Serum and Salivary Sialic Acid and Nitric Oxide Levels Estimation and Comparison after Nonsurgical Periodontal Therapy in Generalised Chronic Periodontitis Patients

Introduction: An exigency for a biomarker arises to expeditiously detect the periodontal disease evolution and to advocate more robust therapy efficacy measurements. Nitric oxide and sialic acid have been proved to be potential inflammatory markers. Hence, the evaluation of the involvement of nitric oxide and sialic acid in periodontal disease will enable us to assimilate the aspect of the complex process of periodontal disease progression. Aim: To estimate and compare the effect of nonsurgical periodontal therapy on serum and salivary sialic acid and nitric oxide levels in generalised chronic periodontitis patients. Materials and Methods: This study was a case-control as well as an interventional study. The subjects for this study were recruited from the Meenakshi Ammal Dental College and Hospital, Chennai from April 2017 to October 2018. Hundred patients were selected for this study. Control group consisted of 50 periodontally healthy subjects and test group consisted of 50 generalised chronic periodontitis subjects. After blood and saliva sample collection for determination of salivary and serum sialic acid and nitric oxide levels, evaluation of periodontal parameters like plaque index, probing pocket depth and Clinical Attachment Level (CAL) was done. Then the test group subjects underwent nonsurgical periodontal therapy and on 90th day post SRP parameters were re-evaluated. The collected data were analysed with IBM SPSS Statistics software, Version 23.0. In the above statistical tool the probability value 0.05 was considered as significant level. Results: The mean difference of plaque index, probing pocket depth, CAL, serum sialic acid, salivary sialic acid, serum Nitric Oxide (NO) and salivary nitric oxide: between the control and test group at baseline was -2.05, -5.01 mm, -5.56 mm, -12.515 mg/dL, -11.97 mg/dL, -129.762 μMol/L and -78.978 μMol/L respectively; for the test group at baseline and 90 days after nonsurgical periodontal therapy was 1.332, 3.15 mm, 3.285 mm, 14.206 mg/dL, 12.76 mg/dL, 130.082 μMol/L, 82.004 μMol/L, respectively. All the values were statistically significant with p-value <0.001. Conclusion: Nonsurgical periodontal therapy led to a decrease in the serum and salivary sialic acid and nitric oxide levels in subjects with generalised chronic periodontitis. A decrease in biochemical parameters was associated with a reduction in probing pocket depth and gain in attachment level.

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A COMPARATIVE STUDY TO ASSES THE EFFICACY OF NANOBIO FUSION GEL AS AN ADJUNCT TO SCALING AND POLISHING IN CHRONIC PERIODONTITIS. - A CLINICAL STUDY

10.36106/gjra/4108515 ◽

2020 ◽

pp. 1-3

Author(s):

Patil A. Veena ◽

Ansari T. Sobia ◽

Agarwal Priyanka ◽

Ayesha Ayesha ◽

Sultana Shahnaaz

Keyword(s):

Periodontal Disease ◽

Chronic Periodontitis ◽

Antimicrobial Agents ◽

Test Group ◽

Controlled Clinical Trial ◽

Pocket Depth ◽

Antioxidant Power ◽

Probing Pocket Depth ◽

Significant Difference ◽

And Control

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.

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Effect of Nonsurgical Periodontal Therapy on Crevicular Fluid and Serum Glutathione Peroxidase Levels

Disease Markers ◽

10.1155/2012/632842 ◽

2012 ◽

Vol 32 (1) ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Swati Pradeep Patel ◽

Nishanth S. Rao ◽

A. R. Pradeep

Keyword(s):

