scholarly journals Soft Tissue Healing and IL-6 Cytokine Levels in Microsurgical and Conventional Open Flap Debridement in Patients with Chronic Periodontitis - A Randomized Clinico-Biochemical Trial

2021 ◽  
Vol 10 (34) ◽  
pp. 2928-2933
Author(s):  
Peddireddy Bhavani

BACKGROUND The present study was conducted to compare clinical outcomes and gingival crevicular fluid (GCF) interleukin (IL)-6 cytokine levels in microsurgical and conventional open flap debridement procedure. METHODS Thirty sites in chronic periodontitis patients were randomly assigned into Group I (microsurgical) and Group II (conventional) open flap debridement in a split-mouth design. Gingival bleeding index (GBI), probing pocket depth (PPD), relative attachment level (RAL) were recorded at baseline and 3 months. GCF IL-6 cytokine levels were assessed at baseline and on 3rd day postoperatively. Pain perception using visual analog score (VAS) and soft tissue healing using early healing index (EHI) were assessed after on 7th day post-surgery. RESULTS There was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups. Intergroup gingival bleeding index scores were statistically significant at the end of 3 months. The difference in visual analog scores between the two groups was found to be statistically insignificant whereas early healing index scores between the groups was found to be statistically significant. Group I showed lower levels of IL-6 on 3rd day postoperatively. It was also found that there was positive correlation of IL-6 levels with clinical parameters such as PPD and RAL. CONCLUSIONS Open flap debridement using microsurgical approach can substantially improve clinical parameters and wound healing compared with conventional macrosurgical approach. IL-6 levels were lower in microsurgical group indicating less invasive surgical approach. KEY WORDS Open Flap Debridement, Periodontal Microsurgery, Wound Healing, IL-6, Cytokine, GCF.

Materials ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 2933
Author(s):  
Carlo Bertoldi ◽  
Luigi Generali ◽  
Pierpaolo Cortellini ◽  
Michele Lalla ◽  
Sofia Luppi ◽  
...  

In the present study, the clinical outcomes obtained using three different protocols of post-operative plaque control for the 4 weeks after surgery were compared. Thirty healthy subjects, presenting at least one periodontal pocket requiring resective surgery, were selected and randomly distributed to three different groups corresponding to respective post-surgical protocols: (A) toothbrushes + chlorhexidine + anti-discoloration system (ADS + CHX); (B) toothbrushes + chlorhexidine (CHX); (C) only toothbrushes. The full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing pocket depth (PPD), recession depth (REC), clinical attachment level (CAL), and bleeding on probing (BoP) were measured in six aspects per tooth (mesio-buccal (MB), buccal (B), disto-buccal (DB), disto-lingual (DL), lingual (L), and mesio-lingual (ML)) at baseline, 3 months, and 6 months after surgery. FMPS and FMBS did not significantly change (p > 0.05), whereas PPD and CAL significantly decreased, and REC significantly increased in all groups during the study (p < 0.05). Clinical results were satisfactory in all cases, with no significant differences between groups 3 months after surgery. Six months after surgery, only PPD-MB was significantly different in the three groups (p < 0.05). Nevertheless, this value was not clinically relevant because the value of PPD-B (about 2 mm) in group C was physiologic. The mechanical plaque control was proven to be fundamental and sufficient in all the six aspects per tooth to guarantee an excellent clinical outcome without the need of chemical plaque control.


2019 ◽  
Vol 11 (2) ◽  
pp. 2-10
Author(s):  
Dr. Shruthi Raveendran ◽  
Dr. Shruthi S ◽  
Dr. Nisha K J ◽  
Dr. Sanjeela Guru ◽  
Dr. Parichaya Batra ◽  
...  

ntroduction: Periodontitis is a multifactorial disease, which, when not adequately treated, is followed with progressive attachment loss which leads to tooth mobility and eventually tooth loss. Periodontal regenerative surgery aims to regenerate and reconstruct the lost periodontal tissue. Regeneration with novabone putty has shown to be effective in reducing probing pocket depth, gain in clinical attachment level and increase in horizontal bone level. Aim: This interventional clinical trial was to evaluate the osseous regenerative potential of a calcium phosphosilicate bioactive glass NOVABONE TM in the treatment of horizontal bone defects. Materials and method: A total of 20 sites with horizontal bone defect was treated with open flap debridement with intra marrow penetration and novabone putty. Statistical analysis: Plaque index, gingival index and radiographic determination were analysed by paired t test. Probing pocket depth and clinical attachment levels were analysed by Wilcoxon Signed Ranks Test. Result: There was significant reduction seen in plaque index, gingival index, probing pocket depth and radiographic crestal level when compared between baseline and 12 months respectively (2.48 ± 0.44, 2.92 ± 0.39, 6.80 ± 0.89, 8.29 ± 0.87) and (1.89 ± 0.42, 1.92± 0.51, 3.00± 0.67, 5.48 ± 0.89) and significant gain in clinical attachment level from 4.40 ± 0.96 to 1.20 ± 0.91. Conclusion: The present study showed novabone putty significantly improved the clinical parameters in horizontal bone defects.


