Comparing clinical attachment level and pocket depth for predicting periodontal disease progression in healthy sites of patients with chronic periodontitis using multi‐state
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Background: : Chronic periodontitis is one of the most common form of periodontal diseases which either require non-surgical periodontal therapy or open flap debridement-surgical therapy or both. To date, it is unclear as of how much changes occur after NSPT or OFD and which therapy provides the best outcome in chronic periodontitis having probing pocket depth ≥ 5-7 mm. Aim: The aim of this randomized controlled clinical trial was to evaluate the Probing Pocket Depth and Clinical Attachment Level between NSPT and OFD in chronic periodontitis patients. Materials and Methods: A total of 52 healthy patients with PPD ≥ 5-7 mm were included in the present study. Half of the patients assigned for the NSPT and half in the OFD group. The PPD and CAL were measured at baseline, three and six months. Independent sample t-test was used to compare the change in mean PPD and CAL between NSPT and OFD group at three and six months, respectively. Results: The difference in the mean decrease of PPD between NSPT and OFD group at three and six months were 0.15 mm (P<0.05) and 0.19 mm (P<0.05), respectively. The difference in the mean gain of CAL between NSPT and OFD group at three and six months were 0.03 mm (p>0.05) and 0.12 mm (P<0.05), respectively. Conclusion: Substantial improvement in periodontal status occurred with both the therapies, however, significantly higher decrease in PPD and gain in CAL were seen with surgical therapy.

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Effects of statins as local drug delivery agents in treating chronic periodontitis and their antimicrobial effects using polymerase chain reaction

Journal of Global Oral Health ◽

10.25259/jgoh_22_2020 ◽

2020 ◽

Vol 3 ◽

pp. 82-88

Author(s):

Ritunja Singh ◽

Gangesh B. Singh ◽

Soumya Gupta ◽

Anil Agrawal

Keyword(s):

Chronic Periodontitis ◽

Periodontal Pocket ◽

Pocket Depth ◽

Female Ratio ◽

Clinical Attachment Level ◽

Antimicrobial Effects ◽

Intergroup Comparison ◽

Anti Inflammatory ◽

Root Planning ◽

Attachment Level

Objectives: The aim of the study was to evaluate the anti-inflammatory effect of statin medication in chronic periodontitis patients and to compare the change in periodontal probing depth and clinical attachment level using 1.2% atorvastatin (ATV) gel and scaling and root planning (SRP) compared to SRP alone. Materials and Methods: This study was carried out on a sample size of 40 patients with equal male and female ratio between the age group of 40–60 years having chronic periodontitis with a minimum of 20 teeth that were selected for the study. Bilateral quadrants were selected and a split mouth study was conducted. Supragingival scaling was carried out in each patient in one long appointment. The patient was then recalled after 1 week for subgingival SRP. Root planing was carried out in two consecutive visits. Left side of the mouth on the 1st day followed by right side of the mouth on the next day. On the 2nd day, after completion of the root planning, followed by placement of 1.2% ATV gel and finally the Coe Pak was placed in one quadrant which was called the test site. In the other quadrant which was called control site placebo gel was placed and the treated site was covered by the Coe Pak. The recording of clinical parameters (plaque index [PI], gingival index [GI], probing pocket depth, and clinical attachment loss) was done at baseline, 1 month and 3 months. The selected site was sampled for subgingival microflora. The data obtained were subjected to statistical analysis. One-way ANOVA, Tukey’s HSD test, and student t-test were used for intergroup and intragroup comparison. Results: In our study, when intergroup comparison of mean value for PI at baseline, 1 month and 3 months was found to clinically insignificant for control and test groups, while for GI, periodontal pocket depth, and clinical attachment level it was found insignificant at baseline while significant at 1 and 3 months. Similarly, when comparison was made for microbial count it was found clinically insignificant between control and test group at baseline, while significant was noted at 3-month interval. Conclusion: Our study evaluated the anti-inflammatory, osteoconductive and antimicrobial effects of atorvastatin giving significant reduction in PI, GI, PPD and gain in CAL along with significant decrease in the microbial load.