Oxidative Stress ◽

Glutathione Peroxidase ◽

Periodontal Disease ◽

Chronic Periodontitis ◽

Periodontal Diseases ◽

Periodontal Therapy ◽

Enzyme Linked Immunosorbent Assay ◽

Pocket Depth ◽

Nonsurgical Periodontal Therapy ◽

Crevicular Fluid

Background: Plasma glutathione peroxidase (eGPx) is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF) eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT) by correlating GCF and serum levels of eGPx.Materials and methods: Thirty subjects (16-Males and 14-Females; age: 30–38 years) participated in the study. The subjects were divided, based on gingival index, probing pocket depth and clinical attachment level into: Healthy (group-1,n=10), Gingivitis (group-2,n=10) and Periodontitis (group-3,n=10). Chronic periodontitis patients after NSPT constituted group 4. GCF and serum samples collected from each subject were quantified for eGPx levels using Enzyme linked Immunosorbent Assay.Results: The mean eGPx concentrations increased from health (14.01 ng/μl and 78.26 ng/ml) to gingivitis (22.86 ng/μl and 90.44 ng/ml) and then to periodontitis (29.89 ng/μl and 103.43 ng/ml), in GCF and serum respectively. After NSPT, there was statistically significant reduction in eGPx concentration in GCF and serum (19.41 ng/μl and 85.21 ng/ml). Further, all the GCF eGPx values showed a positive correlation to that of serum eGPx level.Conclusion: Thus, increased eGPx concentration in GCF can be considered as an indicator of local increase in oxidative stress. While, increase in serum eGPx levels indicates that periodontal disease can also lead to increased oxidative stress at the systemic level.

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Efficacy of silver nanoparticles in chronic periodontitis patients: a clinico-microbiological study

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2020.0026 ◽

2020 ◽

Vol 2 (3) ◽

pp. 142-147

Author(s):

Pooja Kadam ◽

◽

Swapna Mahale ◽

Prasad Sonar ◽

Dipali Chaudhari ◽

...

Keyword(s):

Silver Nanoparticles ◽

Chronic Periodontitis ◽

Periodontal Diseases ◽

Periodontal Therapy ◽

Local Drug Delivery ◽

Pocket Depth ◽

High Antibacterial Activity ◽

Probing Pocket Depth ◽

Nonsurgical Periodontal Therapy ◽

Significant Difference

Introduction: Recent advances in nanotechnology have introduced new therapeutic materials for periodontal therapy. Previous studies showed that nanoparticles of silver provide high antibacterial activity. Taking this in consideration, it can be used in nonsurgical periodontal therapy. The present study focuses on efficacy of subgingival local drug delivery of silver nanoparticles in comparison with tetracycline in chronic periodontitis. Methods: To understand the effect of silver nanoparticles and tetracycline gel in chronic periodontitis, patients which were divided in different: Group A: Scaling and root planning (SRP) with sub-gingival delivery of silver nanoparticles gel, Group B: SRP with sub-gingival delivery of tetracycline gel and Group C: SRP alone. The other data recorded was Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) at baseline (just before placement of gel), 1 month and 3 months of application of gel. Microbiological evaluation (Colony Forming Units, CFU) were recorded at baseline and after 3 months. Results: The results showed that the use of silver nanoparticles delivery after SRP was as efficacious as tetracycline subgingival delivery to treat chronic periodontitis patients. All the clinical as well as microbiological parameters showed statistically significant difference from baseline to 3 months in all the groups. Conclusions: As compared to other therapeutic modalities employed against infection, silver nanoparticles gel is non-toxic at given concentration, has no side effects and does not require complicated application method or any complex armamentarium. It is well tolerated and well accepted by the patients. Silver nanoparticles gel with SRP gives promising results and it can definitely aid in periodontal diseases.

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Evaluation of statins (Simvastatin and lovastatin) in reducing periodontal parameters in patients with chronic periodontitis

International Journal of Multidisciplinary and Current Research ◽

10.14741/ijmcr/v.6.5.15 ◽

2018 ◽

Vol 6 (5) ◽

Author(s):

Ali Banihashem Rad ◽

Majid Reza Mokhtari ◽

Ershad Aghasizadeh ◽

Mojtaba Bakhshande Far ◽

Ahmad Banihashem ◽

...

Keyword(s):

Periodontal Disease ◽

Chronic Periodontitis ◽

Mevalonate Pathway ◽

Blood Cholesterol ◽

Lipid Lowering ◽

Control Group ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Periodontal Index ◽