Author(s):  
Ranjita Shrestha Gorkhali ◽  
Shaili Pradhan ◽  
Rejina Shrestha ◽  
Shweta Agrawal ◽  
Krishna Lamicchane ◽  
...  

Introduction: Treatment of periodontal diseases done by surgical therapy depends upon extent and severity of disease. The ultimate goal of periodontal reconstructive surgery is to regenerate tissues destroyed during periodontal disease. Objective: To evaluate the effectiveness of bovine-derived xenograft with collagen membrane in treatment of intrabony defects by comparing it with open flap debridement alone. Methods: This non-randomised controlled trial was conducted after ethical clearance, at Bir hospital from 2018 March to 2019 April. The study recruited 38 patients by convenience sampling, age from 25-44 years, with chronic periodontitis, and willing to sign informed consent. Intrabony defects were treated by open flap debridement with bovine-derived xenograft and bioresorbable collagen membrane (Test group) and open flap debridement alone (Control group). Probing pocket depth, clinical attachment level, gingival recession, oral hygiene status, and gingival status were assessed at baseline and six months. Results: Six months after therapy, in Test group probing pocket depth reduction was 5.2 mm and gain in mean clinical attachment level was 4.3 mm. In Control group, mean probing pocket depth reduction was 3.8 mm and mean gain in clinical attachment level was 2.7 mm. The test treatment resulted in statistically higher probing pocket depth reduction and clinical attachment level gain than Control group. Conclusion: Both therapies resulted in significant probing pocket depth reductions and clinical attachment gains, and treatment with open flap debridement with bovine-derived xenografts and collagen membrane resulted in significantly higher probing pocket depth reduction and clinical attachment gain than treatment with open flap debridement alone.


2014 ◽  
Vol 8 (1) ◽  
pp. 24-29 ◽  
Author(s):  
SM Apoorva ◽  
A Suchetha ◽  
N Sapna ◽  
A Garg ◽  
P Lakshmi ◽  
...  

ABSTRACT Aim This study was designed to compare the efficacy of tetracycline fibres and povidone iodine when locally delivered to the moderately deep periodontal pocket. Materials and methods 30 subjects were selected for the study and divided into two groups; Group I received Tetracycline fibers (Periodontal AB Plus), Group II received Povidone iodine local drug delivery. The Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) were measured at baseline and at 3 months. Results The intragroup comparison between PPD, CAL and GI at baseline and 3 months showed a statistically significant difference in group I in relation to all parameters; in group II, the PPD and CAL did not show a statistically significant difference. The intergroup comparison of PPD and CAL at the end of 3 months, showed a statistically significant difference between the two groups, with tetracycline fibers giving superior results. Conclusion Tetracycline fibers were more efficacious in improving the periodontal health status when compared to Povidone Iodine.


Author(s):  
Shruti Bhatnagar ◽  
Surangama Debnath ◽  
Sriniwasa Tenkasale Siddeshappa ◽  
Ramreddy K Yeltiwar ◽  
Vikas Dewan

Introduction: Regeneration of periodontium is always difficult to achieve regardless of all advancement. In an attempt to refine, various materials have been tried and tested. The present study was carried out to evaluate regenerative potential of easy-graft CRYSTAL in intrabony defects, clinically, and radiographically. Methods: This randomised split-mouth study was conducted at Rungta College of Dental Sciences and Research from 2015 October to 2015 October. Intrabony pockets more than 5 mm and radiographic evidence of vertical bone loss were selected from 15 patients having two sites each. The chosen sites were randomly divided into test sites: open flap debridement (OFD) with easy-graft CRYSTAL and control sites (OFD). The clinical parameters evaluated were Plaque Index, Gingival Index, Probing Pocket Depth, Relative Attachment Level, and Gingival Recession at baseline, three months, and six months postoperatively. Radiographic parameters recorded were Defect Fill and Percentage of Defect Fill at baseline, three months, and six months. Data were analysed in SPSS v.20. Results: At six months, improved clinical and radiographic values were obtained compared to baseline. The plaque and gingival index showed statistically significant reduction. Both groups showed statistically significant reduction in mean probing pocket depth and gain in relative attachment level. Mean gingival recession score was increased in both the group but was not significant. There was significant increase in Defect Fill and Percentage of Defect fill in both groups with better bone fill in test group. Conclusion: Easy-graft CRYSTAL is a potential regenerative material for the treatment of periodontal intrabony defects.  


