 tooth specimens were collected and treated in four distinct groups: scaled and root planed with hand instruments, scaled with Er:YAG laser, treated with a combination of hand instruments and Er:YAG laser and non-treated control group. The attachment and proliferation rate of HGF were assessed using MTT assay and scanning electron microscope (SEM) examination was used for cell morphological evaluation. Results: The MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide) assay showed significant decrease in HGF cell viability in both hand instruments only and combination treated teeth specimens compared to control specimens (P < 0.05), 24 hours after cell seeding. However, at time 48, the cell viability of attached cells in these 2 treated groups was almost similar to control. In contrast, at 24 and 48 hours after cell seeding, viability of attached cells was higher than control in Er:YAG laser treated only specimens (P < 0.05). According to SEM study, the laser treated specimens showed more surface roughness. Conclusion: Er:YAG laser increased attachment and proliferation of HGF cells in comparison to the hand instruments method. [ABSTRACT FROM AUTHOR]

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Introducción: el compromiso inmunoinflamatorio gingival en áreas interradiculares establece una lesión furcal. Sus terapéuticas tienen como objetivo mantener la salud, la función y la estética del diente. Objetivo: determinar las terapéuticas empleadas en lesiones furcales y la relación con su gravedad. Método: se realizó un estudio descriptivo, con historias clínicas dadas de altas en las consultas de Periodoncia y Estomatología General Integral de la Facultad de Estomatología, del municipio Plaza de la Revolución, entre enero 2009 y mayo 2011. Los 119 molares afectados en la furca conformaron el universo que se estudió en su totalidad. Variables estudiadas: grado de afectación furcal según la clasificación de Carranza y Newman, agrupados por gravedad y su tratamiento. Para la asociación y relación entre variables cualitativas fue utilizado el Chi cuadrado. Resultados: el colgajo con implante, la hemisección y la bicuspidización fueron terapéuticas pobremente representadas con 7,6%, 2.5% y 0,8% respectivamente, mientras que en las más aplicadas estuvieron: colgajo convencional (53,1%), raspado y alisado (26%) y la exodoncia (11,8%). El raspado y alisado (90,3%) obtuvo la supremacía para los grados I y II y la exodoncia (57,1%) para los grados III y IV. p= 0,0004. Conclusiones: las terapéuticas predominantes fueron: el colgajo convencional, el raspado y alisado radicular y la exodoncia. El raspado y alisado fue la terapéutica favorecida para los grados I y II y la exodoncia lo fue en los grados III y IV.Introduction: the destruction of the support tissues in inter-radicular areas of multi radicular tooth is known as furcation lesion. The goals of those therapies are maintaining the teeth health, function and esthetics. Objective: to determine the therapy employed in furcation lesions and its relation with their seriousness. Methods: a transversal study was carried out, with the dental records of patients discharged from the consultations of Periodontics and Integral General Dentistry of the Faculty of Dentistry of the municipality Plaza de la Revolución from January 2009 to May 2011 . The universe was formed by all the 119 molars registered with furcation lesions. The studied variables were: furcation lesion degree according to the Carranza y Newman classification, grouped by seriousness and treatment. The association and relationship among qualitative variables were carried out with Chi square. Results: the flap with implant, the hemisection and the bicuspidizatión were poorly represented with 7, 6%, 2.5% and 0, 8%, respectively while among the most applied ones were the conventional flap (53, 1%), root planning (26%) and the exodontia (11, 8%). Root planning obtained the supremacy (90, 3%) in the lesions grades I and II and the exodontia (57, 1%) was associated to grades III y IV. p= 0,0004 Conclusions: the predominant therapies were: the conventional flap, root planning and the exodontia. Root planning was the favored therapy for the grades I and II, while the dental extraction was the favored one in grades III and IV.

Background: Root surface debridement (RSD) is necessary to create an environment suitable for reattachment of the periodontium. Root surface conditioning may aid the formation of a biocompatible surface suitable for cell reattachment. BioPure™ MTAD (mixture of Doxycycline, citric acid and a detergent) is an endodontic irrigant with antibacterial properties and the ability to remove smear layer. It was hypothesized that MTAD may be useful for root surface conditioning. The efficacy of MTAD as a conditioner was measured by examining fibroblast attachment to root surfaces. Materials and Methods: Thirty-two specimens of human teeth with advanced periodontal disease were used. The surfaces were root planed until smooth. Half of the specimens were treated with 0.9% saline and the other samples with Biopure MTAD. As a negative control group, five further samples were left unscaled with surface calculus. Human gingival fibroblast cells HGF1-PI1 were cultured and poured over the tooth specimens and incubated. After fixation, the samples were sputter-coated with gold and examined with a SEM. The morphology and number of attached, fixed viable cells were examined. The data was analysed using the Mann-Whitney-U statistical test. Results: There was no significant difference between the numbers of attached cells in the experimental group treated with MTAD and the control group treated with saline. Little or no attached cells were seen in the negative control group. Conclusion: RSD created an environment suitable for cell growth and attachment in a laboratory setting. The use of MTAD did not promote the attachment and growth of cells on the surface of human roots following RSD.