Experimental Group

Introduction and objective: Chronic periodontitis is the most common form of periodontal disease. Progression of the disease is due to high levels of pro-inflammatory cytokines. Statins are a class of lipid-lowering drugs that used for cardiovascular disease and stroke. Statins has potential anti-inflammatory effect by blocking intermediate metabolites of the mevalonate pathway. The aim of this study was to evaluate the influence of Lovastatin and Simvastatin in improve the parameters of chronic periodontitis in the population of Khorasan Razavi province. Methods and materials: 40 subjects with chronic periodontitis were selected and informed consent was obtained from participants. Participants were divided into control and experimental groups and we scaling for patients of both groups, then control group without high blood cholesterol and treatment of patients was done without statin drugs and in case groups, patients with blood cholesterol higher than 240 mg/dl with Lovastatin 20 mg/day during 3 month treated. Periodontal indices; such as probing pocket depth (PPD), GI, PI, CAL and bleeding on probing in patients with chronic periodontitis were measured by the examiner before and after treatment in the control group and the experimental group. Also this index were measured 3 months after treatment in both groups by the same person examiner as Blind and dataes were analyzed by statistical software. Results: In this study, Mean ± SD of age was 7.93 ± 43.8 in the control group and the experimental group was 7.72 ± 47.8 and of the 40 patients in the study, 18 were males and 22 were females. Our study showed that the index of GI, CAL, BOP and probing depth were significantly different between the two groups after the intervention (P less than 0.05) and only after the intervention PI index was not significantly different between the two groups (P>0.05). Conclusion: Our findings showed that statins may improve periodontal index in patient with periodontal disease. This is probably because that statins increase bone regeneration and reduced inflammatory parameters such as CRP, MMP-9, TNF-α and the intermediate products.

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Serum Immunoglobulin Levels in Type 2 Diabetes Patients with Chronic Periodontitis

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-11-3-1 ◽

2010 ◽

Vol 11 (3) ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Fatin Awartani

Keyword(s):

Glycemic Control ◽

Periodontal Disease ◽

Chronic Periodontitis ◽

Serum Immunoglobulin ◽

Diabetic Patients ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Group 2 ◽

Immunoglobulin Levels

Abstract Aim The association between diabetes and periodontal disease has been well documented. Periodontitis is associated with alterations in immune responses in both diabetic and nondiabetic subjects. While diabetes is considered to be a risk factor for periodontal disease progression, few studies have demonstrated an association between the level of glycemic control and periodontal disease. Although poor glycemic control is significantly associated with poor periodontal health, few studies have been performed in Saudi Arabia to evaluate the immune responses in poor and better glycemic control and its effect on periodontal tissue. The aim of this study is to assess serum immunoglobulin levels (IgA, IgG, IgM) in type 2 diabetic (poor control and better control) and nondiabetic subjects with chronic periodontitis. Methods and Materials A total of 105 female patients were included in the study and they were divided into three groups, with 35 patients in each group. Group 1 was comprised of cases of diabetes exhibiting better control (HbA1c≤9%) and Group 2 was comprised of cases of diabetes exhibiting poorer control (HbA1c>9%). The third group was comprised of nondiabetic subjects with chronic periodontitis. In this study, clinical examination included plaque index, bleeding on probing, probing pocket depth, and attachment level (measured in all three groups). Serum immunoglobulin (IgA, IgG, IgM) levels were estimated and compared to the levels estimated for diabetic controls. Results Mean plaque index, bleeding index, and probing pocket depth showed no significant differences among the three groups. However, mean clinical attachment loss was significantly higher for Group 2 as compared to Groups 1 and 3. IgA and IgG levels were found to be significantly higher in Group 2 (poorly controlled diabetes) as compared to Group 1 (better control) and Group 3 (control group). There is a positive correlation between CAL and IgA and IgG, whereas there is a negative correlation between CAL and IgM. Conclusion The present study indicates that poor glycemic control may be associated with the increase in IgA and IgG serum antibodies. Elevated antibody levels may explain why poorly controlled diabetes exacerbates periodontal disease. Clinical Significance These findings demonstrate the importance of the immune system as well as good glycemic control, especially in patients diagnosed with periodontitis. The changes observed in immune response may be the cause or the effect of periodontal disease in diabetic patients. The increased incidence of periodontitis in diabetic patients suggests that the alteration in immune response may contribute to the pathogenesis of periodontitis in patients with poorly controlled diabetes. Citation Awartani F. Serum Immunoglobulin Levels in Type 2 Diabetes Patients with Chronic Periodontitis. J Contemp Dent Pract [Internet]. 2010 May; 11(3):001-008. Available from: http:// www.thejcdp.com/journal/view/volume11-issue3- awartani.

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Hyperbaric oxygen therapy for the treatment of moderate to severe periodontitis: a clinical pilot study

Undersea and Hyperbaric Medicine ◽

10.22462/10.12.2020.6 ◽

2020 ◽

pp. 571-580 ◽

Cited By ~ 1

Author(s):

Giorgio Lombardo ◽

◽

Alessia Pardo ◽

Caterina Signoretto ◽

Annarita Signoriello ◽

...

