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Aim: Oral hygiene‐related self‐efficacy (OHSE) describes one's confidence to successfully execute oral hygiene behaviour. The aim of this study was to investigate the long‐term course of OHSE in patients during initial periodontal therapy (IPT) and supportive periodontal therapy (SPT) and its association with clinical parameters. Materials and Methods: Patients diagnosed with periodontitis, undergoing either IPT or SPT, were evaluated at two timepoints. Clinical examination included pocket probing depths (PPDs), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI) and gingival index (GI). Patients' OHSE was assessed with a questionnaire. Statistical analyses included t‐tests and linear regression models. Results: Ninety‐eight patients from an initial group of 201 patients were evaluated after 4 years. The overall OHSE score increased significantly in the IPT group (mean 11.65 ± 15.6, p =.001). The increase in the OHSE category 'interdental cleaning' was significantly correlated with a decrease in the number of pockets requiring treatment (Spearman correlation rs = −.2349, p =.022) and periodontal inflamed surface area (PISA) (rs = −.2099, p =.042). Conclusions: Patients under IPT showed a significant increase of OHSE compared to those under SPT. Improved OHSE, particularly in interdental cleaning, appears to be associated with sustained success of periodontal therapy. [ABSTRACT FROM AUTHOR]

Objective: This study aims to analyse the association between the baseline microbial load of selected periodontopathogenic bacteria collected from gingival crevicular fluid (GCF) and the primary outcome of steps I and II therapy. Materials and methods: 222 patients with stage III periodontitis were included into this retrospective analysis that received steps 1 and 2 periodontal therapy without adjunctive systemic antibiotics. Baseline GCF samples were quantitatively analysed using ELISA-based kits for levels of periodontopathogens (Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Treponema denticola (Td), and Tannerella forsythia (Tf)) and associated with the primary therapy outcome using a “treat-to-target” therapy endpoint (TE) defined as ≤ 4 sites with PD ≥ 5 mm six months after therapy. Results: 38.2% of the patients achieved TE. Patients failing to achieve TE revealed significantly increased levels of Pg, Fn, and Tf at baseline (Pg: p = 0.010, Fn: p = 0.008 Tf: p = 0.004). Multivariate binary logistic regression adjusted for sex, mean probing depth, diabetes, and current smoking status showed an independent relationship between Tf and the TE (aOR 2.570, p = 0.023). Conclusion: Increased microbial load is associated with decreased responsiveness to therapy. The findings suggest that specifically baseline Tf levels are associated with poorer treatment outcomes and might improve the accuracy of periodontal diagnosis. Clinical relevance: The findings of this study support the concept of a critical biomass that is sufficient to induce and maintain an immune response within the periodontal pocket, which ultimately leads to irreversible tissue destruction. However, calculating this level in advance may serve as an early indicator for intervention. Key finding: Baseline Tannerella forsythia levels are associated with poorer treatment outcome. [ABSTRACT FROM AUTHOR]

Aim: The study aims to assess the efficacy of rose bengal (RB)-mediated antimicrobial photodynamic therapy (a-PDT) as an adjunct to scaling and root planing in the management of chronic periodontitis patients in terms of clinical parameters like gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and microbiological parameters like total microbial count, total red complex organism count, Porphyromonas gingivalis count, Treponema denticola count, and Tannerella forsythia count. Materials and Methods: In this randomized controlled clinical trial, a total of 30 patients were recruited who met the inclusion criteria. The participants were randomly allocated into group A with scaling and root planning (SRP) alone and group B with SRP + a-PDT. The clinical and microbiological parameters were measured at baseline and at 3-month follow-up. Intergroup and intragroup comparisons were performed using independent t test and paired t test, respectively. Value of p < 0.05 was considered as statistically significant. Results: At 3-month follow-up, group B treated with SRP + a-PDT showed statistically significant reduction in GI (0.58 - 0.20) and PPD (1.81 - 0.32 mm), gain in CAL (0.73 - 0.04 mm), and reduction in total microbial count [2.80 - 0.08 · 104 colony forming unit (CFU)], total red complex count (0.29 0.14 · 10² CFU), P. gingivalis count (0.43 0.13 · 10² CFU), T. denticola count (0.61 0.04 · 10² CFU), and T. forsythia count (0.59 - 0.04 · 102 CFU) as compared with group A (p < 0.05). Conclusion: RB-mediated a-PDT as an adjunct to SRP was significantly more effective in improving GI, PPD, and CAL and in reducing microbial count as compared with SRP alone in the management of chronic periodontitis. [ABSTRACT FROM AUTHOR]

Aim: To investigate the bidirectional influence between periodontitis and psoriasis, using the respective experimental models of ligature‐ and imiquimod‐induced diseases on murine models. Materials and Methods: Thirty‐two C57/BL6J mice were randomly allocated to four experimental groups: control (P− Pso−), ligature‐induced periodontitis (P+ Pso−), imiquimod‐induced psoriasis (P− Pso+) and periodontitis and psoriasis (P+ Pso+). Samples (maxilla, dorsal skin and blood) were harvested immediately after death. Measures of periodontitis (distance between the cemento‐enamel junction and alveolar bone crest [CEJ–ABC] and the number of osteoclasts) and psoriasis (epidermal thickness and infiltrate cell [/0.03mm2]) severity as well as systemic inflammation (IL‐6, IL‐17A, TNF‐α) were collected. Results: The P+ Pso+ group exhibited the most severe experimental periodontitis and psoriasis, with the highest values of CEJ–ABC, number of osteoclasts, epidermal thickness and infiltrate cells in the dorsal skin, as well as the highest blood cytokine concentration. The P+ Pso− group presented with higher cell infiltrate (/0.03mm2) compared to the control group (p <.05), while the P− Pso+ group showed substantially higher alveolar bone loss (CEJ–ABC) than the control group (p <.05). Conclusions: Experimental periodontitis may initiate and maintain psoriasiform skin inflammation and, vice versa, experimental psoriasis may contribute to the onset of periodontitis. In a combined model of the diseases, we propose a bidirectional association between periodontitis and psoriasis via systemic inflammation. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q‐SI) versus one‐stage full‐mouth subgingival instrumentation (FM‐SI) on probing depth and periodontal pathogen reduction over a 6‐month follow‐up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes. Methods: Patients with periodontitis were randomized to receive Q‐SI (n = 43) or FM‐SI (n = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real‐time PCR. Results: At the 6‐month follow‐up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM‐SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q‐SI patients (p <.001). At 6 months, FM‐SI was more effective at reducing the median proportions of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythia (Tf) (p <.001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (p =.029), Pg (p =.014), and Tf (p <.001) levels and the FM‐SI protocol (p <.001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM‐SI group when lower baseline Pg levels were detected. Conclusion: The FM‐SI was more effective than the Q‐SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6‐month follow‐up period. Higher baseline PPD and Pg levels had a negative impact on PPD reduction at 6 months after FM‐SI. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long‐term effects of periodontal inflammation control on systemic inflammatory markers are unclear. Objective: This study aimed to investigate the long‐term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. Methods: Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow‐ups were conducted over a 3‐ to 5‐year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. Results: A total of 49 patients with GAgP completed APT and follow‐ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1‐mm reduction in PD after treatment, the neutrophil count, neutrophil‐lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109/L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. Conclusion: This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long‐term observation. [ABSTRACT FROM AUTHOR]

