Effectiveness of oral hygiene with and without root planing in treating subjects with chronic periodontitis

Abstract: In general, periodontal disease is caused by bacterial plaque on the tooth surface. Bacterial elimination by curettage will reduce periodontal inflammation. This case report was aimed to review the immune response to chronic periodontitis as well as case management with curettage. We reported a 22-year-old female patient came to the Dental and Oral Hospital of University of Sam Ratulangi (Unsrat) with complaints of swollen front gum, frequent gum bleeding, and gum bleeding during tooth brushing. The gum bleeding had occurred since 6 months ago. Tartar cleaning was performed on her three weeks ago. Based on anamnesis, the patient did not suffer from any systemic disease. Intraoral examination revealed that there were reddish gingiva, swelling in region I, II, III, and IV, and probing depth of teeth 21-25 with a mean of 4 mm. Oral Hygiene Index measurement obtained a value of 1.7 (medium category). This case was diagnosed as chronic periodontitis. The treatment consisted of scaling, irrigation with NaCl solution and aquadest, root planing, gingival curettage, and periodontal pack application. At the first control (one week after gingival curettage), the patient did not complain of any pain on the curettage area, periodontal pack was loose. The objective examination still revealed redness, debris, and calculus, OHI-S: 0,8+0,3=1,1 (good category). The prognosis was good since the patient was cooperative, did not have any systemic disease, and had high motivation to maintain oral hygiene.Keywords: curettage, chronic peridontitis Abstrak: Secara umum penyakit periodontal disebabkan oleh bakteri plak pada permukaan gigi. Eliminasi bakteri dengan kuretase akan menurunkan peradangan periodontal. Laporan kasus ini bertujuan untuk menjelaskan respon imun terhadap penyakit periodontitis kronis serta penatalaksanaan kasus dengan kuretase. Kami melaporkan kasus seorang pasien perempuan berusia 22 tahun datang ke Rumah Sakit Gigi dan Mulut Pendidikan Universitas Sam Ratulangi (Unsrat) dengan keluhan gusi bagian depan bengkak, gusi sering berdarah, dan perdarahan gusi saat menyikat gigi. Gusi berdarah sejak sekitar 6 bulan lalu dan pasien melakukan pembersihan karang gigi sekitar 3 minggu lalu. Dari hasil anamnesis didapatkan bahwa pasien tidak mempunyai riwayat penyakit sistemik. Pada pemeriksaan intraoral terdapat gingiva berwarna kemerahan dan pembengkakan di region I, II, III, IV, probing depthgigi 21-25 dengan rerata sebesar 4 mm. Hasil pengukuran Oral Hygiene Index(OHI) ialah 1,7 (kategori sedang). Diagnosis klinis kasus ini ialah periodontitis kronis. Tindakan yang dilakukan ialah scaling, irigasi dengan NaCl dan akuades, root planing, kuretase gingiva, dan pemasangan periodontal pek. Kontrol pertama dilakukan satu minggu pasca kuretase gingiva, dan pada pemeriksaan subjektif pasien tidak mengeluhkan rasa nyeri di daerah yang telah dilakukan kuretase gingiva, pek periodontal sudah terbuka malam hari pasca kuretase gingiva. Pemeriksaan objektif gingiva masih kemerahan, terdapat debris dan kalkulus, OHI-S: 0,8+0,3=1,1 (kategori baik). Prognosis baik karena pasien kooperatif, tidak memiliki riwayat penyakit sistemik, dan memiliki motivasi yang tinggi untuk menjaga kebersihan rongga mulut.Kata kunci: kuretase; peridontitis kronis

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Keberhasilan terapi fase inisial periodontal pada gingival enlargement pasien anak dengan hidrosefalusThe success of initial periodontal therapy phase in gingival enlargement paediatric patient with hydrocephalus

Jurnal Kedokteran Gigi Universitas Padjadjaran ◽

10.24198/jkg.v32i3.28240 ◽

2020 ◽

Vol 32 (3) ◽

pp. 244

Author(s):