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Salivary Matrix Metalloproteinase-8 (MMP-8) in Relation to Periodontal Health Status Among a Group of Hypertensive Patients

Journal of Baghdad College of Dentistry ◽

10.26477/jbcd.v30i3.2531 ◽

2018 ◽

Vol 30 (3) ◽

pp. 48-53

Author(s):

Iman Z AlMudaris ◽

Nadia A AlRawi

Keyword(s):

Periodontal Disease ◽

Plaque Index ◽

Control Group ◽

Study Group ◽

Periodontal Health ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

Significant Difference ◽

Attachment Level

Background: Hypertension is probably the most important public health problem around the world. People with periodontal disease may be at greater risk of hypertension. The inflammatory effects of periodontal disease help to promote endothelial dysfunction in arteries which may lead to changes in blood pressure. Salivary MMP-8 has been associated with both periodontal disease and prevalent hypertension. Aim of study: This study was conducted to measure salivary matrix metalloproteinase - 8, in relation to periodontal health condition among a group of patients with hypertension in comparison with control group. Materials and methods: Ninety subjects, aged 45-50 years old were included in this study, seeking treatment for chest pain in Ibn-AlBaytar center for cardiac surgical treatments in Baghdad, Iraq. The subjects were divided into study group (45 patient) who were diagnosed to be a hypertensive patient, and a control group (45 subject), with no hypertension. Plaque status was evaluated according to the Silness and Loe, probing pocket depth and clinical attachment level. Unstimulated saliva was collected from all subjects to analyses MMP-8. Result: A high mean value of plaque index, clinical attachment level and probing pocket depth for the study group than the control group with statistically no significant difference. In addition to that, a significant positive correlation between the plaque index and the clinical attachment level among both groups. Salivary MMP-8 level showed a higher level in the study group than in the control group, with statistically significant difference between groups, and a significant positive correlation was detected between salivary MMP-8 with plaque index, among study group, Conclusions: Higher percentage of periodontal diseases was found among patients with blood hypertension. In addition, high level of salivary MMP-8 is potentially associated with periodontal status of the study group.

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The Influence of Smoking and Non-Insulin-Dependent Diabetes Mellitus on Periodontal Disease

Journal of International Medical Research ◽

10.1177/147323000203000203 ◽

2002 ◽

Vol 30 (2) ◽

pp. 116-125 ◽

Cited By ~ 14

Author(s):

R Orbak ◽

A Tezel ◽

V Çanakçi ◽

T Demir

Keyword(s):

Diabetes Mellitus ◽

Periodontal Disease ◽

Systemic Disease ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Insulin Dependent ◽

Attachment Level

The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.

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Comparative Evaluation of Subgingivally Delivered 10% Doxycycline Hyclate and Xanthan-based Chlorhexidine Gels in the Treatment of Chronic Periodontitis

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-9-7-25 ◽

2008 ◽

Vol 9 (7) ◽

pp. 25-32 ◽

Cited By ~ 10

Author(s):

Ashish Verma ◽

Rajan Gupta ◽

Nymphea Pandit ◽

Shweta Aggarwal

Keyword(s):

Chronic Periodontitis ◽

Comparative Evaluation ◽

Doxycycline Hyclate ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Treatment Groups ◽

Probing Pocket Depth ◽

Single Center Study ◽

Additional Reduction ◽

Attachment Level

Abstract Aim The aim of this study was to evaluate and compare the efficacy of subgingivally delivered 10% doxycycline hyclate and xanthan based chlorhexidine gels when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Methods and Materials A randomized, controlled, single center study was conducted involving 90 sites in 30 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of doxycycline gel [SRP+DH], SRP + insertion of chlorhexidine gel [SRP+CHX]), and SRP alone [SRP]. Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 1 month, and 3 months post therapy. Results All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (p<0.001). At 3 months, sites treated with SRP+DH and SRP+CHX showed an additional reduction in PPD of 0.86 ± 1.0 mm and 0.66 ± 1.58 mm, respectively, significantly greater than SRP alone (p<0.02). Differences in mean PPD reduction between SRP+DH and SRP+CHX were not significant (p=0.46). At 3 months, differences in relative CAL between both SRP+DH (0.80 ± 0.92) and SRP+CHX (0.63 ± 1.47) and SRP alone were statistically significant (p<0.02). Differences in relative CAL between SRP+DH and SRP+CHX were not significant (p=0.54). Conclusion The results suggest treatment with 10% doxycycline hyclate and xanthan based chlorhexidine gels as an adjunct to SRP improves PPD and CAL patients with periodontitis compared to SRP alone. Clinical Significance The use of local drug therapy may refocus the need for surgical periodontal therapy toward deeper pockets. Citation Gupta R, Pandit N, Aggarwal S, Verma A. Comparative Evaluation of Subgingivally Delivered 10% Doxycycline Hyclate and Xanthan-based Chlorhexidine Gels in the Treatment of Chronic Periodontitis. J Contemp Dent Pract 2008 November; (9)7:025-032.