Objectives: Probiotics are promising adjuncts to non‐surgical periodontal therapy (scaling and root planing (SRP)) for managing gingival and periodontal diseases. Probiotics are considered alternatives to antibiotics, especially with the emergence of antimicrobial resistance. Hence, the present systematic review aims to generate evidence on the role of probiotics compared to antimicrobial agents for managing periodontal diseases (gingivitis and periodontitis). Method: Six electronic databases (PubMed, SCOPUS, Web of Science, EBSCO, Cochrane, Clinical Trial Registry) were searched to collect studies comparing the effect of probiotics with antibiotics for periodontal disease. In total, 5530 articles were retrieved from all databases, of which 1891 were included for title and abstract screening. After screening, a total of ten clinical studies were included for data extraction and analysis. Probing pocket depth (PPD), Clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), gingival index (GI), and microbial profile were recorded. Results: Probiotics showed a significant reduction in the PPD and CAL compared to antibiotics. Antibiotics were more effective in reducing the PI and GI. A combination of probiotics and antibiotics superior compared to probiotics and antibiotics alone. Conclusion: Probiotics can be used as an alternative to antibiotics, however, a combination is more effective for managing periodontal disease. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies have demonstrated a positive role of hyaluronic acid (HA) on periodontal clinical outcomes. This in-vitro study aimed to investigate the impact of four different HAs on interactions between periodontal biofilm and immune cells. Methods: The four HAs included: high-molecular-weight HA (HHA, non-crosslinked), low-molecular-weight HA (LHA), oligomers HA (OHA), and cross-linked high-molecular-weight HA (CHA). Serial experiments were conducted to verify the influence of HAs on: (i) 12-species periodontal biofilm (formation and preexisting); (ii) expression of inflammatory cytokines and HA receptors in monocytic (MONO-MAC-6) cells and periodontal ligament fibroblasts (PDLF) with or without exposure to periodontal biofilms; (iii) generation of reactive oxygen species (ROS) in MONO-MAC-6 cells and PDLF with presence of biofilm and HA. Results: The results indicated that HHA and CHA reduced the bacterial counts in a newly formed (4-h) biofilm and in a pre-existing five-day-old biofilm. Without biofilm challenge, OHA triggered inflammatory reaction by increasing IL-1b and IL-10 levels in MONO-MAC cells and IL-8 in PDLF in a time-dependent manner, whereas CHA suppressed this response by inhibiting the expression of IL-10 in MONO-MAC cells and IL-8 in PDLF. Under biofilm challenge, HA decreased the expression of IL-1b (most decreasing HHA) and increased IL-10 levels in MONOMAC-6 cells in a molecular weight dependent manner (most increasing CHA). The interaction between HA and both cells may occur via ICAM-1 receptor. Biofilm stimulus increased ROS levels in MONO-MAC-6 cells and PDLF, but only HHA slightly suppressed the high generation of ROS induced by biofilm stimulation in both cells. Conclusion: Overall, these results indicate that OHA induces inflammation, while HHA and CHA exhibit anti-biofilm, primarily anti-inflammatory, and antioxidant properties in the periodontal environment. [ABSTRACT FROM AUTHOR]

The term periodontal disease is used to define diseases characterised by inflammation and regeneration of the gums, cementum, supporting bone, and periodontal ligament. The conventional treatment involves the combination of scaling, root planning, and surgical approaches which are invasive and can pose certain challenges. Intrapocket administration of nanofibers can be used for overcoming challenges which can help in speeding up the wound repair process and can also be used to promote osteogenesis. To help make drug delivery more effective, nanofibers are an interesting solution. Nanofibers are nanosized 3D structures that can fill the pockets and have excellent mucoadhesion which prolongs their retention time on the target site. Moreover, their structure mimics the natural extracellular matrix which enables nanomaterials to sense local biological conditions and start cellular-level reprogramming to produce the necessary therapeutic efficacy. In this review, the significance of intrapocket administration of nanofibers using recent research for the management of periodontitis has been discussed in detail. Furthermore, we have discussed polymers used for the preparation of nanofibers, nanofiber production methods, and the patents associated with these developments. This comprehensive compilation of data serves as a valuable resource, consolidating recent developments in nanofiber applications for periodontitis management into one accessible platform. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). Conclusions: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to analyze the effects of periodontal treatment on markers of atherosclerotic coronary artery disease and circulating levels of periostin. Background: Periostin is necessary for periodontal stability, but it is highly present in atherosclerotic plaques. Treatment of periodontal disease, with low levels of local periostin, is thought to reduce systemic levels of periostin. Thus, this may contribute to cardiovascular health. Methods: A pilot randomized controlled clinical trial was designed to include patients with severe periodontal disease and history of atherosclerotic coronary artery disease. Samples of gingival crevicular fluid (GCF) and serum were collected before and after periodontal treatment by periodontal surgery or non‐surgical therapy. The levels of several markers of inflammation and cardiovascular damage were evaluated including CRP, IFN‐γ, IL‐1ß, IL‐10, MIP‐1α, periostin, and TNF‐α in GCF and CRP, Fibrinogen, IFN‐γ, IL‐1ß, IL‐6, IL‐10, L‐Selectin, MIP‐1α, Periostin, TNF‐α, and vWF in serum. Results: A total of 22 patients with an average of 56 years old were recruited for participating in this study. Twenty of them were male. Most of them (82%) had suffered an acute myocardial event and underwent surgery for placing 1, 2, or 3 stents in the coronary arteries more than 6 months ago but less than 1 year. The treatment of periodontal disease resulted in an overall improvement of all periodontal parameters. Regarding the evaluation of GCF and serum, a significant increase of periostin in the GCF was observed after periodontal surgery. In contrast, although other markers in GCF and serum improved, no significant correlations were found. Conclusion: Treatment of periodontal disease through periodontal surgery induces a local and transient increase in the levels of periostin in the gingival crevicular fluid. The effects on systemic markers of inflammation and cardiovascular function have not been confirmed. [ABSTRACT FROM AUTHOR]