Nunung Rusminah ◽

Zavani Nur Hikmah ◽

Fahmi Oscandar

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Oral Hygiene ◽

Chronic Periodontitis ◽

Periodontal Therapy ◽

Paediatric Patients ◽

Root Planing ◽

Gingival Enlargement ◽

And Control ◽

Oral Hygiene Instruction

Pendahuluan: gingival enlargement umumnya terjadi akibat inflamasi kronis yang disebabkan oleh faktor lokal, seperti induksi plak pada gingiva dan faktor sistemik seperti pengaruh hormon dan obat-obatan sistemik tertentu. Hidrosefalus merupakan kondisi yang diakibatkan adanya volume cerebrospinal fluid (CSF) berlebih yang tidak terserap sempurna, dalam jumlah yang sangat tinggi pada ventrikel di otak dan terkadang juga terdapat di ruang subarachnoid, yang menyebabkan terjadinya dilatasi ventrikel secara progresif. Kondisi ini menghasilkan peningkatan tekanan intrakranial dan sering merusak jaringan di sekitarnya. Pasien hidrosefalus menunjukkan pembesaran kepala dan mengalami keterlambatan pertumbuhan. Tujuan penelitian laporan kasus ini adalah menjelaskan keberhasilan terapi fase inisial perawatan periodontal pada gingival enlargement pasien anak dengan hidrosefalus. Laporan kasus: Pasien hidrosefalus laki-laki berusia 12 tahun, mengalami pembesaran gingiva pada rahang atas, sering berdarah pada saat tersentuh sikat gigi ataupun terkena sentuhan lainnya, terjadi kurang lebih sejak dua bulan yang lalu, pasien tidak mengonsumsi obat-obatan secara sistemik. Hasil pemeriksaan klinis dan radiologis dapat ditegakkan diagnosis inflammatory gingival enlargement rahang atas disertai periodontitis kronis gigi 27, dengan diagnosis banding periodontitis kronis. Gingival enlargement merupakan faktor predisposing pembentukan plak. Gingival enlargement pada pasien ini dirawat dengan terapi inisial yaitu Oral hygiene Instruction (OHI), scaling, root planing, dan kontrol. Simpulan: Terapi fase inisial periodontal berupa OHI, scaling, root planing, dan kontrol, berhasil menghilangkan gingival enlargement pada pasien anak dengan hidrosefalus.Kata kunci: Gingival enlargement, hidrosefalus, perawatan inisial periodontal. ABSTRACTIntroduction: Gingival enlargement generally occurs due to chronic inflammation caused by local factors, such as plaque induction on the gingiva and systemic factors such as hormonal influences and certain systemic drugs. Hydrocephalus is a condition that results from the incompletely absorbed excess volume of cerebrospinal fluid (CSF), with very high amounts in the ventricles in the brain and sometimes also in the subarachnoid space, leading to progressive dilation of the ventricles. This condition results in increased intracranial pressure and often damages surrounding tissue. Hydrocephalus patients show head enlargement and growth delay. This case report was aimed to describe the success of the initial phase of periodontal therapy in gingival enlargement of paediatric patients with hydrocephalus. Case report: A 12-year-old male hydrocephalus patient, had enlarged maxillary gingiva, often bled when touched by a toothbrush or when exposed to other touches, occurred for about two months prior, and the patient did not take any medication systemically. The clinical and radiological examination results can confirm the diagnosis of inflammatory maxillary gingival enlargement with chronic periodontitis in tooth #27, with a differential diagnosis of chronic periodontitis. Gingival enlargement is a predisposing factor for plaque formation. Gingival enlargement in this patient was treated with initial therapy, namely oral hygiene instruction (OHI), scaling, root planing, and control. Conclusion: The initial periodontal therapy phase in the form of OHI, scaling, root planing, and control, succeeded in eliminating gingival enlargement in paediatric patients with hydrocephalus.Keywords: Gingival enlargement, hydrocephalus, initial periodontal therapy.

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EFFECTS OF SCALING AND ROOT PLANING WITH OR WITHOUT ORAL HYGIENE MEASURES ON THE TREATMENT OF CHRONIC PERIODONTITIS: AN IMMUNOHISTOCHEMICAL AND CLINICO-BIOCHEMICAL STUDY

Egyptian Dental Journal ◽

10.21608/edj.2016.92714 ◽

2016 ◽

Vol 62 (1) ◽

pp. 315-328

Author(s):

Nehad Taha ◽

Mohamed Zayed ◽

Ahmed A. Aziz

Keyword(s):

Oral Hygiene ◽

Chronic Periodontitis ◽

Biochemical Study ◽

Scaling And Root Planing ◽

Root Planing ◽

Hygiene Measures

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Short-term results in evaluating a gingiva-adhesive hydrophobic-chlorhexidine-gel for chronic periodontitis

Medicine and Pharmacy Reports ◽

10.15386/cjmed-312 ◽

2014 ◽

Vol 87 (3) ◽

pp. 186-191

Author(s):

Ciprian Sarbu ◽

Darian Rusu ◽

Horia Călniceanu ◽

Adrian Kasaj ◽

Stefan Adrian Petrutiu ◽

...

