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

Background: Ischemia-modified albumin (IMA) is a systemic indicator of inflammatory diseases and is suggested as an oxidative stress marker. Objective: To determine the IMA and high-sensitivity C-reactive protein (hsCRP) serum levels for patients with chronic periodontitis (CP) and to evaluate the impact of non-surgical periodontal therapy on serum IMA and hsCRP levels. Methods: Twenty one systemically healthy patients with CP and 15 systemically and periodontally healthy controls (C) were enrolled in the study. Periodontal pocket depth (PPD), bleeding on probing (BOP) and attachment loss (AL) were recorded at the time of diagnosis and 6 weeks after the nonsurgical periodontal therapy. Blood samples were obtained before and after treatment from all groups, and serum IMA and hsCRP levels were evaluated by ELISA method. Results: All of the clinical findings were found to be elevated in the CP group in comparison to C group (p<0.05). Levels of IMA and hsCRP were higher in the CP group (p<0.05) and decreased after non-surgical periodontal therapy (p<0.05). Positive correlations were determined between PPD, BOP and hsCRP (p<0.05) as well as between PPD, AL, BOP and IMA levels (p<0.01) before treatment. A significant positive correlation was also observed between hsCRP and IMA (p<0.01) before and after treatment. Conclusion: IMA is a marker indicating systemic inflammation during periodontal disease, and is significantly reduced as a result of non-surgical periodontal therapy. Therefore, IMA might be suggested as a useful indicator of periodontal disease.

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial

BMC Oral Health ◽

10.1186/s12903-020-01363-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Holger F. R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevance The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.

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Effect of Nonsurgical Periodontal Therapy on Crevicular Fluid and Serum Glutathione Peroxidase Levels

Disease Markers ◽

10.1155/2012/632842 ◽

2012 ◽

Vol 32 (1) ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Swati Pradeep Patel ◽

Nishanth S. Rao ◽

A. R. Pradeep

Keyword(s):

Oxidative Stress ◽

Glutathione Peroxidase ◽

Periodontal Disease ◽

Chronic Periodontitis ◽

Periodontal Diseases ◽

Periodontal Therapy ◽

Enzyme Linked Immunosorbent Assay ◽

Pocket Depth ◽

Nonsurgical Periodontal Therapy ◽

Crevicular Fluid

Background: Plasma glutathione peroxidase (eGPx) is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF) eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT) by correlating GCF and serum levels of eGPx.Materials and methods: Thirty subjects (16-Males and 14-Females; age: 30–38 years) participated in the study. The subjects were divided, based on gingival index, probing pocket depth and clinical attachment level into: Healthy (group-1,n=10), Gingivitis (group-2,n=10) and Periodontitis (group-3,n=10). Chronic periodontitis patients after NSPT constituted group 4. GCF and serum samples collected from each subject were quantified for eGPx levels using Enzyme linked Immunosorbent Assay.Results: The mean eGPx concentrations increased from health (14.01 ng/μl and 78.26 ng/ml) to gingivitis (22.86 ng/μl and 90.44 ng/ml) and then to periodontitis (29.89 ng/μl and 103.43 ng/ml), in GCF and serum respectively. After NSPT, there was statistically significant reduction in eGPx concentration in GCF and serum (19.41 ng/μl and 85.21 ng/ml). Further, all the GCF eGPx values showed a positive correlation to that of serum eGPx level.Conclusion: Thus, increased eGPx concentration in GCF can be considered as an indicator of local increase in oxidative stress. While, increase in serum eGPx levels indicates that periodontal disease can also lead to increased oxidative stress at the systemic level.

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy – a randomized clinical trial

10.21203/rs.3.rs-47863/v2 ◽

2020 ◽

Author(s):

Holger F.R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods:Forty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions:Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery.

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Adjunctive Effects of a Sub-Antimicrobial Dose of Doxycycline on Clinical Parameters and Potential Biomarkers of Periodontal Tissue Catabolism

Dentistry Journal ◽

10.3390/dj7010009 ◽

2019 ◽

Vol 7 (1) ◽

pp. 9 ◽

Cited By ~ 1

Author(s):

Gülnur Emingil ◽

Ali Gürkan ◽

Taina Tervahartiala ◽

Marcela Hernandez ◽

Semiha Özgül ◽

...

