scholarly journals Diode Laser Has an Additional Benefit When Used with Conventional Scaling and Root Planning for Chronic Periodontitis Treatment - Comparative Analysis

2021 ◽  
Vol 10 (32) ◽  
pp. 2548-2553
Author(s):  
Himanshu Deswal ◽  
Amit Bhardwaj ◽  
Harpreet Singh Grover

BACKGROUND Almost 47 % of the population over the age group of 30 is affected by chronic periodontitis. Although the first and gold standard therapy in periodontal treatment is scaling and root planing (SRP), which is a non-surgical approach towards treatment, yet another therapy for the treatment of chronic periodontitis is to irradiate the periodontal pockets with laser. The purpose of this study was to confirm as to whether the use of diode laser (800 – 980 nm) as adjunct to scaling and root planning (SRP) improved the results of conventional mechanotherapy in the treatment of chronic periodontitis patients. METHODS In this study we designed our groups in such a way that 40 patients (20 males and 20 females) with two deepest nonadjacent pockets ≥ 5mm in two different quadrants were selected. In this study each treatment group belonged to a separate quadrant of the mouth. One group was allotted to SRP group while the second one was allotted to SRP + Diode Laser group. Clinical parameters like (Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) in chronic periodontitis patients were measured and evaluated at baseline, after 1 month and after 3 months of the treatment. Statistical analysis was also done intra group and inter group. RESULTS From this we infer that PPD was significantly reduced in SRP and SRP + Diode laser groups from baseline and post 1 month (P < 0.001), between baseline and post 3 months (P < 0.001) and between 1 month and 3 months (P < 0.001). There was also significant improvement in CAL in SRP and SRP + Diode Laser groups from baseline and post 1 month (P < 0.0001), between baseline and post 3 months (P < 0.0001) and between 1 month and 3 months (P < 0.0001). BOP also reduced in SRP and SRP + Diode Laser group from baseline. When SRP and SRP + Diode laser groups were compared they showed non statistically significant results but individually both the groups showed statistically significant results. CONCLUSIONS The results of the present study indicate that, comparison of SRP alone group which is a conventional method with SRP as adjunct to Diode laser group i.e., a non-surgical approach showed improvement of CAL and also reduction in PPD and BOP for the treatment of chronic periodontitis patients. KEY WORDS Periodontitis, Laser, Scaling and Root Planing, Adjunct Therapy, Diode Laser

Author(s):  
Reya Shree ◽  
Varun Dahiya ◽  
Pradeep Shukla ◽  
Prerna Kataria ◽  
Mona Dagar

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.


2019 ◽  
Vol 15 (1) ◽  
pp. 10-17
Author(s):  
Pujan Acharya ◽  
Manoj Kumar ◽  
CS Saimbi

Background: Chronic periodontitis is the most prevalent form of periodontitis with a multifactorial  etiology, dental plaque being the primary etiologic agent. The removal of such etiologic factor through scaling and root planing builds the foundation of treatment. In addition, the use of an antimicrobial adjunct augments elimination of microbes leading to subsequent control of the disease. Chlorhexidine and Metronidazole have been found to be active against several periodontopathogens. In this study, the use of these antimicrobial gels has been made. To evaluate and compare the clinical efficacy of subgingival application of 1% Metronidazole, 1% Chlorhexidine and Combination gel when used as an adjunct to non-surgical therapy. Methods: A total of 120 patients, age group 30-60 years with chronic generalized periodontitis were included in the randomized, controlled, double blinded study. The patients were randomly divided into four groups and treated with scaling and root planing along with antimicrobial adjunct. The antimicrobials used were Chlorhexidine, Metronidazole, Combination of Chlorhexidine and Metronidazole, and Placebo. Clinical parameters (plaque index, gingival index, probing pocket depth and clinical attachment level) were recorded at baseline, 1 month and 3 months. Results: In all the groups, there was a statistically significant reduction in all the clinical parameters at different time intervals. Inter-group comparison with respect to clinical changes showed that Combination gel was the best. Conclusions: Long term, controlled randomized trials with more samples are suggested to further validate the efficacy of these antimicrobial drugs.  


2020 ◽  
Vol 19 (2) ◽  
pp. 427-432
Author(s):  
Raghavendra Reddy Nagate ◽  
M Yuvaraja ◽  
Saad M. AlQahtani ◽  
Nabeeh A. AlQahtani ◽  
Shreyas Tikare ◽  
...  