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Effect of Periodontal Surgery on Osteoprotegerin Levels in Gingival Crevicular Fluid, Saliva, and Gingival Tissues of Chronic Periodontitis Patients

Disease Markers ◽

10.1155/2015/341259 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Sandy H. S. Hassan ◽

Mahmoud I. El-Refai ◽

Noha A. Ghallab ◽

Rehab Fawzy Kasem ◽

Olfat G. Shaker

Keyword(s):

Chronic Periodontitis ◽

Gingival Crevicular Fluid ◽

Prognostic Biomarker ◽

Bone Destruction ◽

Gingival Index ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Crevicular Fluid ◽

Open Flap Debridement ◽

Attachment Level

Objectives. This study was undertaken to investigate the OPG profiles in gingival crevicular fluid (GCF), saliva, and gingival tissues of chronic periodontitis (CP) patients in response to open flap debridement (OFD).Subjects and Methods. The study included 30 subjects divided into 2 groups: 20 CP patients and 10 periodontally healthy subjects. Plaque index, gingival index, pocket depth, and clinical attachment level measurements were recorded for all subjects. GCF, salivary, and gingival samples were collected from all 30 subjects at baseline and 3 and 6 month after OFD from the 20 CP patients. GCF and salivary OPG levels were assessed by ELISA assay, while OPG expression in gingival tissues was examined by immunohistochemistry.Results. GCF, salivary and gingival OPG profiles were significantly higher in control subjects compared to CP patients at baseline (P<0.001). Within CP group, OPG levels in GCF, saliva, and gingival samples showed a significant increase at 3 and 6 months after OFD (P<0.001) compared to baseline. Although OPG values increased significantly in gingival samples and insignificantly in saliva after 3 months compared to 6 months, yet GCF levels were significantly decreased.Conclusions. OPG might be considered as a diagnostic and prognostic biomarker of periodontal bone destruction. This trial is registered withNCT02160613.

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Ozone Gel in Chronic Periodontal Disease: A Randomized Clinical Trial on the Anti-Inflammatory Effects of Ozone Application

Biology ◽

10.3390/biology10070625 ◽

2021 ◽

Vol 10 (7) ◽

pp. 625

Author(s):

Marco Colombo ◽

Simone Gallo ◽

Alessandro Garofoli ◽

Claudio Poggio ◽

Carla Renata Arciola ◽

...

Keyword(s):

Periodontal Disease ◽

Antimicrobial Properties ◽

Experimental Treatment ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Beneficial Effects ◽

Probing Pocket Depth ◽

Chronic Periodontal Disease ◽

Attachment Level ◽

Chlorhexidine Gel

The search for new topical treatments able to display not only antimicrobial properties but also a multiplicity of other beneficial effects while expressing safe cytocompatibility toward host tissues is being progressively developed. Antiseptics represent an aid to the gold standard nonsurgical treatment Scaling-and-Root-Planing (SRP) for periodontal disease. This split-mouth study aims to assess the efficacy of the ozonized gel GeliO3 (Bioemmei Srl, Vicenza, Italy) plus SRP (experimental treatment), with respect to SRP + chlorhexidine gel. Ten participants were treated with SRP + chlorhexidine gel (control sites) and with SRP + ozone gel (trial sites). After 1 (T1) and 3 months (T2) from baseline (T0), patients were revisited. At each time-point, the following indexes were assessed: probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BoP). It has been assessed that the use of the ozonized gel in addition to SRP did not show significant differences if compared to conventional SRP + chlorhexidine. Chlorhexidine was found to be more effective than ozone in reducing CAL and GI at T2. Ozone deserves consideration for its wide applicability in several clinical fields. In this connection, we also glance at the latest research on ozone therapy.

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Efficacy of 2% ibuprofen subgingival irrigation as an adjunct to non-surgical therapy in the treatment of chronic periodontitis: A randomized controlled, split-mouth, clinical trial

Journal of Advanced Periodontology & Implant Dentistry ◽

10.15171/japid.2019.012 ◽

2019 ◽

Vol 11 (2) ◽

pp. 69-76

Author(s):

Amirhossein Farahmand ◽

Ferena Sayar ◽

Zohreh Omidali ◽

Mahsa Soleimani ◽

Bahareh Jafarzadeh Esfahani

Keyword(s):

Clinical Trial ◽

Chronic Periodontitis ◽

Periodontal Treatment ◽

Periodontal Pocket ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Root Planing ◽

Mandibular Molar ◽

Attachment Level

Background. Pharmacological factors, such as ibuprofen, released topically in the periodontal pocket modulate the host response and enhance the influence of non-surgical periodontal treatment. Methods. In this double-blind, randomized, split-mouth, clinical trial, 38 outpatients with mild to moderate chronic periodontitis were enrolled by applying the simple random sampling method. They had at least one tooth with a periodontal pocket depth of >4 mm in each quadrant and had undergone phase I of periodontal treatment one week after scaling and root planing (SRP). The parameters of clinical periodontal evaluation, including probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI), were measured. In addition, two mandibular molar teeth in one quadrant were randomly nominated for subgingival irrigation with 0.5 mL of 2% ibuprofen or placebo mouthwash. The measurements were repeated after at least one week for three months. Results. Thirty-four individuals (18 women and 16 men), with an age range of 28‒36 years, were evaluated for three months. Moreover, periodontal clinical parameters were assessed within three months. There was a significant improvement in pocket depth (PD) and clinical attachment level (CAL) readings after 12 weeks in both groups (paired t-test). On comparing, the group with scaling and root planing (SRP) + ibuprofen showed more favorable results than the group with SRP + placebo (P<0.05). There were significant improvements in PI and BI in both groups; the differences between the two groups were significant (P<0.05). Conclusion. The mouthwashes containing ibuprofen might reduce the symptoms of periodontal disease and might be used as an adjunct in the healing process

