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Periodontitis is one the most common diseases of the oral cavity and affects majority of the population. In the recent times there have been several advances in the treatment modalities for the same. One of the most common aetiological factors for the disease is dental plaque. Thus, the aim of various therapeutic options is the elimination of dental plaque. The methods range from something as simple as tooth brushing and oral hygiene practices to those administered by a dental professional. There are various mechanical methods and chemical methods for the same. There are also certain methods like the usage of local drug delivery and mouthwashes that can be used as adjuncts to any type of periodontal therapy. The treatment modalities can be surgical or non-surgical. With the patient being kept at the centre of the equation, non-surgical periodontal therapy is more acceptable to the patient and is also easy to perform and not very complex. In the present review, various options for the management of periodontal disease through non-surgical periodontal therapy have been addressed along with recent advances towards the same.
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Objetivos: Evidências atuais reconhece que a periodontite (PE) e a artrite reumatóide (AR) compartilham comuns fatores de risco e alguns caminhos fisiopatológicos semelhantes, como inflamação crônica induzida por citocinas pró-inflamatórias e destruição de tecidos conjuntivos e ósseos. Assim, esta tese apresenta quatro estudos da possível associação entre PE e AR com os seguintes objetivos: avaliar a condição periodontal, gravidade e extensão da periodontite e aspectos clínicos e epidemiológicos da sua associação com a AR. Investigar a influência do tratamento periodontal não cirúrgico (TPNS) sobre os parâmetros clínicos periodontais, níveis bacterianos de A. actinomycetemcomitans, P. gingivalis, T. forsythia, T dentícola e a atividade da AR (DAS28). Adicionalmente quantificar níveis sanguíneos e salivares dos biomarcadores RANKL, OPG, RANKL / OPG, Survivina, e anticorpos antipeptídeos citrulinados cíclicos (ACPAs) e anti-carbamiladas (Anti-CarP). Métodos: A amostra do estudo foi composta por um total de 471 indivíduos divididos aleatoriamente em grupos, de acordo com o objetivo de cada estudo. O ensaio clínico realizou as seguintes avaliações no início do estudo (T1) e 45 dias (T2) após TPNC: exames periodontais de boca completa, análise microbiológica por meio de qPCR em tempo real, avaliações do Disease Activity Score (DAS-28). Em adição, a quantificação de biomarcadores e anticorpos Anti-Carp e ACPAs realizada por meio de ELISA no soro/saliva. Resultados: O presente estudo reportou uma alta prevalência de PE em indivíduos com AR e uma importante associação entre ocorrência, gravidade e extensão da PE associadas à AR e ao tabagismo. O tratamento periodontal não cirúrgico foi eficaz em melhorar a condição cliníca periodontal, reduziu a presença dos patógenos periodontais avaliados e melhorou o quadro clínico da AR (redução dos escores de DAS-28). Adicionalmente, reduziu os níveis de survivina, RANKL e concentração de ACPAs e Anti-CarP. Conclusão: Nossos achados corroboram a robustez das evidências científicas da associação entre periodontite e AR. Assim, o controle da infecção periodontal em pacientes com AR e PE pode ser uma importante ferramenta terapêutica no controle da AR.
Objectives: Current evidence recognizes that periodontitis (PE) and rheumatoid arthritis (RA) share common risk factors and some similar pathophysiological pathways, such as chronic inflammation induced by pro-inflammatory cytokines and destruction of connective and bone tissues. Thus, this thesis presents four studies of the possible association between PE and RA with the following objectives: to assess the periodontal condition, severity and extent of periodontitis and the clinical and epidemiological aspects of its association with RA. To investigate the influence of non-surgical periodontal treatment (TPNS) on the periodontal clinical parameters, bacterial levels of A. actinomycetemcomitans, P. gingivalis, T. forsythia, T dentic and the activity of RA (DAS28). In addition to quantify blood and salivary levels of the biomarkers RANKL, OPG, RANKL / OPG, Survivina, and cyclic citrullinated anti-peptide antibodies (ACPAs) and anti-carbamylates (Anti-CarP). Methods: The study sample consisted of a total of 471 individuals randomly divided into groups, according to the objective of each study. The clinical trial performed the following assessments at baseline (T1) and 45 days (T2) after TPNC: periodontal examinations of full mouth, microbiological analysis using real-time qPCR, assessments of the Disease Activity Score (DAS-28). In addition, the quantification of biomarkers and Anti-Carp antibodies and ACPAs performed by ELISA in serum / saliva. Results: The present study reported a high prevalence of PE in individuals with RA and an important association between the occurrence, severity and extent of PE associated with RA and smoking. The non-surgical periodontal treatment was effective in improving the clinical periodontal condition, reduced the presence of the periodontal pathogens evaluated and improved the clinical picture of RA (reduced DAS-28 scores). Additionally, it reduced the levels of survivin, RANKL and concentration of ACPAs and Anti-CarP. Conclusion: Our findings corroborate the robustness of the scientific evidence on the association between periodontitis and RA. Thus, the control of periodontal infection in patients with RA and PE can be an important therapeutic tool in the control of RA.