BackgroundPeriodontal disease is widespread among pregnant women, and it is possible that taking action to improve oral health conditions can make improvements in adverse pregnancy outcomes. Herein, we summarize the recent evidence using a network meta-analysis to assess the effects of different periodontal treatment intervention strategies on the risk of adverse pregnancy outcomes in pregnant women.Materials and methodsRandomized controlled trials were retrieved from PubMed, Web of Science, Embase, and Cochrane Library databases. After literature screening, data extraction, and quality evaluation of the included literature were performed, the R studio 4.2.2 “netmeta” package was used for the network meta-analysis.ResultsA total of 20 studies were included, and 5 adverse pregnancy outcomes (preterm birth, low birth weight, preterm birth and/or low birth weight infants, small for gestational age, and pre-eclampsia) were considered to examine the effects of different periodontal treatment interventions strategies on the risk of the abovementioned outcome indicators. The results of the network meta-analysis demonstrated that the three periodontal treatment intervention strategies of sub- and/or supra-gingival scaling and root planing + chlorhexidine rinsing (SRP + CR), sub- and/or supra-gingival scaling and root planing+chlorhexidine rinsing + tooth polishing and plaque control (SRP + CR + TP), and sub- and/or supra-gingival scaling and root planing +sonic toothbrush + tooth polishing and plaque control (SRP + ST + TP) reduced the risk of preterm birth [odds ratio (OR) = 0.29, 95% confidence interval (CI) (0.10–0.88), OR = 0.25, 95CI% (0.10–0.63), OR = 0.28, 95CI% (0.11–0.69), respectively]. In addition, two periodontal treatment intervention strategies, SRP + CR and SRP + CR + TP, were effective methods in terms of the risk of preterm birth and/or low birth weight [OR = 0.18, 95CI% (0.06–0.52), OR = 0.31, 95CI% (0.12–0.79)].ConclusionThe available evidence suggests that the risk of preterm birth and preterm birth and/or low birth weight can be reduced with certain periodontal treatment intervention strategies. Future studies should focus on optimizing intervention strategies and the optimal timing for different periods of pregnancy, in order to provide a reference for pregnant women’s healthcare.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=407901, CRD42023407901.

Objectives: In preparation of a definitive randomized clinical trial (RCT), the current parallel-grouped triple-blind pilot RCT assessed the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with polylactic acid/polyglycolic acid (PLA/PGA) membrane for improvement of periodontal tissue regeneration in Class II furcation type defects. Method and materials: With the present single-center investigation, 24 patients/24 mandibular molars revealing Class II furcation lesions with involved buccal surfaces were randomly allocated and treated surgically, using either a PLA/PGA membrane alone (control, n = 12) or in combination with rhBMP-2 (n = 12). Assessors, participants, and the statistician were blinded to the treatment groups. Clinical parameters including Plaque Index (PI), Papillary Bleeding Index (PBI), clinical attachment level, vertical probing depth, horizontal probing depth, and gingival recession were assessed at baseline and 6 months postsurgery. Results: Baseline values concerning the investigated parameters were comparable between both groups (P > .05). After 6 months, clinical attachment level gain was similar (P = .76), while greater reductions in vertical probing depth (P = .01) and horizontal probing depth (P = .05), along with less gingival recession (P = .03) were observed in the PLA/PGA + rhBMP-2 group (compared to the controls). An increased number of completely closed furcation type defects was observed in the PLA/PGA + rhBMP-2 group (with no adverse effects). Conclusions: When treating Class II furcation lesions, the use of rhBMP-2 (combined with PLA/PGA membranes) seems advantageous. The presented set-up seems feasible with regards to recruitment, randomization, acceptance, retention, and adherence to the study protocol. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). Conclusions: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.

This study aimed to evaluate the degree of periodontal involvement in subjects with and without bruxism, with generalized chronic periodontitis of varying severity grades, and to assess the effects of occlusal correction therapy in association with non-surgical periodontal therapy on periodontal status. The following periodontal parameters were analyzed: probing depth (PD), clinical attachment level (CAL), Papilar bleeding index (PBI) and Plaque Index (PI), and X-rays, at the initial (pre-therapeutic) moment and at 3 months after therapy completion. The present study demonstrated that bruxism generates significant clinical changes in a periodontopathic environment. High values of periodontal attachment loss, recessions, missing teeth, tooth mobility, and furcation lesions translate into major losses of periodontal tissue in patients with periodontal disease and bruxism. Periodontal therapy, combined with occlusal correction and bruxism therapy, resulted in statistically significant improvements in periodontal parameters. Thus, occlusal trauma therapy in patients with bruxism becomes an absolute necessity in periodontal therapy.

Objectives: To compare ultrasonic scaler prototypes based on a planar piezoelectric transducer with different working frequencies featuring a titanium (Ti-20, Ti-28, and Ti-40) or stainless steel (SS-28) instrument, with a commercially available scaler (com-29) in terms of biofilm removal and reformation, dentine surface roughness and adhesion of periodontal fibroblasts. Materials and methods: A periodontal multi-species biofilm was formed on specimens with dentine slices. Thereafter specimens were instrumented with scalers in a periodontal pocket model or left untreated (control). The remaining biofilms were quantified and allowed to reform on instrumented dentine slices. In addition, fibroblasts were seeded for attachment evaluation after 72 h of incubation. Dentine surface roughness was analyzed before and after instrumentation. Results: All tested instruments reduced the colony-forming unit (cfu) counts by about 3 to 4 log10 and the biofilm quantity (each p < 0.01 vs. control), but with no statistically significant difference between the instrumented groups. After 24-hour biofilm reformation, no differences in cfu counts were observed between any groups, but the biofilm quantity was about 50% in all instrumented groups compared to the control. The attachment of fibroblasts on instrumented dentine was significantly higher than on untreated dentine (p < 0.05), with the exception of Ti-20. The dentine surface roughness was not affected by any instrumentation. Conclusions: The planar piezoelectric scaler prototypes are able to efficiently remove biofilm without dentine surface alterations, regardless of the operating frequency or instrument material. Clinical relevance: Ultrasonic scalers based on a planar piezoelectric transducer might be an alternative to currently available ultrasonic scalers. [ABSTRACT FROM AUTHOR]