Keyword(s):

Hyperbaric Oxygen ◽

Chronic Periodontitis ◽

Soft Tissues ◽

Test Group ◽

Clinical Parameter ◽

Control Group ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Parallel Group ◽

Hbo2 Therapy

Objectives: To clinically and microbiologically evaluate the effects of hyperbaric oxygen (HBO2) therapy in addition to full-mouth ultrasonic subgingival debridement (FM-UD), in the initial treatment of chronic periodontitis. Methods: Twenty patients presenting moderate to severe generalized forms of chronic periodontitis were included in a three-month randomized, parallel-group, single-blinded, prospective study. At baseline patients were randomly assigned to two treatment groups [Test Group (FM-UD+HBO2) and Control Group (FM-UD)]. Both groups were treated with an FM-UD session. Ten HBO2 sessions (one session per day for 10 days at a pressure of 2.5 ATA) were additionally administered to the Test Group. Soft tissues parameters [probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL) and visible plaque index (VPI)] were assessed at baseline (immediately before FM-UD treatment), after two weeks, after six weeks and at three months. For each patient, a site presenting PPD ≥ 6mm and positive BOP was selected as a qualifying site (QS), to be monitored clinically (at T0, T1, T2 and T3) and microbiologically (at T0, T1 and T3). Results: There were no statistically significant differences between the two groups for any clinical parameter analyzed after three months, except for BOP, which was significantly (p < 0.05) reduced in the Test Group. Reductions in bacterial levels were detected in both groups after therapy. Faster bacterial recolonization occurred after three months in the Control Group. Conclusion: HBO2 therapy in combination with FM-UD may represent an efficacious approach to the treatment of moderate to severe forms of periodontitis.

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Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis

Folia Medica ◽

10.2478/folmed-2014-0016 ◽

2014 ◽

Vol 56 (2) ◽

pp. 109-115 ◽

Cited By ~ 6

Author(s):

Antoaneta M. Mlachkova ◽

Christina L. Popova

Keyword(s):

Chronic Periodontitis ◽

Alveolar Bone ◽

Incidence Rates ◽

Periodontal Therapy ◽

Pocket Depth ◽

Attachment Loss ◽

Dental Biofilm ◽

Nonsurgical Periodontal Therapy ◽

Root Planning ◽

Scaling And Root Planning

Abstract INTRODUCTION: Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. MATERIALS AND METHODS: The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). RESULTS: Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth ⋋ 5 mm (PD ⋋ 5 mm). Pockets with PD > 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. CONCLUSION: The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate chronic periodontitis. Given a good patient compliance, the antimicrobial periodontal therapy can be quite efficient in arresting the inflammatory process and reducing the depth of periodontal pockets; it can also achieve a stable attachment loss level and obviate the need to use a surgical periodontal treatment modality.

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A Novel Systemic Indicator of Periodontal Tissue Damage: Ischemia Modified Albumin

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207321666181018165255 ◽

2018 ◽

Vol 21 (8) ◽

pp. 544-549 ◽

Cited By ~ 1

Author(s):

Mahmure A. Tayman ◽

Canan Önder ◽

Şivge Kurgan ◽

Muhittin A. Serdar ◽

Meral Günhan

Keyword(s):

Periodontal Disease ◽

Inflammatory Diseases ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Oxidative Stress Marker ◽