Purpose: To evaluate the efficacy of pluronic F-127 gel containing green tea catechin extract as a local drug delivery system in the treatment of chronic periodontitis. Methods: A total of 20 chronic periodontitis patients participated as per the set inclusion and exclusion criteria. Complete scaling and root planing (SRP) was done for all subjects and pluronic F-127 gel containing green tea catechin was applied on one site. The contralateral site received SRP alone. The plaque index (PI), gingival index (GI), and probing pocket depth (PPD) were recorded at baseline and on the 28th day. Results: At the 28th-day follow-up, green tea catechin tooth sites showed significantly lower mean scores (GI = 0.55, p = 0.30 and PPD = 3.35 mm) than the corresponding SRP tooth sites (GI = 1.25, PI = 1.15, and PPD = 4.40 mm) (p < 0.05). Conclusion: When compared to scaling and root planing alone, the local drug delivery gel containing green tea catechin as an adjuvant was more effective in reducing the clinical parameters of periodontitis. Keywords: Adjuvant therapy, Camellia sinensis, Local drug delivery, Periodontal pocket


2019 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP.Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained.Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP.Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.


2014 ◽  
Vol 6 (2) ◽  
pp. 35-39
Author(s):  
Ashish Agarwal ◽  
Narinder Dev Gupta

Background and aims. Along with conventional periodontal therapy, subginigval application of platelet-rich plasma (PRP) may provide more effective improvements in clinical parameters due to the presence of multiple growth factors. The aim of this double-blind, split-mouth, randomized study was to evaluate the adjunctive use of PRP with scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and methods. A total of 87 non-smokers suffering from moderate to severe chronic periodontitis were selected. Parameters were probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and modified bleeding index (mBI). After full-mouth SRP the sites were randomly divided into experimental sites receiving subgingival application of autologous PRP and controls treated with placebo gel. Measurements were recorded at baseline, 3 months and 6 months. Paired t-test was used to compare response to treatment between the two sites. Results. Statistically significant changes in parameters were seen in both groups from baseline to 6 months. Inter-group comparison revealed significantly more clinical attachment gain for the experimental group (P>0.05). The mean CAL gain was 2.40±0.4 mm for control sites and 2.68±0.5 mm for experimental sites. Conclusion. This study supports the use of PRP during nonsurgical debridement of periodontal pockets measured 6 months after SRP.


2013 ◽  
Vol 14 (6) ◽  
pp. 1080-1086 ◽  
Author(s):  
Md Jalaluddin ◽  
Shabeer Ahamed ◽  
Imran Khalid ◽  
Ninad Moon ◽  
TK Shafi ◽  
...  

ABSTRACT Background Local delivery of antimicrobial agents provides higher concentration of the drug in the periodontal site for longer periods than systemically delivered methods. In the present study an attempt is made to know the efficacy of controlled local drug delivery of doxycycline as an adjunctive treatment in the management of chronic periodontitis. Materials and methods A total of 12 patients, diagnosed as Chronic Periodontitis in the age of 25 to 55 years, were selected of both the sexes in this study. They were divided into Experimental group consisted of 30 sites who received complete scaling and root planing (SRP) followed by placement of Atridox gel and control group consisted of 30 sites who received only SRP. Clinical parameters were recorded at, baseline, days 30, 90 and 180. Parameters were plaque index, gingival index, gingival bleeding index and microbial analysis, probing pocket depth and Clinical attachment level (CAL). The microbiological analysis was done at baseline visit and at 90th day. Probing pocket depth and CAL were recorded only on day 0 and 180th day. Results In 180 days study, both the groups exhibited a significant improvement in periodontal status. Significant gain in attachment level was observed in both the group. Between both the groups the clinical parameters in the experimental groups exhibited better results as compared to the control group. Both the groups exhibited significant reduction in the number of spirochetes. Conclusion Combination therapy of SRP and 10% DH gel demonstrated better results at all levels suggesting that this therapy can play a significant role as an adjunct to SRP in the management of chronic periodontitis. How to cite this article Ahamed S, Jalaluddin Md, Khalid I, Moon N, Shafi TK, Ali FM. The Use of Controlled Release Locally Delivered 10% Doxycycline Hyclate Gel as an adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: Clinical and Microbiological Results. J Contemp Dent Pract 2013;14(6):1080-1086.


2020 ◽  
Author(s):  
Han Zhao ◽  
Jingchao Hu ◽  
Li Zhao

Abstract Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of data supporting the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results 17 studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth≥4mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites appears to provide slight benefits in PPD reduction. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.