Objectives: To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints. Material and methods: Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression. Results: Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture. Conclusions: Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often. Clinical relevance: Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture. [ABSTRACT FROM AUTHOR]

"Selman Waksman" first used the term "antibiotic" in 1942 to refer to any material produced by a bacterium that inhibits the growth of other micro-organisms in high dilution. The pathogenic bacteria, the patient, and the medication are the three main components of the antibiotic periodontal therapy idea. Patients with attachment loss or with aggressive types of periodontitis or those with periodontitis linked with underlying medical conditions are the best candidates for systemic antimicrobial therapy. The three main objectives of Periodontal Therapy are disrupting biofilms, suppressing potential periodontal pathogens throughout the entire oral cavity, and halting the illness. The microbial etiology of inflammatory periodontal disease provides the rationale for the use of antibiotic medication in periodontal therapy. This idea is predicated on the idea that a certain bacterium causes destructive periodontal disease and that antibiotic agents can be present in humans in doses greater than those required to kill or inhibit infections. [ABSTRACT FROM AUTHOR]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: This study aimed to elucidate the impact of periodontal therapy on glycaemic control in individuals with type 2 diabetes and various baseline blood glucose levels using a large‐scale claims database from Japan. Materials and Methods: Using the JMDC Claims Database, we identified individuals with type 2 diabetes who underwent health check‐ups in the fiscal years 2018 or 2019 and were followed up until the next year's health check‐up. We conducted a weighted cohort analysis using stabilized inverse probability weights for treatment and censoring to estimate the effect of periodontal therapy on changes in haemoglobin A1c levels within a year. Analysis was done for different baseline haemoglobin A1c categories: 6.5%–6.9%, 7.0%–7.9% and ≥8.0%. Results: Of the 4279 insured persons included in the study, 957 received periodontal therapy. Overall, there was a tendency towards improved glycaemic control among those who received periodontal therapy. Participants with baseline haemoglobin A1c levels of 7.0%–7.9% who received periodontal therapy exhibited significantly better glycaemic control compared with those without dental visits (difference; −0.094 [95% confidence interval: −0.181 to −0.007]). Conclusions: Periodontal therapy may improve glycaemic control in individuals with diabetes, especially in those with haemoglobin A1c levels ≥7.0%. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease and chronic kidney disease (CKD) are both prevalent conditions with significant implications for public health. This prospective clinical study aimed to explore the potential relationship between periodontal disease and the progression of CKD in renal transplant recipients. Materials and Methods: A total of 150 renal transplant recipients with varying degrees of periodontal disease were enrolled in this study. Baseline periodontal assessments, including probing depth, clinical attachment loss, and bleeding on probing, were conducted. The estimated glomerular filtration rate (eGFR) was measured at baseline and followed up at regular intervals over 24 months. Participants were divided into groups based on the severity of periodontal disease for comparative analysis. Results: At baseline, the mean eGFR was 60.5 ± 10.2 mL/min/1.73 m2 in the mild periodontal disease group, 58.3 ± 9.8 mL/min/1.73 m2 in the moderate periodontal disease group, and 55.7 ± 8.5 mL/min/1.73 m2 in the severe periodontal disease group. Over the 24-month follow-up period, participants with severe periodontal disease experienced a significant decline in eGFR compared to those with mild or moderate periodontal disease (P < 0.05). In addition, individuals with severe periodontal disease exhibited a higher incidence of CKD progression, defined as a decline in eGFR greater than 10% from baseline. Conclusion: This prospective clinical study suggests a potential association between severe periodontal disease and the progression of CKD in renal transplant recipients.

Graphical Abstract

Purpose: To evaluate the use of hydrogen peroxide as an adjunct to ultrasonication (US) in biofilm removal and whether it can limit the spread of viable microorganisms in the aerosol. Materials and Methods: Multi-species biofilms were formed on dentin disks and titanium disks fixed on a plastic surface. After placing the specimens in a periodontal pocket model, an ultrasonic scaler was applied for 30 s, in part combined with 0.25% or 0.5% H2O2. After treatment, the remaining biofilm was analysed for bacterial counts (colony forming units [CFU]), biofilm quantity and metabolic activity. Further, the cytotoxic effect of hydrogen peroxide on periodontal ligament fibroblasts was assessed and the spread of bacteria in aerosol was quantified. Results: Ultrasonication reduced bacterial counts in biofilm, biofilm mass and metabolic activity on both dentin and titanium disks. Adjunctive use of 0.25% and 0.5% H2O2 more effectively reduced the viable bacteria in biofilm than ultrasonication alone; this was also found on both dentin and titanium. The different concentrations of H2O2 did not lead to corresponding differences in bacterial mass and metabolic activity. The spread of bacteria through aerosols was statistically significantly reduced when adjunctive H2O2 was used. However, a certain cytotoxic effect on periodontal ligament fibroblasts by H2O2 could not be ruled out. Conclusions: Irrigating with H2O2 during periodontal instrumentation with an ultrasonic scaler increases the reduction of viable bacteria within biofilms. It might limit bacterial spreading via aerosols. [ABSTRACT FROM AUTHOR]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The regeneration of lost/damaged support tissue in the periodontium, including the alveolar bone, periodontal ligament, and cementum, is an ambitious purpose of periodontal regenerative therapy and might effectively reduce periodontitis-caused tooth loss. Guided tissue regeneration (GTR) is a technique currently used in dentistry for periodontal surgery, which allows osseous regeneration prior to soft tissue migration into the area of interest. Calcium phosphate-based bone grafts (mostly Tricalcium Phosphate or Hydroxyapatite) are bio ceramics that show the greatest similarity to the mineral found in the bone. Thereby, giving calcium-phosphate excellent biocompatibility, biodegradability and osteoconductivity. The aim of the study is to fabricate hydroxyapatite reinforced polymeric hydrogel membrane for regeneration. Materials and Method: Pure alginate fabrication was done by cross linking sodium alginate with calcium chloride. Hydroxyapatite (HAP) alginate (Alg) was formulated by adding nanoparticles to the alginate mixture, which was then cross-linked with calcium chloride to formulate a HAP alginate polymeric membrane. The Fourier-transform infrared spectroscopy (FT-IR), Scanning Electron Microscope (SEM), and biocompatibility tests were performed to analyse the membrane characteristics. Results: Fabricated Hydroxyapatite- alginate (Hap- Alg) membrane has longer durability, because of strong crystal structure which in turn might take a longer time to regenerate. The membrane was found to be biocompatible and HAp induces faster mineralisation which in turn will increase the tissue regeneration rate of the membrane. Conclusion: The findings of our study suggests that the HAP-Alg hydro gel membrane is highly durable and hemocompatible and it has faster mineralisation capability thus making it superior from the clinically available membranes for GTR. Further analyses needs to be conducted to evaluate the potential of this membrane to be used for regeneration.

Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm removal. The objective of this systematic review was to assess existing literature regarding the subgingival use of various types of air-polishing powders, as an effective method of subgingival biofilm control. For this, 55 articles on this subjected were sourced from searched databases and subjected to an evaluation process of their contained information, which was subsequently structured and compiled into this manuscript. The existing literature acknowledges that good subgingival biofilm control is essential for the success of periodontal therapy, including through subgingival air-polishing, as an adjunctive procedure. This approach has the potential to enhance patient comfort during and after subgingival mechanical plaque removal, thereby mitigating damage to periodontal structures. Consequently, it may lead to improved healing capabilities within the periodontal tissues and the formation of a more stable reparative gingival junctional epithelium. [ABSTRACT FROM AUTHOR]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Periodontal regeneration using a barrier membrane can be affected by several factors, including patient-related factors (such as smoking habits), surgical techniques, and type of barrier membrane. Smoking exposure has a negative impact on the periodontium due to its direct inhibition of gingival fibroblast function. Vitamin C is widely recognized as an antioxidant that can be used to mitigate the detrimental impact of smoking products on periodontal cells. This study aimed to investigate whether vitamin C could improve the proliferation and viability of gingival fibroblasts extracted from smoking and non-smoking donors and then cultured on non-crosslinked (CopiOs Pericardium) and crosslinked (BioMend) collagen membranes. To address this aim, human gingival fibroblasts were extracted from healthy periodontium of smoker patients (Group 1) and non-smoker patients (Group 2). The cells were cultivated and subsequently subcultured in a growth medium supplemented with the required nutrients. Subsequently, the medium at passage six was supplemented with vitamin C, i.e., at the start of the experiment. An evaluation of cell proliferation and viability was carried out using cell migration assays and AlamarBlue® assays for cells grown on BioMend and CopiOs Pericardium collagen membranes. Assessment of the morphology and attachment of gingival fibroblasts to the experimental collagen membranes was conducted using scanning electron microscopy (SEM). The viability and proliferation assessments of hGFs from the migration assay were evaluated using AlamarBlue®. The results exhibited significant fluorescent intensity of gingival fibroblasts on both membrane groups (BioMend and CopiOs Pericardium) in the smoker group compared to the non-smoker group (p < 0.05), which was interpreted to be the result of hGF metabolic activity and the exclusion of any cytotoxic effects, particularly from vitamin C addition. Vitamin C positively affected cells from the smoker group with statistically significant results in the BioMend group (Wilcoxon signed-rank test of p value < 0.05; p = 0.028). SEM images revealed the crosslinking pattern of the BioMend membrane and the non-crosslinked natural tissue structure of the CopiOs Pericardium membrane, which did not change regardless of whether the cultured smoker or non-smoker hGFs were treated with vitamin C. Small numbers of attached hGFs in membrane matrices in all samples, mainly in the peripheries, were observed. It can be concluded that the addition of vitamin C to collagen membranes in vitro seems to combat the adverse effects of smoking products on gingival fibroblasts. [ABSTRACT FROM AUTHOR]

The link between periodontitis and systemic diseases has increasingly become a focus of research in recent years. In this context, it is reasonable—especially in vulnerable patient groups—to minimize bacteremia during periodontal treatment. The aim of the present in vivo feasibility study was to investigate the possibility of laser-based bacteremia prevention. Patients with stage III, grade B generalized periodontitis were therefore treated in a split-mouth design either with prior 445 nm laser irradiation before nonsurgical periodontal therapy or without. During the treatments, clinical (periodontal measures, pain sensation, and body temperature), microbiological (sulcus samples and blood cultures before, 25 min after the start, and 10 min after the end of treatment), and immunological parameters (CRP, IL-6, and TNF-α) were obtained. It was shown that periodontal treatment-related bacteremia was detectable in both patients with the study design used. The species isolated were Schaalia georgiae, Granulicatella adiacens, and Parvimonas micra. The immunological parameters increased only slightly and occasionally. In the laser-assisted treatments, all blood cultures remained negative, demonstrating treatment-related bacteremia prevention. Within the limitations of this feasibility study, it can be concluded that prior laser disinfection can reduce bacteremia risk during periodontal therapy. Follow-up studies with larger patient numbers are needed to further investigate this effect, using the study design presented here. [ABSTRACT FROM AUTHOR]

Objectives: A beneficial effect of cross-linked hyaluronic acid (cHA) on periodontal wound healing and regeneration has recently been demonstrated. The present in vitro study was designed to obtain deeper knowledge on the effect of cHA when applied in the gingival sulcus (serum-rich environment) during non-surgical periodontal therapy. Materials and methods: The influence of cHA, human serum (HS), and cHA/HS on (i) a 12-species biofilm formation, (ii) the adhesion of periodontal ligament fibroblasts (PDLF) to dentine surface, (iii) the expression and secretion of interleukin-8, and (iv) the expression of receptors of HA in PDLF and gingival fibroblasts (GF) were evaluated. Results: At 4 h of biofilm formation, cHA and HS in combination (cHA/HS) slightly decreased the colony-forming unit counts in biofilm whereas the metabolic activity of biofilm was reduced in all test groups (cHA, HS, cHA/HS) vs. control. At 24 h, the quantity of biofilm was reduced in all test groups vs. untreated control. The test substances did not affect adhesion of PDLF to dentin. HS increased the expression of IL-8 by PDLF and GF which was partially downregulated by cHA. HS and/or cHA promoted the expression of the HA receptor RHAMM in GF but not in PDLF. Conclusions: In summary, the present data indicate that serum neither negatively affect the activity of cHA against periodontal biofilm nor had any unwanted influence on the activity of PDLF. Clinical relevance: These findings lend additional support for the positive effects of cHA on cells involved in periodontal wound healing, thus pointing to its potential use in non-surgical periodontal therapy. [ABSTRACT FROM AUTHOR]