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Chronic Periodontal Disease May Influence the Pulp Sensitivity Response: Clinical Evaluation in Consecutive Patients

ISRN Dentistry ◽

10.5402/2012/246875 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

Elizangela Partata Zuza ◽

Ana Luiza Vanzato Carrareto ◽

Ana Emília Farias Pontes ◽

Marcelo Brunozzi ◽

Juliana Rico Pires ◽

...

Keyword(s):

Periodontal Disease ◽

Clinical Response ◽

Test Data ◽

Chronic Periodontitis ◽

Gingival Recession ◽

Clinical Attachment Level ◽

Single Root ◽

Probing Depth ◽

Chronic Periodontal Disease ◽

Attachment Level

Purpose. The aim of the present study was to evaluate the clinical response of the pulp in teeth with chronic periodontitis. Methods. Consecutive patients who had been admitted to the Clinics of Periodontology and fulfilled the criteria of inclusion were enrolled from January to December 2007. Ninety-eight single-root teeth from 27 patients with chronic periodontitis were evaluated clinically with regard to clinical attachment level (CAL), probing depth (PD), and gingival recession (REC). After periodontal measurements, Pulpal Sensitivity (PS) was evaluated with the use of a cooling stimulus test. Data was analyzed with Student’s t test and contingency C coefficient. Results. Teeth that responded positively to PS test presented lower values of CAL (7.8 ± 2.8 mm), PD (5.0 ± 2.3 mm), and REC (2.8 ± 1.8 mm) in comparison to those that responded negatively (CAL = 12.0 ± 2.2 mm; PD = 7.9 ± 1.6 mm; REC = 4.1 ± 2.4 mm) (P<0.01, Student’s t test). In addition, significant correlations were observed between PS and periodontal parameters. Conclusions. Within the limits of this study, it could be suggested that the progression of periodontitis may significantly influence the negative pulpal response.

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Clinical Effects of the Local Drug Delivery Of 0.5% Azithromycin Gel in Treatment of Chronic Periodontitis Among Smokers Versus Non Smokers

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672053 ◽

2016 ◽

Vol 04 (02) ◽

pp. 094-103

Author(s):

Jasmine Kaur ◽

Viniti Goel ◽

Ranjan Malhotra ◽

Vishakha Grover

Keyword(s):

Drug Delivery ◽

Chronic Periodontitis ◽

Alveolar Bone ◽

Local Drug Delivery ◽

Clinical Effects ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Root Planing ◽

Attachment Level

Abstract Background: Along with conventional periodontal surgical therapy, local delivery of antibiotics may provide more effective treatment in smokers by targeting tissue-invasive bacteria. The aim of this randomized, clinical trial was to evaluate the adjunctive effects of subgingivally delivered 0.5% azithromycin (AZM) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis in smokers versus non smokers. Methods: 38 sites in patients of chronic periodontitis were randomized and categorized into two treatment groups: Group 1 consisted of 19 sites in patients who were smokers and Group 2 consisted of 19 sites in non smokers, who received Scaling and Root Planing (SRP) plus 0.5% azithromycin gel Local drug delivery. Clinical parameters were recorded at baseline, 1 and 2 months. They included probing depth (PD) and clinical attachment level (CAL) and percentage bone fill. Results: Azithromycin resulted in significant improvements in both the groups. Mean decrease in PD in non smokers by the end of 2 months was 3.903mm and in smokers was 3.917mm. Gain in CAL in non smokers by the end of 2 months was 3.879mm and in smokers it was 3.920mm. Mean bone fill at one month for smokers was 15.86% and was 26.58% at 2 months. In non-smokers the mean bone fill was 17.19% at 1 month and 24.03% at 2 months. Conclusions: When compared to the non smokers, the adjunctive use of 0.5% AZM resulted in similar improvement in clinical outcome in the treatment of chronic periodontitis among smokers. Local drug delivery of Azithromycin gel contributed to decrease in probing pocket depth, gain in clinical attachment level and in alveolar bone. The apparent bone regeneration also raises the intriguing possibility that Azithromycin encourages bone formation once tissue inflammation has subsided.

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