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Periodontitis , Arthritis, Rheumatoid , Tobacco Use Disorder , Conservative Treatment , Biomarkers , Case-Control Studies , Risk FactorsABSTRACT
OBJECTIVE@#To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use.@*METHODS@#Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies.@*RESULTS@#Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group.@*CONCLUSIONS@#CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.
Subject(s)
Humans , Anti-Bacterial Agents , Therapeutic Uses , Chronic Periodontitis , Drug Therapy , Clarithromycin , Dental Scaling , Periodontal Index , Root Planing , Treatment OutcomeABSTRACT
Objective: To evaluate the efficacies of clarithromycin and metronidazole in the treatment of chronic periodontitis, and to provide the evidence-based medical evidence for the rational use of drugs in the treatment of chronic periodontitis. Methods: CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, Science Direct and EM base database from inception to June, 2017 were searched by computer for the literatures about the treatment of clarithromycin and metronidazole for chronic periodontitis. Two reviewers independently screened the literatures, extracted the data and evaluated the bias risk of included studies. Then Meta- analysis was performed using RevMan 5.3 software. Results: A total of 5 randomized controlled trial (RCT) involving 516 patients with chronic periodontitis were included. Subgroup analysis was performed according to the follow-up time. Compared with metronidazole group, the probing depth (PD) reduction, attachment loss (AL) gain, and sulcus bleeding index (SBI) reduction of the patients with chronic periodontitis in clarithromycin group at 1 month and 3 months after follow-up were more significant; the differences in PD, AL, and SBI were significant (MD= 0. 53, 95% CI: 0.67 0. 39, P<0. 01; MD = 0. 31,95% CI: 0.39 0. 24, P<0. 01; MD = 0.23, 95% CI: 0.29 0.16, P<0.01). Conclusion: Systemic antibiotic use of clarithromycin in the treatment of the patients with chronic periodontitis after non-surgical periodontal therapy has a significant additional effect than metronidazole in short-term observation.
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Objective:To evaluate the efficacies of clarithromycin and metronidazole in the treatment of chronic periodontitis, and to provide the evidence-based medical evidence for the rational use of drugs in the treatment of chronic periodontitis.Methods:CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect and EMbase database from inception to June, 2017were searched by computer for the literatures about the treatment of clarithromycin and metronidazole for chronic periodontitis.Two reviewers independently screened the literatures, extracted the data and evaluated the bias risk of included studies.Then Meta-analysis was performed using RevMan 5.3 software.Results:A total of 5 randomized controlled trial (RCT) involving516patients with chronic periodontitis were included.Subgroup analysis was performed according to the follow-up time.Compared with metronidazole group, the probing depth (PD) reduction, attachment loss (AL) gain, and sulcus bleeding index (SBI) reduction of the patients with chronic periodontitis in clarithromycin group at 1month and 3months after follow-up were more significant;the differences in PD, AL, and SBI were significant (MD=-0.53, 95％CI:-0.67-0.39, P＜0.01;MD=-0.31, 95％CI:-0.39--0.24, P＜0.01;MD=-0.23, 95％CI:-0.29--0.16, P＜0.01) .Conclusion:Systemic antibiotic use of clarithromycin in the treatment of the patients with chronic periodontitis after non-surgical periodontal therapy has a significant additional effect than metronidazole in short-term observation.
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Abstract Objective In this study, we aimed to histologically and immunologically evaluate the effect of diode laser treatment when applied adjunctive to scaling and root planing (SRP) in an experimental periodontitis model. Materials and methods We used Wistar-Albino rats (n=60) with average weight of 230 g. Experimental periodontitis was induced by ligature at the right and left first mandibular molar teeth in all rats. After 11 days, the ligature was removed and rats were divided into two groups. The control group (n=30) received only SRP treatment, while the laser group (n=30) received a diode laser (GaAlAs, 810 nm, 1 W, 10 J, 20 s) treatment adjunctive to SRP. Ten rats in each group were sacrificed after 7, 15, and 30 days. Histopathological examination was performed in the left mandible of rats. Myeloperoxidase (MPO) was evaluated by western blot in the gingival specimens from the right mandible. Results MPO levels in the laser group were statistically significantly lower compared with the control group (p≤0.05). There was no statistically significance at any time between MPO levels in the control group (p>0.05). MPO levels in the laser group at the 7th day were statistically significantly higher compared to the 15th (p≤0.05) and the 30th day (p≤0.05). Inflammatory cell infiltration decreased over time in both groups and was statistically significantly lower in the laser group than in the control group at all times (p≤0.01). Conclusions Within the limits of this study, we suggest that diode laser application is an adjunctive treatment because it reduced inflammation and MPO when applied in addition to SRP. On the other hand, more studies are needed for the assessment of the effects of diode laser application to periodontal tissues.
