scholarly journals Probing Pocket Depth and Clinical Attachment Level between Non-Surgical and Surgical Periodontal Therapy in Chronic Periodontitis Patients: A Randomised Controlled Clinical Trial

Author(s):  
Harish Kumar Shah ◽  
Shivalal Sharma ◽  
Khushboo Goel ◽  
Sajeev Shrestha ◽  
Surya Raj Niraula

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.

2019 ◽  
Vol 13 (3) ◽  
pp. 183-191
Author(s):  
Prerna Y. Shirke ◽  
Abhay P. Kolte ◽  
Rajashri A. Kolte ◽  
Pranjali V. Bawanakar

Background. Atorvastatin (ATV), which belongs to the statin class of drugs, is the formidable inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. This clinical trial evaluated and compared the clinical and radiographic changes in chronic periodontitis (CP) patients, obtained through 1.2% ATV as an adjunct to scaling and root planing (SRP) in the treat-ment of intraosseous defects. Methods. Twenty CP patients, with a minimum of one pair of bilateral intraosseous, were randomly selected for this split-mouth study. Group 1 included 20 sites treated with SRP and subgingival delivery of a placebo gel, whereas an equal number of sites in group 2 were treated by SRP along with subgingival delivery of 1.2% ATV gel. The plaque index (PI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD) and clinical attachment level (CAL) were evaluated at baseline and 3- and 6-month intervals, while the intraosseous defect was assessed at baseline and 6-month interval using cone-beam computed tomography (CBCT). Paired t-test was used to determine statistical significance. Results. A greater reduction in the mean PPD and gain in CAL was found in group 2 compared to group 1 at 3- and 6-month intervals. Furthermore, a significantly greater bone fill was obtained in group 2 (1.70±0.54 mm) compared to group 1 (0.22±0.43 mm) after six months.Conclusion. ATV, as an adjunct to SRP, enhanced periodontal regeneration, as a noninvasive way to treat periodontal in-traosseous defects.


2021 ◽  
Vol 10 (16) ◽  
pp. 3475
Author(s):  
Markus Schlee ◽  
Hom-Lay Wang ◽  
Thomas Stumpf ◽  
Urs Brodbeck ◽  
Dieter Bosshardt ◽  
...  

Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration, and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), and 6 (T2) and 12 (T3) months after the replacement of the restoration. Results: The mean PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 were 100%, BoP decreased at T2 to 36.8% and at T3 to 35.3%. Suppuration was found to be at a level of 10.6% at T2 and 11.8% at T3. The radiologic bone level measured from the implant shoulder to the first visible bone to the implant contact was 4.9 ± 1.9 mm at mesial sites and 4.4 ± 2.2 mm at distal sites at T0 and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and the improvement of clinical parameters were demonstrated 18 months after therapy.


2008 ◽  
Vol 9 (7) ◽  
pp. 25-32 ◽  
Author(s):  
Ashish Verma ◽  
Rajan Gupta ◽  
Nymphea Pandit ◽  
Shweta Aggarwal

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lili Ma ◽  
Xiuchun Diao

Abstract Background The aim of this meta-analysis was to evaluate the difference in treatment outcomes between sub-gingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis. Methods We searched the MEDLINE (PubMed), SCOPUS and CENTRAL databases and identified 15 randomized clinical trials published within the last decade (2007–2019): 9 with split-mouth design and 6 with parallel study design. We extracted data and performed both qualitative and quantitative syntheses. The primary outcomes assessed were gain in clinical attachment level (CAL), reduction in probing pocket depth (PPD), improvement in gingival inflammation, and results of microbiological assays. Results We used meta-analysis plots to assess all the clinical outcomes. The mean differences in PPD reductions at 1 month (MD 0.63), 3 months (MD 0.69), and 6 months (MD 0.75); and the CAL gains at 1 month (MD 0.54), 3 months (MD 0.64), and 6 months (MD 0.68) showed more favorable responses in sites treated with the CHX chip as an adjuvant to SRP, than in sites treated with SRP alone. Conclusion SRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.


2019 ◽  
Vol 11 (2) ◽  
pp. 69-76
Author(s):  
Amirhossein Farahmand ◽  
Ferena Sayar ◽  
Zohreh Omidali ◽  
Mahsa Soleimani ◽  
Bahareh Jafarzadeh Esfahani

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


2020 ◽  
pp. 1-3
Author(s):  
Patil A. Veena ◽  
Ansari T. Sobia ◽  
Agarwal Priyanka ◽  
Ayesha Ayesha ◽  
Sultana Shahnaaz

Introduction: Various chemical agents such as nonsteroidal, anti-inflammatory drugs and antimicrobial agents has gained popularity in treatment of periodontal disease but simultaneously lead to condition such as drug resistance and drug allergy. Hence , the topical application of herbal agents such as propolis, aloevera, green tea extracts, Neem reduces the potency and effectiveness to prevent progression of periodontal disease. NanoBioFusion(NBF)gel contains the natural antioxidant power of propolis,vit C,vit E which allows the ultrafine antioxidant to surpase the moist intraoral environment to enter the cells and rejuvenate,revitalize,support,protect and optimize gum and soft oral tissue.Hence the present study is aimed to evaluate the clinical effect of locally delivered NBF gel as an adjunctive therapy to scaling and polishing in the treatment of Periodontitis. Materials and Methods: Chronic Periodontitis patients with 40 sites and probing pocket depth (PD) between 5 and 7 mm were selected in a randomized controlled clinical trial. SRP was performed in both control and test group followed by NBF gel application in 40 sites. The plaque index, gingival index and probing Pocket depth,were recorded at baseline, 6 weeks, and 3 months.The statistical analysis with paired t‑test was used to compare the test and control sites. Results: From baseline to a period of 3 months, a statistically significant difference was seen between both groups for Pocket probing depth and from baseline to 6 weeks the mean GI and PI score have a statistically significant result was obtained(P=0.01& 0.00). Conclusions: Locally delivered NBF gel exhibited a significant improvement compared with SRP alone in chronic periodontitis.


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.


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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alicia Morales ◽  
Rafael Contador ◽  
Joel Bravo ◽  
Paola Carvajal ◽  
Nora Silva ◽  
...  

Abstract Background The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis. Methods Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear. Trial registration NCT02839408, 10/28/2017, Clinicaltrial.gov.


2020 ◽  
Vol 3 ◽  
pp. 82-88
Author(s):  
Ritunja Singh ◽  
Gangesh B. Singh ◽  
Soumya Gupta ◽  
Anil Agrawal

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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