The regeneration of lost/damaged support tissue in the periodontium, including the alveolar bone, periodontal ligament, and cementum, is an ambitious purpose of periodontal regenerative therapy and might effectively reduce periodontitis-caused tooth loss. Guided tissue regeneration (GTR) is a technique currently used in dentistry for periodontal surgery, which allows osseous regeneration prior to soft tissue migration into the area of interest. Calcium phosphate-based bone grafts (mostly Tricalcium Phosphate or Hydroxyapatite) are bio ceramics that show the greatest similarity to the mineral found in the bone. Thereby, giving calcium-phosphate excellent biocompatibility, biodegradability and osteoconductivity. The aim of the study is to fabricate hydroxyapatite reinforced polymeric hydrogel membrane for regeneration. Pure alginate fabrication was done by cross linking sodium alginate with calcium chloride. Hydroxyapatite (HAP) alginate (Alg) was formulated by adding nanoparticles to the alginate mixture, which was then cross-linked with calcium chloride to formulate a HAP alginate polymeric membrane. The Fourier-transform infrared spectroscopy (FT-IR), Scanning Electron Microscope (SEM), and biocompatibility tests were performed to analyse the membrane characteristics. Fabricated Hydroxyapatite- alginate (Hap- Alg) membrane has longer durability, because of strong crystal structure which in turn might take a longer time to regenerate. The membrane was found to be biocompatible and HAp induces faster mineralisation which in turn will increase the tissue regeneration rate of the membrane. The findings of our study suggests that the HAP-Alg hydro gel membrane is highly durable and hemocompatible and it has faster mineralisation capability thus making it superior from the clinically available membranes for GTR. Further analyses needs to be conducted to evaluate the potential of this membrane to be used for regeneration. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review is to provide a comprehensive summary of the current evidence regarding the efficacy and safety of nonsurgical periodontal therapy (NSPT) in pre- and postmenopausal women. Materials and Methods: We performed a systematic search of five databases until May 2022 with no language or date restrictions. We included experimental or quasi-experimental clinical studies in pre- or postmenopausal female patients (=40 years). We considered NSPT as scaling and root planning (SRP). The primary outcomes were: periodontal index (PRI) by Russell, plaque index (PI) by Löe and Silness or O'Leary and adverse events. A secondary outcome was a change in the bone mineral densitometry T-score. Results: We included three studies but did not meta-analyze the studies due to high heterogeneity. Two studies were pre-post trials, and one was a nonrandomized controlled trial. One trial included both pre- and postmenopausal women and two studies only evaluated postmenopausal women. The studies that compared the effect of SRP in pre- and postmenopausal women found a statistically significant reduction in PRI and PI according to Löe and Silness, and O'Leary. Another study found that SRP plus vitamin D and calcium supplementation decreased PI values. No study reported adverse events. The nonrandomized controlled trial reported a high risk of bias, and the two quasi-experimental studies showed high quality. Conclusion: All the studies included in the analysis demonstrated the effectiveness of Non-Surgical Periodontal Therapy (NSPT) in both pre- and postmenopausal patients with periodontitis. However, future studies with higher methodological quality and larger sample sizes are necessary. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between lifestyle behaviours and clinical periodontal outcomes following Steps 1/2 of periodontal therapy. Methods: A total of 120 subjects with untreated Stage II/III periodontitis participated in this study. At baseline, questionnaires were administered to assess the following lifestyle behaviours: adherence to Mediterranean diet (MD), physical activity (PA) and stress levels, sleep quality, smoking and alcohol use. Participants received Steps 1/2 of periodontal therapy and were re‐evaluated after 3 months. A composite outcome of the endpoint of therapy (i.e., no sites with probing pocket depth [PPD] ≥4 mm with bleeding on probing, and no sites with PPD ≥ 6 mm) was regarded as the primary outcome. Simple and multiple regression analyses were used to evaluate the association between lifestyle behaviours and clinical periodontal outcomes. Disease severity at baseline, body mass index, diabetes, household disposable income and plaque control were considered as confounders. Results: Multiple regression analyses showed significantly lower odds of achieving the endpoint of therapy in subjects with poor sleep quality (odds ratio [OR] = 0.13; 95% confidence interval [CI]: 0.03–0.47; p <.01), smoking (OR = 0.18; 95% CI: 0.06–0.52; p <.05) and alcohol use above the suggested intake (OR = 0.21; 95% CI: 0.07–0.63; p <.01). Subjects with a combination of 'unhealthy lifestyles' (low adherence to MD and low PA levels and high levels of stress and poor sleep quality) showed higher proportions of residual PPD≥6 mm (MD = 1.51; 95% CI: 0.23–2.80; p <.05) and lower odds of achieving the endpoint of therapy (OR = 0.85; 95% CI: 0.33–0.99; p <.05) at re‐evaluation. Conclusions: Subjects with unhealthy lifestyle behaviours showed worse clinical outcomes 3 months after Steps 1/2 of periodontal therapy. [ABSTRACT FROM AUTHOR]

Curcumin, a potent active compound found in turmeric and Curcuma xanthorrhiza oil, possesses a wide range of therapeutic properties, including antibacterial, anti-inflammatory, antioxidant, and wound healing activities. However, its clinical effectiveness is hindered by its low bioavailability and rapid elimination from the body. To overcome these limitations, researchers have explored innovative delivery systems for curcumin. Some promising approaches include solid lipid nanoparticles, nanomicelle gels, and transdermal formulations for topical drug delivery. In the field of dentistry, curcumin gels have shown effectiveness against oral disorders and periodontal diseases. Moreover, Pickering emulsions and floating in situ gelling systems have been developed to target gastrointestinal health. Furthermore, curcumin-based systems have demonstrated potential in wound healing and ocular medicine. In addition to its therapeutic applications, curcumin also finds use as a food dye, contraception aid, corrosion-resistant coating, and environmentally friendly stain. This paper primarily focuses on the development of gel compositions of curcumin to address the challenges associated with its clinical use. [ABSTRACT FROM AUTHOR]

Background: Mouth rinse agents reduce inflammation and microbial burden, improving periodontal clinical parameters. Yet, improper clinical use of these compounds might have several deleterious repercussions. Given the lack of research on the knowledge and application of antiplaque mouth rinse agents, this research was conducted. Methods: The research is an electronic survey wherein responses were gathered for ten items with predetermined answers in addition to covariate data. The questions were conceived to illuminate the level of knowledge possessed by dental professionals and their utilization pattern in periodontal practice. The data gathered underwent quantitative statistical analysis. Results: Participants in the study included 100 dental professionals from various disciplines, all of whom agreed that mouth rinses are a vital adjuvant in periodontal therapy. Most acknowledged being aware of the various mouth rinse agents, but their knowledge and application of mouth rinses were largely confined to chlorhexidine gluconate, with little consideration being given to alternative antiplaque agents. Conclusion: Little knowledge exists among dental professionals regarding mouth rinse agents and their appropriate application. Dental schools, clinical advisory organizations, and other establishments could educate dental professionals on the specific guidelines for utilizing antiplaque mouth rinses in a dental context, especially as an adjunct to periodontal therapy. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT). Materials and methods: After the administration of psychological questionnaires, patients diagnosed with generalized stage III–IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT. Results: Of the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD. Conclusion: Psychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017). Practical implications: Based on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies. [ABSTRACT FROM AUTHOR]

