Influence of Tooth-Brushing on Early Healing after Access Flap Surgery: A Randomized Controlled Preliminary Study

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.

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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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/597 ◽

2021 ◽

Vol 10 (34) ◽

pp. 2928-2933

Author(s):

Peddireddy Bhavani

Keyword(s):

Soft Tissue Healing ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Gingival Bleeding ◽

Group I ◽

Tissue Healing ◽

Cytokine Levels ◽

Early Healing ◽

Open Flap Debridement ◽

Attachment Level

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.

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A retrospective clinical, radiographic and microbiological study of periodontal conditions of teeth with and without crowns

Brazilian Oral Research ◽

10.1590/s1806-83242007000400012 ◽

2007 ◽

Vol 21 (4) ◽

pp. 348-354 ◽

Cited By ~ 3

Author(s):

Marcio Dias Giollo ◽

Patrícia Moura Valle ◽

Sabrina Carvalho Gomes ◽

Cassiano Kuchenbecker Rösing

Keyword(s):

Pocket Depth ◽

Clinical Attachment Level ◽

Mean Values ◽

Probing Pocket Depth ◽

Periodontal Breakdown ◽

And Control ◽

Attachment Level ◽

Digital Caliper ◽

Bana Test

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

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v2i2.23611 ◽

2018 ◽

Vol 2 (2) ◽

pp. 40-44

Author(s):

Harish Kumar Shah ◽

Shivalal Sharma ◽

Khushboo Goel ◽

Sajeev Shrestha ◽

Surya Raj Niraula

Keyword(s):

Clinical Trial ◽

Surgical Therapy ◽

Chronic Periodontitis ◽

Controlled Clinical Trial ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

The Mean ◽

The Difference ◽

Attachment Level

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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Longitudinal Relationship between Plasma Reactive Oxygen Metabolites and Periodontal Condition in the Maintenance Phase of Periodontal Treatment

Disease Markers ◽

10.1155/2014/489292 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Tatsuya Machida ◽

Takaaki Tomofuji ◽

Daisuke Ekuni ◽

Mayu Yamane ◽

Toshiki Yoneda ◽

...

Keyword(s):

Reactive Oxygen ◽

Maintenance Phase ◽

High Plasma ◽

Oxidative Status ◽

Reactive Oxygen Metabolites ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Plaque Control ◽

Attachment Level ◽

Oxygen Metabolites

Aim. The present cohort study describes the longitudinal relationship between plasma oxidative status and periodontitis progression during the maintenance phase of treatment.Materials and Methods. Forty-five patients (mean age 58.8 years) were monitored from 2008 to 2013. Periodontal conditions, including probing pocket depth (PPD) and clinical attachment level (CAL), were recorded. Measurements of plasma reactive oxygen metabolites (ROM) and biologic antioxidant potential (BAP) were performed to evaluate plasma oxidative status. The patients were assigned into 2 groups as low and high plasma ROM level using a cut-off value which was median of plasma ROM level at baseline.Results. In the subjects with low plasma ROM level at baseline, changes in mean CAL were positively correlated with changes in plasma ROM levels, bleeding on probing, and plaque control record, but not with PPD. In the subjects with high plasma ROM at baseline, changes in CAL were significantly associated with only PPD at baseline. On the other hands there were no significant associations between changes in CAL and those in plasma BAP levels.Conclusions. When plasma ROM level in periodontitis patients was low, increases in plasma ROM level were associated with those in CAL during the maintenance phase of treatment.

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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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NovaboneTM dental putty as a potential regenerative material for treating horizontal defects in chronic periodontitis patients.

RGUHS Journal of Dental Sciences ◽

10.26715/rjds.11_2_2 ◽

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 ◽

...

Keyword(s):

Bone Defects ◽

Plaque Index ◽

Gingival Index ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

Calcium Phosphosilicate ◽

Bone Level ◽

Open Flap Debridement ◽

Attachment Level

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.

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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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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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Evaluation of Bovine Derived Xenograft Combined with Bioresorbable Collagen Membrane in Treatment of Intrabony Defects

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v4i2.34231 ◽

2020 ◽

Vol 4 (2) ◽

pp. 61-67

Author(s):

Ranjita Shrestha Gorkhali ◽

Shaili Pradhan ◽

Rejina Shrestha ◽

Shweta Agrawal ◽

Krishna Lamicchane ◽

...

Keyword(s):

Test Group ◽

Control Group ◽

Collagen Membrane ◽

Intrabony Defects ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

Open Flap Debridement ◽

Attachment Level ◽

Depth Reduction

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.

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Validity of a New Kit Measuring Salivary Lactate Dehydrogenase Level for Screening Gingivitis

Disease Markers ◽

10.1155/2017/9547956 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Daisuke Ekuni ◽

Mayu Yamane-Takeuchi ◽

Kota Kataoka ◽

Aya Yokoi ◽

Ayano Taniguchi-Tabata ◽

...

Keyword(s):

Logistic Regression ◽

Lactate Dehydrogenase ◽

Real Time ◽

Odds Ratio ◽

Logistic Regression Model ◽

Lactate Dehydrogenase Level ◽

Pocket Depth ◽

Clinical Attachment Level ◽

Probing Pocket Depth ◽

Attachment Level

Aim. The aim of this study was to determine the usefulness of a new kit that can evaluate salivary lactate dehydrogenase (LD) level in real time for screening gingivitis. Materials and Methods. The study included 70 systemic healthy volunteers [29 males and 41 females; mean age ± SD: 24.1±2.6 years]. Resting saliva was collected from each participant and LD level was evaluated in real time using the kit (a color-changing sheet with an integer scale ranging from 1 to 10). A dentist measured probing pocket depth, clinical attachment level, and the proportion of sites with bleeding on probing (% BOP) at six sites on all teeth. Gingivitis was diagnosed when the BOP value was ≥20%. Results. Salivary LD level was positively correlated with mean % BOP (odds ratio: 1.47, 95% confidence interval: 1.132–1.916, and P<0.001) in a logistic regression model. The sensitivity and specificity of the kit were 0.89 and 0.98, respectively, at a cut-off value of 8.0 for LD level. Conclusions. The new kit for measurement of salivary LD level may be a useful tool to screen for gingivitis in young adults, which contributes to early detection of future periodontitis.

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