1991 ◽  
Vol 70 (12) ◽  
pp. 1531-1536 ◽  
Author(s):  
P.J. Leggott ◽  
P.B. Robertson ◽  
R.A. Jacob ◽  
J.J. Zambon ◽  
M. Walsh ◽  
...  

This study describes the relationship between varying ascorbate intake, periodontal status, and subgingival microflora as part of a multidisciplinary investigation of ascorbic acid (AA) metabolism in young men housed for 13 weeks in a nutrition suite that provided controlled periods of ascorbic acid depletion and repletion. Twelve medically healthy non-smoking men, aged 25 to 43 years, ate a rotating four-day diet adequate in all nutrients except ascorbic acid. Following an initial baseline period during which the subjects received 250 mgAA/day, the subjects received 5 mgAA/day for a 32-day depletion period. Eight of the 12 subjects participated in a subsequent 56-day repletion period designed to replace the reduced body AA pool slowly. Plasma and leukocyte ascorbate levels, Plaque Index, Gingival Index, probing depths, and attachment level were monitored at the beginning and end of the depletion and repletion periods. Subgingival plaque samples were obtained and examined for selected organisms by indirect immunofluorescence microscopy. A uniform oral hygiene program was reinforced after each examination. Ascorbate concentrations in plasma and leukocytes responded rapidly to changes in vitamin C intake. There were no significant changes in plaque accumulation, probing pocket depth, or attachment level during the study. In contrast, gingival bleeding increased significantly after the period of AA depletion and returned to baseline values after the period of AA repletion. However, no relationship could be demonstrated between either the presence or proportion of target periodontal micro-organisms and measures of gingival bleeding or ascorbate levels.


2021 ◽  
Vol 10 (02) ◽  
pp. 78-83
Author(s):  
Firas B.H. Al-Taweel ◽  
Saif S. Saliem ◽  
Osama H. Abd ◽  
Simon A. Whawell

Abstract Objective The aim of this study was to assess whether serum cytokine levels correlate with clinical periodontal parameters in health or disease. Materials and Methods Male subjects (40–60 years) with CP (n = 30), CP + CHD (n = 30), and healthy controls (n = 20) had plaque index (PLI), gingival index (GI), bleeding on probing, probing pocket depth (PPD), and clinical attachment level (CAL) evaluated. Serum IL-1β and IL-6 levels were quantified using enzyme-linked immunosorbent assay. Results PLI, GI, PPD, and CAL were significantly higher in patients with CP + CHD compared to those with CP. Serum levels of IL-1β and IL-6 were also significantly higher in CP + CHD compared to those with CP, with both groups also being significantly higher than controls. There was a strong correlation between IL-1β and PPD and CAL and between IL-6 and GI and CAL in the CP group and between IL-6 and GI and PPD in the CP + CHD group. Conclusion The results provide further evidence that periodontitis triggers systemic inflammation. Cytokine levels in patients with periodontitis may represent a useful screening tool to identify those at greater risk of cardiovascular events.


2007 ◽  
Vol 21 (4) ◽  
pp. 348-354 ◽  
Author(s):  
Marcio Dias Giollo ◽  
Patrícia Moura Valle ◽  
Sabrina Carvalho Gomes ◽  
Cassiano Kuchenbecker Rösing

The aim of this study was to evaluate retrospectively the periodontal conditions of teeth with fixed crowns that had been in place from 3 to 5 years before the study was conducted. Forty individuals were recalled for a follow-up visit. Full-mouth clinical examinations were carried out and Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), and clinical attachment level (CAL) were assessed in 6 sites per tooth. Parallel radiographs were also taken and blindly analyzed by a digital caliper (distance between the apex and the bone crest). BANA tests were performed. A contra-lateral sound tooth was considered the control. Mean values were obtained and Wilcoxon and paired sample t tests were used to compare the test and control sites. Crowns had a mean VPI value of 30.42% as compared to 49.17% for sound teeth. The GBI was 33.33% and 26.25% for test and control teeth respectively. Assessment of PPD revealed values of 2.30 and 2.14 mm, and assessment of CAL revealed averages of 2.02 and 1.89 mm for test and control teeth respectively. The mean values for radiographic distances were 12.73 and 13.67 mm, and for the BANA test, 67.50 and 50.00 for sound and crowned teeth, respectively. Statistically significant differences were observed for all parameters except for CAL and for the BANA test. It may be concluded that, with the methods used in the present study, crowns may be associated with more signs of inflammation, however not with periodontal breakdown.


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