Author(s):  
Sandeep S. Prabhu ◽  
Krishna Kripal ◽  
Deepthi R. ◽  
Rakesh M.P. ◽  
Manjunath S.M. ◽  
...  

Background and aims: Studies have investigated the occurrence of Human cytomegalovirus (HCMV) and Epstein Barr Virus (EBV) in samples of both chronic and aggressive periodontitis lesions and their role in the pathogenesis of the disease have been suggested. It is important to determine the role and presence of these viruses in chronic generalized periodontitis patients after Scaling and root planing (SRP) alone and in conjunction with diode laser application. Thus the aim of the present study was to determine the prevalence of human cytomegalovirus (HCMV), Epstein–Barr virus(EBV) in gingival crevicular fluid (GCF) samples obtained from chronic generalised periodontitis patients. Materials (Subjects) and Methods: A total of 30 patients were included in the study based on the inclusion and exclusion criteria as follows: Group I – 15 chronic generalized periodontitis patients who received treatment with scaling and root planing. Group II – 15 chronic generalized periodontitis patients who received treatment with scaling and root planing and Diode laser. In each patient GCF samples were collected at baseline, 7 days and 21 days after treatment. Clinical parameters like gingival index, probing pocket depth and clinical attachment level were recorded and as GCF samples collected. Results: Correlation between quantification of EBV values with clinical parameters such as gingival index, probing pocket depth and clinical attachment loss in two groups showed statistical significance (P < 0.001). Relative quantification of EBV was statistically significant, whereas HCMV was significantly absent. The mean values of GI, PPD and CAL parameters at different time interval was found to be statistically significant in both group (P < 0.001) Conclusions: Only EBV was detected more frequently in patients with CGP, but HCMV was not detected with similar frequency in the groups studied. We also found that group with application of diode laser showed statistical significant results.


2020 ◽  
pp. 1-3
Author(s):  
Meera M Nair ◽  
Chhavi Grover ◽  
Priyanka Goel ◽  
Shubhra Vaish ◽  
Anshi Jain Gupta ◽  
...  

Background: The aim of present study is to assess the efficacy of 2% and 5% grape seed extract (GSE) gel as local drug delivery agent as an adjunct to conventional SRP in the treatment of chronic periodontitis. METHOD: 30 patients with Chronic Periodontitis with pocket depth >5 mm were selected and randomized into 3 groups (10 patients per group). Group1 will be treated with 2% GSE, group 2 will be treated with 5% GSE and group 3 will be treated with placebo gel. Scaling and root planing will be performed and oral instructions will be given. Gingival index (GI), plaque index (PI), Probing Pocket Depth (PPD) and clinical attachment level (CAL) will be recorded at baseline and 1 month. Plaque samples shall be collected at baseline and 1 month and anaerobic culture shall be done to evaluate the antimicrobial efficacy of the Grape seed extract. Results and conclusion: The results were calculated statistically and analytically for the same after 1 month.


Author(s):  
Sangeeta Roy ◽  
C.S. Joshi ◽  
Pradeep Shukla ◽  
Gaurav Malhotra ◽  
Prerna Kataria ◽  
...  

Background and Objectives: C?reactive protein (CRP) is a type I acute phase reactant. A number of studies have reported elevated gingival crevicular fluid (GCF) CRP levels in periodontitis subjects, which decrease following periodontal therapy. Effect of diode laser as an adjuct to Scaling & Root planing is also well stablished. The aim of the present study was to evaluate the effect of periodontal treatment SRP with diode laser, on CRP levels in GCF in patients with chronic periodontitis. Materials and Methods: A total of 40 subjects with moderate periodontitis based on community periodontal index scores, were included in the study. Periodontal therapy was performed dividing each side of jaw as a group (Split mouth); one side SRP alone & another Diode laser with SRP. GCF was collected from each subject at Baseline (prior to treatment) and 1 month after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using a commercially available highly sensitive kit. Results: The present study demonstrated that the mean CRP values at baseline were found to be 0.11043mg/l in side-I (side treated with SRP alone); 0.11042mg/l in side-II (side treated with SRP & laser) of the patient, which reduced to 0.4148 mg/L in side I and 0.3985mg/L in side II after treatment, which are highly significant according to statistical analysis but the changes between two sides were non- significant statistically. Interpretation and Conclusion: Within the limitations of this study, it can be concluded that periodontal therapy is able to reduce the GCF C reactive protein level significantly, but there was no statistically significant result in CRP level, between sides treated with SRP & SRP with laser. Key words: Chronic periodontitis, C?reactive protein, gingival crevicular fluid, Scaling and root planing, Diode laser


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