Keyword(s):

Placebo Group ◽

Gingival Crevicular Fluid ◽

Periodontal Therapy ◽

Tartrate Resistant Acid Phosphatase ◽

Clinical Parameters ◽

Periodontal Tissue ◽

Pocket Depth ◽

Double Blind ◽

Beneficial Effects ◽

Nonsurgical Periodontal Therapy

Objectives: The aim of the present randomized, double-blind, placebo-controlled, parallel-arm study was to examine the effectiveness of a sub-antimicrobial dose of doxycycline (SDD) in combination with nonsurgical periodontal therapy, compared to nonsurgical periodontal therapy alone, on potential gingival crevicular fluid (GCF) biomarkers of periodontal tissue catabolism related to the clinical outcomes over a 12-month period. Materials and Methods: GCF was collected and clinical parameters were recorded from 30 periodontitis patients randomized either to an SDD or placebo group. The SDD group received SDD (20 mg) b.i.d for 3 months plus scaling and root planing (SRP), while the placebo group was given placebo capsules b.i.d for 3 months plus SRP. The patients were evaluated every 3 months during the 12-month study period. At each visit, clinical parameters and GCF sampling were repeated. Matrix metalloproteinase (MMP)-8, MMP-9, MMP-13, myeloperoxidase (MPO), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase-5 (TRAP-5) were determined by IFMA and ELISA. Results: Significant improvements were observed in all clinical parameters in both groups over 12 months (p < 0.0125) while the SDD group showed significantly better reduction in gingival index (GI) and pocket depth and a gain in clinical attachment compared to the placebo group (p < 0.05). GCF MMP-8 and OPG levels significantly reduced in the SDD group compared to baseline (p < 0.05). GCF MMP-9 significantly decreased in both groups compared to baseline (p < 0.05). GCF MPO significantly decreased at 3 and 9 months in the SDD group, while it significantly decreased at 6 months in the placebo group (p < 0.05). TRAP and MMP-13 could be detected in none of the samples. Conclusions: The present results indicate that three months of adjunctive usage of SDD to nonsurgical periodontal therapy compared to nonsurgical periodontal therapy alone in periodontitis patients results in further improvement of clinical periodontal parameters and GCF markers of periodontal tissue breakdown over a 12-month period. Beneficial effects of adjunctive SDD therapy is likely to be related to the reduced levels of two major periodontitis-associated MMPs, MMP-8 and -9, and their potential oxidative activator MPO.

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Non-Surgical Periodontal Therapy Decreases Periodontal Pocket Depth and Clinical Attachment Loss of Rheumatoid Arthritis Patients

10.53350/pjmhs2115113376 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3376-3377

Author(s):

Marryam Riaz ◽

Sohaib Shujaat ◽

Ayesha Fahim ◽

Shamail Zafar ◽

Mariyah Javed ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Gingival Recession ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

P Value ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Public And Private ◽

Attachment Loss ◽

Before And After

Objective: The objective of the present study was to determine the effect of non-surgical periodontal therapy on the disease severity in rheumatoid arthritis patients. Methods: Five hundred and twenty arthritis patients were included in the study, using consecutive non-probability sampling from the outpatient department of various public and private hospitals of Pakistan. Patients with periodontitis along with systemic Rheumatoid Arthritis (RA) were included in the study. Clinical parameters taken for the severity of periodontitis were the Gingival recession (GV), Periodontal Pocket Depth (PPD) and Clinical Attachment Loss (CAL). Independent sample t-test was used for significance before and after non-surgical periodontal therapy. Data was presented with mean (standard deviation). Results: The PPD and CAL of Rheumatoid Arthritis patients were found to be decreased significantly following non-surgical periodontal treatment (p value < 0.05), unlike the gingival recession, which did not decrease significantly (p value > 0.05). Conclusion: The PPD and CAL values of periodontal patients with rheumatoid arthritis were significantly reduced after giving non-surgical Periotherapy along with oral hygiene instruction. Keywords: arthritis; gingiva; periodontitis; periodontal pocket

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Evaluation of Serum Resistin Levels in Periodontal Health and Disease and Effects of Non Surgical Periodontal Therapy on Its Levels

Disease Markers ◽

10.1155/2012/153418 ◽

2012 ◽

Vol 32 (5) ◽

pp. 289-294 ◽

Cited By ~ 10

Author(s):

Archana Devanoorkar ◽

C.D. Dwarakanath ◽

Gayatri Gundanavar ◽

Rahul Kathariya ◽

Sudhir R Patil

Keyword(s):

Statistical Significance ◽

Periodontal Therapy ◽

Control Group ◽

Periodontal Health ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Nonsurgical Periodontal Therapy ◽

Health And Disease ◽

Group 2 ◽

Group 1

Background: Resistin and adiponectin are the adipokines secreted by adipocytes and various inflammatory cells. These adipokines are known to play an important role in insulin resistance. The aim of this study was to determine the serum resistin levels in periodontal health and disease and also, to determine the effect of nonsurgical periodontal therapy on its levels.Methods: A total of 40 patients (20 Males and 20 Females; age range 20–50 years) participated in the study. Subjects were categorized as healthy (group 1; Controls) and chronic periodontitis (group 2; Study) groups based on their periodontal status. Periodontal parameters (Plaque index (PI), Gingival index (GI), Bleeding index (BI), Probing pocket depth (PPD), Clinical attachment loss (CAL)) together with serum resistin levels were assessed at baseline and between 6–8 weeks following nonsurgical periodontal therapy for subjects in group~2 and only at baseline in group 1. Sera were tested in duplicate (single run), and the results were averaged.Results: Study group showed higher (1.89 ± 1.83 ng/ml) serum resistin levels, compared to control group (1.35 ± 0.70 ng/ml). However, this difference was not statistically significant (P=0.227). Also, resistin levels decreased following nonsurgical periodontal therapy but, this decrease failed to show any statistical significance, with pretreatment levels being 1.89 ± 1.83 ng/ml and post treatment levels being 1.59 ± 1.01 ng/ml (P=0.386).Conclusion: Observations of the present study revealed that there was not much difference in the serum resistin levels between the cases and the controls. Also the decrease in the resistin levels following nonsurgical periodontal therapy did not show any statistical significance.