Pocket Depth ◽

Ischemia Modified Albumin ◽

Nonsurgical Periodontal Therapy ◽

Before And After ◽

The Impact

Background: Ischemia-modified albumin (IMA) is a systemic indicator of inflammatory diseases and is suggested as an oxidative stress marker. Objective: To determine the IMA and high-sensitivity C-reactive protein (hsCRP) serum levels for patients with chronic periodontitis (CP) and to evaluate the impact of non-surgical periodontal therapy on serum IMA and hsCRP levels. Methods: Twenty one systemically healthy patients with CP and 15 systemically and periodontally healthy controls (C) were enrolled in the study. Periodontal pocket depth (PPD), bleeding on probing (BOP) and attachment loss (AL) were recorded at the time of diagnosis and 6 weeks after the nonsurgical periodontal therapy. Blood samples were obtained before and after treatment from all groups, and serum IMA and hsCRP levels were evaluated by ELISA method. Results: All of the clinical findings were found to be elevated in the CP group in comparison to C group (p<0.05). Levels of IMA and hsCRP were higher in the CP group (p<0.05) and decreased after non-surgical periodontal therapy (p<0.05). Positive correlations were determined between PPD, BOP and hsCRP (p<0.05) as well as between PPD, AL, BOP and IMA levels (p<0.01) before treatment. A significant positive correlation was also observed between hsCRP and IMA (p<0.01) before and after treatment. Conclusion: IMA is a marker indicating systemic inflammation during periodontal disease, and is significantly reduced as a result of non-surgical periodontal therapy. Therefore, IMA might be suggested as a useful indicator of periodontal disease.

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Effects of Nonsurgical Periodontal Therapy on Clinical Response, Microbiological Profile, and Glycemic Control in Malaysian Subjects with Type 1 Diabetes

The Scientific World JOURNAL ◽

10.1155/2014/232535 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Samira Mukhtar Buzinin ◽

Aied Mohammed Alabsi ◽

Alexander Tong Boon Tan ◽

Vui King Vincent-Chong ◽

Dasan Swaminathan

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Periodontal Disease ◽

Test Group ◽

Periodontal Therapy ◽

Control Group ◽

Chronic Periodontal Disease ◽

Nonsurgical Periodontal Therapy ◽

Significant Difference

The association between diabetes mellitus and chronic periodontal disease has long been established. Most of the researches linking these two very common chronic diseases were based on type 2 diabetes mellitus and chronic periodontal disease. However, this study was conducted to investigate the association between type 1 diabetes and chronic periodontal disease in Malaysian subjects. Forty-one Malaysian subjects, of which 20 subjects were type 1 diabetics and with chronic periodontal disease (test group) and 21 subjects with only chronic periodontal disease (control group), were included in the study. Periodontal parameters and plaque samples for microbiological evaluation were done at baseline, 2 and 3 months after nonsurgical periodontal therapy. Blood samples were taken from only the test group and evaluated for HbA1c at baseline and 3 months after periodontal therapy. There were no statistically significant difference in periodontal parameters between groups (P>0.05) and no significant improvement in the level of HbA1c in the test group. Microbiological studies indicated that there were significant reductions in the levels of the tested pathogens in both groups. The results of our study were similar to the findings of several other studies that had been done previously.

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Comparative Assessment of a Standard Oral Hygiene Regimen with and without Mouthwash and Related Clinical Findings over a 14-day Period

Journal of Periodontology & Implant Dentistry ◽

10.15171/jpid.2015.004 ◽

2018 ◽

Vol 7 (1) ◽

pp. 21-25

Author(s):

Mahdi Kadkhodazadeh ◽

Reza Amid ◽

Parisa Zarnegarnia ◽

Fatemeh Mollaverdi ◽

Yaser Safi ◽

...

Keyword(s):

Oral Hygiene ◽

Chronic Periodontitis ◽

Statistical Significance ◽

Cetylpyridinium Chloride ◽

Test Group ◽

Clinical Findings ◽

Control Group ◽

Pocket Depth ◽

Dental Floss ◽

Probing Pocket Depth

Background and aims. The goal of this study was to evaluate the clinical efficacy of a standard oral hygiene routine (daily tooth brushing and flossing) along with cetylpyridinium chloride (CPC) mouthwash in comparison to the same protocol without mouthwash in chronic periodontitis patients during a 14-day period. Materials and methods. This comparative study was carried out or 50 non-smoking patients with chronic periodontitis; 25 patients followed an oral hygiene regimen using a toothbrush and dental floss (control group) and the remaining 25 used the mentioned protocol along with CPC mouthwash (test group) for 14 days. The plaque index (PI), modified gingival index (MGI) and probing pocket depth (PPD) were assessed. Wilcoxon and Mann-Whitney U tests were used to evaluate and compare the prevalence of indices between the two groups. Statistical significance was set at P<0.05. Results. The results showed greater improvement of MGI in the test group (P=0.001). No statistically significant differences were observed in PI (P=0.47) and PPD (P=0.43) between the two groups. Conclusion. Adding mouthwash to a standard oral hygiene regimen may improve some clinical gingival parameters when compared with an oral hygiene routine without a mouthwash

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