To assess the effects of non-surgical periodontal therapy on salivary biomarkers in non-diabetic and type 2 diabetic periodontitis patients and to investigate if saliva may be used to monitor glucose levels in type 2 diabetes. 250 participants with chronic generalized periodontitis aged 35–70 years were divided into two groups: test group with type 2 diabetes (125 subjects with 64 males & 61 females) and control group with non-diabetic (125 subjects with 83 males & 42 females). Participants received non-surgical periodontal treatment. Pre-NSPT and 6-week post-NSPT saliva glucose, amylase, total protein, and C-reactive protein (CRP) levels were measured. Intergroup correlations were assessed using Karl Pearson's correlation coefficient and paired t -test. Non-surgical periodontal therapy significantly decreased CRP (p < 0.05) in diabetics and non-diabetics. CRP mean values changes from baseline 1.79 to post op 1.5 and baseline 1.5 to post-op 1.24 in males and females of test group, respectively. In control group males and females, mean values change from baseline 1.48 to post-op 1.42 and 1.499 to 1.40. Other parameters Glucose, amylase & total protein showed improvement in the level, but statistically non-significant (p > 0.05). Salivary glucose levels corresponded favorably with HbA1C levels. In individuals with type 2 diabetes and non-diabetic generalized chronic periodontitis, non-surgical periodontal therapy may play a role in lowering the level of significant salivary biomarkers. Saliva can be utilized as a non-invasive approach for monitoring glucose levels in people with type 2 diabetes and chronic periodontitis. [Display omitted] [ABSTRACT FROM AUTHOR]

Periodontal inflammation are inflammation of supporting tissues of periodontium. The microbial factor can cause infection which is polymicrobial in origin and causes dysbiosis and shift in oxidative stress with compromised antioxidant capacity. This study focused at determination of the effect of nonsurgical periodontal therapy (NSPT) and vitamin C supplementation on total antioxidant capacity (TAOC) in chronic periodontitis patients (ChP). A total of 70 ChPand 35 periodontally healthy subjects (control) were recruited in this study. Further, ChP group was subdivided into ChP1 group (n = 35) which received NSPT only and ChP 2 group (n = 35) which received NSPT with vitamin C 500 mg once daily for 3 months. Serum and saliva samples were taken at baseline and at 3 months postNSPT for measurement of TAOC. Clinical parameters measured were measured at 1-, 3-, 6- and 12-month interval. Lower levels of serum and salivary TAOC levels were observed in ChP patients than healthy subjects (p < 0.05). Improvement in Clinical parameters was observed in both the groups ChP1 and ChP 2 group post therapy (p < 0.05). The periodontal treatment showed insignificant changes in serum and salivary TAOC levels (p > 0.05). The supplemental dose of vitamin C didn't have any additional benefits (p > 0.05). There lies an association of oxidative stress with periodontitis, low serum and salivary TAOC levels were seen in chronic periodontitis patients. NSPT improved the periodontal inflammatory status. However, benefits of vitamin C as an adjunct to NSPT remains inconclusive and needs to be further explored by multicentre longitudinal studies. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the systemic impact of periodontitis, previously considered a local disease, on cancer occurrence. We enrolled 683,854 participants, comparing cancer incidence among those with and without periodontitis and assessing the impact of periodontal treatment on cancer risk. Regardless of gender, age, Charlson comorbidity index, or the use of non-steroidal anti-inflammatory drugs, periodontitis patients had a lower overall cancer risk than controls. However, men with periodontitis had a higher risk of prostate cancer (adjusted hazard ratio [aHR] = 1.22; 95% confidence interval [CI] = 1.10–1.35), and both men and women had a higher risk of thyroid cancer (women: aHR = 1.20, 95%CI = 1.04–1.38; men: aHR = 1.51, 95% CI = 1.15–1.99). Patients with periodontitis who received treatment showed a reduced cancer risk (aHR = 0.41; 95% CI = 0.38–0.44) compared to untreated patients. Proper treatment for periodontitis may lower an individual's cancer risk more than if they did not have the disease at all, suggesting that periodontitis is a modifiable risk factor for cancer. [ABSTRACT FROM AUTHOR]

Tissue engineering is a highly promising field of reconstructive biology that draws on recent advances in medicine, surgery, molecular and cellular biology, polymer chemistry, and physiology. The objective of using tissue engineering as therapeutic application has been to harness its ability to exploit selected and primed cells together with an appropriate mix of regulatory factors, to allow growth and specialization of cells and matrix. The authors reviewed controlled clinical trials which also included histological studies that evaluated the potential of tissue engineering as a clinical tool in regeneration. periodontal regeneration with the use of combination of tissue engineered products with an osteoconductive matrix improve the beneficial effect of these materials by accelerating cellular in growth and revascularization of the wound site. The use of rh Platelet-derived growth factor + beta tricalcium phosphate for regeneration of the periodontal attachment apparatus in combination with collagen membranes as an acceptable alternative to connective tissue graft for covering gingival recession defects. The growth factors promote true regeneration of the periodontal attachment apparatus and the use of combination protein therapeutics which is commercially available can provide more predictable, faster, less invasive, less traumatic, and efficient outcome for the patient. [ABSTRACT FROM AUTHOR]

Abstract Background Smoking is an established modifying factor for the host immune response of periodontitis patients. However, its exact influence remains unclear. We aimed to compare the cytokine profile of periodontitis patients with and without smoking habits both before and after periodontal therapy to preliminarily explore its influence on the host immune response to periodontitis. Methods The protocol of the present meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42021255656. Meta-analysis was performed for each cytokine if at least three studies were included. We synthesized the evidence to compare the cytokine profile of periodontitis with and without smoking both in gingival cervical fluid (GCF) and serum to explore the impact of smoking on periodontitis both locally and systemically. Moreover, we also compared the cytokine profile of the two groups of patients after periodontal therapy to explore the effect of smoking on the outcome of periodontal therapy. Results Fifteen studies were included in this meta-analysis. We found that there was no significant difference between the two groups of patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients. Discussion There was no significant difference between smoking and nonsmoking periodontitis patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1β levels in their GCF than nonsmoking patients, which indicates that smoking may impair the response of periodontitis to periodontal treatment.