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Use of Lasers in Nonsurgical Periodontal Therapy

International Journal of Experimental Dental Science ◽

10.5005/jp-journals-10029-1036 ◽

2013 ◽

Vol 2 (1) ◽

pp. 29-32

Author(s):

Varun Kulkarni ◽

Juhi Uttamani ◽

Imaad Shaikh

Keyword(s):

Soft Tissue ◽

Laser Therapy ◽

Periodontal Diseases ◽

Bacterial Load ◽

Periodontal Therapy ◽

Periodontal Treatment ◽

Periodontal Pocket ◽

Current Evidence ◽

Area Of Interest ◽

Nonsurgical Periodontal Therapy

ABSTRACT The use of dental lasers for treatment of periodontal diseases has been the area of interest in the recent years. Current evidence indicates that the use of lasers for the treatment of adult chronic periodontitis—either used solely or as an adjunct to traditional scaling and root planning therapy—offers minimal benefit. This article which is a peer review of various articles provides a brief explanation of the mechanism behind soft tissue lasers. The use of laser therapy in addition to traditional nonsurgical periodontal treatment in the management of periodontal diseases is reviewed. Lasers have been applied for hard and soft tissue debridement, as also for the bacterial load reduction from the periodontal pocket. Although, subgingival application of few of them during nonsurgical periodontal therapy can result in undesired outcomes, even when using manufacturer-recommended parameters. Over the past 20 years the research conducted regarding the clinical application of lasers is very limited. This article tries to fill in the void by reviewing the current and potential application of laser therapy. It has in turn proven to be a promising field in nonsurgical periodontal treatment of diseases. How to cite this article Uttamani J, Shaikh I, Kulkarni V. Use of Lasers in Nonsurgical Periodontal Therapy. Int J Experiment Dent Sci 2013;2(1):29-32.

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Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis

Folia Medica ◽

10.2478/folmed-2014-0016 ◽

2014 ◽

Vol 56 (2) ◽

pp. 109-115 ◽

Cited By ~ 6

Author(s):

Antoaneta M. Mlachkova ◽

Christina L. Popova

Keyword(s):

Chronic Periodontitis ◽

Alveolar Bone ◽

Incidence Rates ◽

Periodontal Therapy ◽

Pocket Depth ◽

Attachment Loss ◽

Dental Biofilm ◽

Nonsurgical Periodontal Therapy ◽

Root Planning ◽

Scaling And Root Planning

Abstract INTRODUCTION: Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. MATERIALS AND METHODS: The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). RESULTS: Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth ⋋ 5 mm (PD ⋋ 5 mm). Pockets with PD > 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. CONCLUSION: The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate chronic periodontitis. Given a good patient compliance, the antimicrobial periodontal therapy can be quite efficient in arresting the inflammatory process and reducing the depth of periodontal pockets; it can also achieve a stable attachment loss level and obviate the need to use a surgical periodontal treatment modality.

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The Location and Incidence of Patent Accessory Pulpal Canals in Permanent Molars with Periodontal Lesion by Using Micro-Computed Tomography

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3274 ◽

2021 ◽

Vol 11 (1) ◽

pp. 85-88

Author(s):

Dima Chouchi ◽

Atilla Berberoğlu ◽

Kaan Orhan ◽

Ilker Etikan ◽

Hayriye Tümer ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Micro Ct ◽

Micro Computed Tomography ◽

Pocket Depth ◽

Human Teeth ◽

Similar Region ◽

Permanent Molars

Objective: In this study, the event of patent accessory pulpal canals situated in periodontal pockets has been resolved to utilize the micro-CT method. Methods: Fifty-seven extracted permanent human teeth were utilized to examine the commonness, location, and diameter of the patent accessory canals that are opening outside toward the periodontal pocket by utilizing micro-CT and high-resolution desktop. Results: Through 57 molars 6 (10.25%) were accessible with patent accessory, canals inside furcation area, of root, 49 (85%) were accessible with patent accessory canals inside the mesial and distal buccal root, and 28 (49.1%) were accessible with patent accessory, canals inside the palatal/lingual root. A measurably critical variety was found alongside the nearness of patent accessory trench in various roots and pocket depth at a similar region of the nearness waterway just as the nearness of these canals and connection misfortune in this region. Conclusions: Progression of periodontal pocket might be responsible for opening accessory canal and cause pulp pathosis, making successful periodontal therapy difficult.

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