Platelet-rich Plasma with Scaling and Root Planing: A Double-blind Split-mouth Randomized Study

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.

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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

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1455 ◽

2013 ◽

Vol 14 (6) ◽

pp. 1080-1086 ◽

Cited By ~ 4

Author(s):

Md Jalaluddin ◽

Shabeer Ahamed ◽

Imran Khalid ◽

Ninad Moon ◽

TK Shafi ◽

...

Keyword(s):

Controlled Release ◽

Chronic Periodontitis ◽

Control Group ◽

Clinical Parameters ◽

Scaling And Root Planing ◽

Doxycycline Hyclate ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Attachment Level

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.

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COMPARATIVE EVALUATION OF EFFICACY OF SCALING AND ROOT PLANING WITH AND WITHOUT CHLORHEXIDINE CHIP AND DIODE LASER IN CHRONIC PERIODONTITIS PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i11.2287 ◽

2021 ◽

Vol 5 (11) ◽

Author(s):

Reya Shree ◽

Varun Dahiya ◽

Pradeep Shukla ◽

Prerna Kataria ◽

Mona Dagar

Keyword(s):

Diode Laser ◽

Chronic Periodontitis ◽

Control Group ◽

Clinical Parameters ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Before And After ◽

Laser Group

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.

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Clinical Evaluation of Topical Metronidazole and Chlorhexidine Gel following Scaling and Root Planing in Patients with Chronic Periodontitis

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i1.19197 ◽

2019 ◽

Vol 15 (1) ◽

pp. 10-17

Author(s):

Pujan Acharya ◽

Manoj Kumar ◽

CS Saimbi

Keyword(s):

Chronic Periodontitis ◽

Etiologic Agent ◽

Etiologic Factor ◽

Clinical Parameters ◽

Scaling And Root Planing ◽

Antimicrobial Drugs ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Topical Metronidazole

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.

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Efficacy of Pluronic F-127 gel containing green tea catechin extract on chronic periodontitis – A clinical study

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v19i2.27 ◽

2020 ◽

Vol 19 (2) ◽

pp. 427-432

Author(s):

Raghavendra Reddy Nagate ◽

M Yuvaraja ◽

Saad M. AlQahtani ◽

Nabeeh A. AlQahtani ◽

Shreyas Tikare ◽

...

Keyword(s):

Drug Delivery ◽

Green Tea ◽

Chronic Periodontitis ◽

Local Drug Delivery ◽

Periodontal Pocket ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Green Tea Catechin

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

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Adjunctive Subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: A systematic review and meta-analysis

10.21203/rs.2.16824/v1 ◽

2019 ◽

Author(s):

Han Zhao ◽

Jingchao Hu ◽

Li Zhao

Keyword(s):

Clinical Outcomes ◽

Chronic Periodontitis ◽

Meta Analysis ◽

Periodontal Treatment ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Manual Search ◽

Probing Pocket Depth ◽

Root Planing ◽

Significant Difference

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.

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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/523 ◽

2021 ◽

Vol 10 (32) ◽

pp. 2548-2553

Author(s):

Himanshu Deswal ◽

Amit Bhardwaj ◽

Harpreet Singh Grover

Keyword(s):

Diode Laser ◽

Surgical Approach ◽

Chronic Periodontitis ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Laser Group ◽

Root Planning ◽

Scaling And Root Planning

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

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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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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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Adjunctive Subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: A systematic review and meta-analysis

10.21203/rs.2.16824/v2 ◽

2020 ◽

Author(s):

Han Zhao ◽

Jingchao Hu ◽

Li Zhao

Keyword(s):

Clinical Outcomes ◽

Chronic Periodontitis ◽

Meta Analysis ◽

Periodontal Treatment ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Manual Search ◽

Probing Pocket Depth ◽

Root Planing ◽

Significant Difference

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.

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EFFICACY OF 2% AND 5% GRAPE SEED EXTRACT GELAS AN ADJUNCT TO CONVENTIONAL SCALING AND ROOT PLANING IN THE TREATMENT OF CHRONIC PERIODONTITIS: A CLINICO-MICROBIOLOGIC STUDY

10.36106/ijsr/9036259 ◽

2020 ◽

pp. 1-3

Author(s):

Meera M Nair ◽

Chhavi Grover ◽

Priyanka Goel ◽

Shubhra Vaish ◽

Anshi Jain Gupta ◽

...

Keyword(s):

Chronic Periodontitis ◽

Grape Seed Extract ◽

Grape Seed ◽

Seed Extract ◽

Local Drug Delivery ◽

Scaling And Root Planing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Root Planing ◽

Group 2

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.

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