Background: Mouth rinse agents reduce inflammation and microbial burden, improving periodontal clinical parameters. Yet, improper clinical use of these compounds might have several deleterious repercussions. Given the lack of research on the knowledge and application of antiplaque mouth rinse agents, this research was conducted. Methods: The research is an electronic survey wherein responses were gathered for ten items with predetermined answers in addition to covariate data. The questions were conceived to illuminate the level of knowledge possessed by dental professionals and their utilization pattern in periodontal practice. The data gathered underwent quantitative statistical analysis. Results: Participants in the study included 100 dental professionals from various disciplines, all of whom agreed that mouth rinses are a vital adjuvant in periodontal therapy. Most acknowledged being aware of the various mouth rinse agents, but their knowledge and application of mouth rinses were largely confined to chlorhexidine gluconate, with little consideration being given to alternative antiplaque agents. Conclusion: Little knowledge exists among dental professionals regarding mouth rinse agents and their appropriate application. Dental schools, clinical advisory organizations, and other establishments could educate dental professionals on the specific guidelines for utilizing antiplaque mouth rinses in a dental context, especially as an adjunct to periodontal therapy.

Hyaluronic acid (HA) is a component of the extracellular matrix of the non-mineralized and mineralized tissues, including the periodontium. HA have important physiological and biological properties. HA maintains the tissue volume, presents bacteriostatic, anti-inflammatory, osteoinductive, and angiogenetic properties, as well as stimulates many cell functions having a role in wound healing. HA has been used as an adjunctive in the treatment of gingivitis, periodontitis, gingival recessions, or in the reconstruction of papilla deficiencies. In periodontitis patients, the association of HA with subgingival mechanical instrumentation reduces local inflammation and its use with access flap results in larger attachment level gain of infrabony defects compared to control groups non treated with HA. HA application in conjunction with advanced flaps may improve gingival recession levels. HA injection for papillary deficiency seems to be a viable treatment option that improves clinical volume, esthetic outcomes and is associated with minimal pain.

Aim: Retrospective analysis of subgingival microbiological data at intake in relation to the clinical periodontal status at intake and following non‐surgical periodontal treatment. Materials and Methods: Data were obtained from a population that consisted of patients diagnosed with moderate‐to‐severe periodontitis who had undergone non‐surgical periodontal treatment between 2016 and 2020. The presence and number of eight selected putative periodontal pathogens [Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythia (Tf), Parvimonas micra (Pm), Fusobacterium nucleatum (Fn), Treponema denticola (Td) and Filifactor alocis (Fa)] at intake and the percentage of teeth and sites with PPD >5 mm at intake and after treatment were extracted. Correlations within collected data were analysed with adjustment for multiple comparisons. Sub‐analyses were performed based on gender, age, and smoking and diabetic status. Results: Six hundred and sixty‐one patients could be included. The percentage of teeth with PPD >5 mm and the percentage of sites with PPD >5 mm at intake were significantly correlated to Pi, Tf, Pm, Fn and Fa. Patients with higher numbers of these pathogens at intake had a better treatment response. Those patients with higher numbers of Aa had a lower percentage of teeth and sites with PPD >5 mm at intake. Those with higher numbers of Aa also showed a smaller decrease in the percentage of sites with PPD >5 mm. Conclusion: The clinical periodontal status at intake and the response to treatment showed a weak but significant positive relationship for Pi, Tf, Pm, Fn and Fa. Conversely, higher numbers of Aa at intake were associated with more localized periodontitis and a reduced treatment response. [ABSTRACT FROM AUTHOR]

Aim: (i) To evaluate the efficacy of active periodontal therapy supplemented by supportive periodontal care (SPC) in retaining dentition during a 30‐year follow‐up period in patients susceptible to periodontitis, and (ii) to assess the prognostic factors associated with tooth loss. Materials and Methods: One‐hundred and fifty‐four patients with periodontitis, retrospectively classified as stage I–IV and grade B–C periodontitis, treated between 1984 and 1986 in a private practice, were enrolled in this study. After periodontal assessment, patients received non‐surgical treatment followed by surgical periodontal therapy, orthodontic treatment, and tooth‐splinting, where appropriate. SPC consisted of a strict recall programme every 3–6 months over a 30‐year period. Recurrences were treated either with subgingival root planing or flap surgery. Dental and periodontal variables were measured at baseline (T0), end of active therapy (T1), and after 25 (T2) and 30 (T3) years. Generalized mixed models were analysed to assess the prognostic factors associated with and survival analyses for tooth loss. Results: Data on 154 patients (4083 teeth) were available at baseline (T0). Teeth considered unworthy of treatment were extracted during active therapy (160, 3.9%) and at re‐assessment (13, 0.3%; T1). After 25 years of SPC, 140 teeth out of 3910 in 154 patients (3.6%) were lost (24 in 18 patients for periodontal reasons). Between 25 and 30 years, 20 patients (482 teeth) dropped out, and 61 teeth (2%) were lost (15 in 14 patients for periodontal reasons). Overall, 201 teeth (5.1%) were lost (39 for periodontal reasons) in 30 years of SPC. Generalized mixed models showed that stage III or stage IV periodontitis was associated with greater tooth loss during SPC compared to stage I or stage II (OR = 2.10; p =.048). Generalized periodontitis showed a statistically significant OR = 3.24 (p =.016) compared to the localized one. In SPC (T1–T3), age (p =.011), gender (male; p =.038), molar teeth (p = <.001), T0 and T1 pocket depth (p = <.001), tooth mobility grades 2 (p =.018) and 3 (p =.050), T0 and T1 bone loss (p = <.001), and presence of a root canal treatment (p = <.001) and a crown (p =.009) were statistically significantly associated with tooth loss. Conclusion: (i) Periodontal therapy and a stringent SPC are effective in maintaining most of the teeth in patients with moderate/advanced periodontitis for 30 years, and (ii) age, gender, molar teeth, pocket depth, bone loss, and the presence of a root canal treatment and a crown are prognostic factors associated with tooth loss. [ABSTRACT FROM AUTHOR]

Low-level laser therapy (LLLT) is a light source that generates light of a single wavelength. Low-level Laser do not cause temperature elevation within the tissue, but rather produce their effects from photobiostimulation within the tissues. Low-level LASERS do not cut or ablate the tissue. The application of LLLT has become popular in a variety of clinical applications in periodontics including promotion of analgesic effect, reduction of inflammation, and edema and wound healing following nonsurgical and surgical procedures. This review focuses on the molecular and subcellular mechanism of low intensity LASER therapy and their applications in periodontal therapy. [ABSTRACT FROM AUTHOR]