Keyword(s):

Oral Hygiene ◽

Chronic Periodontitis ◽

Test Group ◽

Study Groups ◽

Plaque Index ◽

Control Group ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Root Planing ◽

Chlorhexidine Gel

Background and Aims: Oral mucosa and interproximal spaces of the teeth could favor the colonization of periodontopathogenic bacteria, which could be targeted by chemical antiplaque agents such as chlorhexidine, present in different oral hygiene products, thus improving the control of biofilm growth and delaying microbial accumulation. The study aimed to evaluate whether the use of a hydrophobic gel with good gingival adhesion for 14 days after the scaling and root planing of patients with chronic periodontitis would improve the treatment outcome, when compared with the use of a regular hydrophyllic gel.Material and Methods: Patients with moderate disease were included in two study groups. At baseline and 3 months after the treatment the following parameters were recorded: pocket depth, Approximal Plaque Index, Modified Gingival Index, Simplified Oral Hygiene Index, bleeding on probing. Patients received scaling and root planing in two sessions at 24 hours interval. After the treatment, patients in the test group applied the hydrophobic adhesive chlorhexidine gel once a day, every other day, while in the control group the gel was used twice daily.Results. Both treatments resulted in significant improvement in all clinical indices, except Approximal Plaque Index, which deteriorated significantly in both groups. Three months after mechanical treatment, the mean probing depth changed in the test group from 4.16±0.45 mm to 2.80±0.42 mm, and in the control group from 4.16±0.30 to 2.69±0.19.Conclusions: Both adjunctive anti-infective therapies induced clinical improvement 3 months from baseline. The differences between the two treatments were not statistically significant.

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Diamond burs versus Gracey curettes and efficacy of root planing in chronic periodontitis patients: A randomized clinical trial

10.26226/morressier.5ac383252afeeb00097a4449 ◽

2018 ◽

Author(s):

Fatma Türktekin

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Chronic Periodontitis ◽

Root Planing

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Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes

Head & Face Medicine ◽

10.1186/s13005-020-00253-z ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Yonghuan Bian ◽

Changhao Liu ◽

Zhaojiang Fu

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Chronic Periodontitis ◽

Root Planing ◽

Tnf Α ◽

Significant Difference ◽

Hs Crp

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.

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Gingival crevicular fluid level of soluble triggering recep-tor expressed on myeloid cells-1(strem-1) in periodontal health and disease: a case-control study

International Journal of Dental Research ◽

10.14419/ijdr.v5i2.7689 ◽

2017 ◽

Vol 5 (2) ◽

pp. 83

Author(s):

Surabhi Gigras ◽

Sudhir R Patil ◽

Veena HR ◽

Sneha Dani

Keyword(s):

Chronic Periodontitis ◽

Myeloid Cells ◽

Cell Surface Receptor ◽

Periodontal Health ◽

Group Iii ◽

Root Planing ◽

Group I ◽

Health And Disease ◽

Group Ii ◽

Crevicular Fluid

Background: The Triggering Receptor Expressed On Myeloid Cells-1(TREM-1) is a cell-surface receptor of the immunoglobulin superfamily and found to be involved in the amplification of the inflammatory response to various microbial infections, including periodontal diseases.Objectives: The present study was designed to examine gingivalcrevicular fluid(GCF) levels of soluble TREM-1 (sTREM-1) levels in periodontal health and disease as well as evaluate the effect of scaling and/or root planing on the same.Methods: Based on gingival index, probing pocket depth, clinical attachment level, and radiologic parameters (bone loss), 45 subjects were initially divided into three groups- Group, I (Periodontally healthy), Group II (Gingivitis) and Group III (Chronic Periodontitis).From each of the subjects, GCF sample was collected at baseline and scaling and/or root planing was instituted in group II and group III patients. GCF samples were subsequently collected at eight-week interval. Levels of sTREM-1 in collected GCF samples were estimated using enzyme-linked immunosorbent assay.Results: The lowest GCF levels of sTREM-1 were found in periodontal health (69.50±1.8pg/ml) followed by gingivitis (257.17±79pg/ml) and chronic periodontitis (3658.14±55pg/ml) in increasing order, suggesting that levels of sTREM-1 in crevicular fluid increased with the severity of periodontal disease. sTREM-1 levels decreased significantly from baseline to the end of 8 weeks following non-surgical periodontal therapy.Conclusion: Increased GCF levels of sTREM-1 from periodontal health to disease strengthen its association with periodontal status.

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