EFFICACY OF PHOTODYNAMIC THERAPY AS AN ADJUNCT TO NON – SURGICAL PERIODONTAL THERAPY IN TYPE-2 DIABETES MELLITUS PATIENT

Background: To Evaluate the additional benefit of Antimicrobial Photodynamic therapy, if any in the glycemic control of type 2 diabetes mellitus chronic periodontitis patients . Methods: Fifty diabetic patients with chronic periodontitis were taken for the study who met the inclusion criteria of clinical attachment loss ?3 to 5 mm at ? 30% of sites and bleeding on probing present in two different quadrants . After SRP ( Scaling and root planing ) , one quadrant was selected for aPDT while other served as a control group. Clinical parameters i.e. Plaque index, Probing depth ,Relative attachment level and HBA1c were measured at baseline, 1 week , 1month and 3 months. Results: Statistically significant differences in the mean probing depth, Relative attachment level, plaque deposit, and HBA1c were found between baseline and 12 weeks post-treatment for both groups. No significant differences in glucose levels were detected among the two groups in 1 week . Reduction in the mean HbA1c level after treatment was observed in both groups in 1 month and 3 months . Conclusion: Antimicrobial Photodynamic Therapy when used in addition to scaling and root planing yields significant improvement of mean probing depth , Plaque deposit ,Relative attachment levels, periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group. Keywords: photodynamic therapy , scaling and root planing, glycated haemoglobin ,Randomized controlled trial

A Comparative Clinical Study of Er:YAG Laser and Hand Instruments in the Treatment of Moderate Chronic Periodontitis

Introduction: Moderate chronic periodontitis is the most common periodontal disease. The treatment of this condition should aim at achieving a biocompatible root surface and decontamination of the pocket, thereby restoring the health status. Aim: In the present study, the aim was to examine the clinical effectiveness of fibreless Er:YAG laser used for scaling and root planing and to compare it with a conventional treatment with Gracey curettes. Materials and methods: The study included 909 periodontal pockets which were treated in a split-mouth design with either Gracey curettes or with Er:YAG laser (1.5 W). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index were recorded. Results: There was a considerable decrease of PPD, CAL, BoP, and plaque presence values at 1 and 3 months after therapy in both treatment groups. Sites treated with Er:YAG laser demonstrated mean CAL gain of about 1.00 mm and 0.44 mm at the first and third month, respectively. In the control group, there was also significant gain of CAL of about 1.33 mm at the first and 0.30 mm at the third month. Significant difference was observed in all parameters between both groups in favour of the laser treatment. Conclusions: The results of the present study suggest that the Er:YAG laser shows clinical effectiveness in the treatment of moderate chronic periodontitis. It can be used as a single treatment modality for subgingival scaling and root planing resulting in greater improvements in all recorded data in contrast to conventional treatment.

Evaluation of Anti-inflammatory and Antioxidant Effects of Punicalagin (Pomegranate Extract) on IL-1 Beta and Superoxide Dismutase Levels in Patients with Chronic Periodontitis – A Randomized Controlled Trial

Purpose: Pomegranates have been shown to possess anti-inflammatory and antioxidant properties. This study aimed to evaluate the effects of Punicalagin (Pomegranate extract) on IL-1β and SOD levels in chronic periodontitis patients. Materials and Methods: 30 patients were included in the study. The sites were randomly divided into control site and test site. Control sites were treated with Scaling and Root Planing (SRP) alone and test sites were treated with punicalagin gel along with SRP. Clinical parameters such as probing pocket depth, Clinical Attachment Level (CAL), Gingival Index (GI), Plaque index (PI), Sulcus Bleeding Index (SBI) and biochemical markers such as IL-1β and Superoxide Dismutase levels were compared between baseline and at 21 days post therapy. Results: Test sites showed significant differences when compared to control sites in relation to all clinical and biochemical parameters. Conclusion: Within the limitations of this study, there is an improvement in the clinical parameters with an increase in the anti-oxidant marker level and a decrease in inflammatory marker level when punicalagin gel was placed along with Scaling and Root Planing in patients with Chronic Periodontitis.

Comparative Evaluation of Open Flap Debridement Therapy with Two Different Types of Platelet Concentrates, T-PRF and L-PRF as Adjuncts- A Systematic Review

Conventional Periodontal therapy such as scaling and root planing and open flap debridement aims to halt the inflammation process and promotes repair of disease-related defects. Current regenerative procedures offers a limited potential toward attaining a complete periodontal restoration and none is considered a gold standard in the treatment of intrabony defects. This study was done to compare the efficiency of Titanium-Platelet Rich Fibrin and Leukocyte-Platelet Rich Fibrin as adjuncts to Open Flap Debridement therapy to treat intra-bony periodontal defects. A search was conducted through PubMed and various other databases such as Cochrane, Google Scholar and EBSCO Host , under the key words, OFD , T-PRF,L-PRF, Clinical Outcomes, Comparison and Randomised Contolled Trials. Six relevant articles were selected for analysis. Compared to non-platelet concentrates, L-PRFproves to be the better adjunct to open flap debridement therapy. When compared to T-PRF, however, L-PRF has comparatively inferior properties of bone defect resolution and fill.We can conclude that T-PRF has better properties, greater bone defect fill and defect resolution as compared to L-PRF.

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

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.

Management of endo perio lesion with class iii furcation defect –A case report

The primary aim of periodontal and endodontic therapy is to restore the lost periodontium and maintain the natural dentition. An ideal endodontic treatment involves removal of any infected pulp completely, preventing or minimizing any chances of reinfection, with proper irrigation and drying of canals, care to be taken not to break any file during cleaning and shaping of canals, proper obturation and not over or under filling of canals, proper sealing, proper restoration and an ideal crown placement. An ideal periodontal treatment involves scaling and root planing, proper reflection of flap to visualize the furcation areas, removal of diseased soft tissue surrounding the lesion and furcation areas and giving adequate oral hygiene instructions. Based on grade of furcation defects, suitable treatment modalities should be chosen. This case report aims at managing an endo-perio lesion involving class III furcation defect using tunneling technique.