Subject(s)
Animals , Periodontitis/pathology , Periodontitis/therapy , Dental Scaling/methods , Peroxidase/analysis , Low-Level Light Therapy/methods , Lasers, Semiconductor/therapeutic use , Periodontitis , Time Factors , Random Allocation , Blotting, Western , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Combined Modality Therapy , Disease Models, Animal , LigationABSTRACT
Resumen: El agrandamiento gingival es una lesión crónica inflamatoria, cuyo factor causal es la placa bacteriana. Se presenta como una tumefacción a nivel de la papila interdental y/o la encía marginal, puede estar de manera localizada o generalizada, siendo de progresión lenta e indolora, pudiendo ser exacerbado por efectos hormonales o por el uso de fármacos. Este artículo reporta el caso de una paciente con agrandamiento gingival y lesiones gingivales inducidas por placa bacteriana resuelto mediante terapia periodontal no quirúrgica. Se realizó la terapia manual y antibióticoterapia sistémica por siete días. Al mes de reevaluación se evidencio la resolución del agrandamiento; reducción de la inflamación, supuración, porcentaje de bolsas y grado de movilidad dental, se realiza mantenimiento periodontal. A los tres meses se observa reducción en el porcentaje de bolsas periodontales y grado de movilidad dental; se realizó terapia periodontal de mantenimiento.
Abstract: Gingival enlargement is a chronic inflammatory lesion caused by bacterial plaque. It appears as a tumefaction at the level of the inter-dental papilla and/or marginal gingival tissue; it can be localized or generalized. It exhibits slow and painless progression and can be exacerbated by hormonal causes or use of drugs. The present article studies the case of a patient afflicted with gingival enlargement and gingival lesions induced by bacterial plaque. The case was resolved with use of non surgical periodontal therapy. For seven days, antibiotic therapy and manual therapy were conducted. Re-evaluation one month later revealed resolution of the enlargement, decrease of inflammation, suppuration, periodontal pocket percentage and degree of dental mobility; periodontal maintenance was executed at that point. After three months, decrease of periodontal pockets percentage and degree of dental mobility were observed; at that point maintenance periodontal therapy was conducted.
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Dentistry has entered an exciting era of technological advancements. The advent of newer modalitiesof treatment like the use of laser radiation has heralded a change in the field of Periodontics since itsdevelopment and subsequent applications for dental hard and soft tissue procedures. Extensive researchhas been done on the possible benefits of lasers derived from the adjunctive effects of bacterial controland haemostasis associated with its use. This review attempts to explore the current status of laserapplications in the treatment of periodontal diseases and the emerging concepts in the utilization of laserenergy. The limitations of lasers in periodontal therapy are also briefly discussed.
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Background: Photodynamic therapy (PDT) is a method of microbial reduction which can benefit periodontal treatment in areas of difficult access, such as deep pockets and furcations. The aim of this randomized controlled clinical trial was to evaluate the effects of PDT as an adjunct to full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis. Material and Methods: Twenty-two patients with at least one pocket with a probing depth (PD) of ≥7 mm and one pocket with a PD of ≥5 mm and bleeding on probing (BOP) on each side of the mouth were included, characterizing a split mouth design. The control group underwent full-mouth ultrasonic debridement and the test group received the same treatment associated with PDT. The PDT was performed on only one side of the mouth and the initial step consisted of subgingival irrigation with 0.005% methylene blue dye. Two minutes after applying the photosensitizer, the low power laser – AsGaAl (Photon Lase III – PL7336, DMC, São Carlos -São Paulo, Brazil) was applied (660 nm, 100 mW, 9 J, 90 seconds per site, 320 J/cm 2 , diameter tip 600 µm). The following clinical parameters were evaluated: plaque index, gingival index, BOP, gingival recession (GR), PD, and clinical attachment level (CAL). All parameters were collected before, 1, 3 and 6 months after treatment. Results: An improvement in BOP, PD and CAL was observed after treatment, in both groups, but without any difference between them. After 6 months, the PD decreased from 5.11±0.56 mm to 2.83±0.47 mm in the test group (p<0.05) and from 5.15±0.46 mm to 2.83±0.40 mm in the control group (p<0.05). The CAL changed, after 6 months, from 5.49±0.76 mm to 3.41±0.84 mm in the test group (p<0.05) and from 5.53±0.54 to 3.39±0.51 mm in the control group (p<0.05). Conclusion: Both approaches resulted in significant clinical improvements in the treatment of severe chronic periodontits, however, the PDT did not provide any additional benefit to those obtained with full-mouth ultrasonic debridement used alone.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Chronic Periodontitis/therapy , Debridement/methods , Photochemotherapy/methods , Ultrasonic Therapy/methods , Analysis of Variance , Dental Scaling/methods , Periodontal Index , Statistics, Nonparametric , Time Factors , Treatment OutcomeABSTRACT
Aims and Objectives: The purpose of this study was to assess the clinical and microbiological effects of a newly developed root-conditioning gel system containing tetracycline and a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Materials and Methods: Four anterior teeth from four quadrants with a probing depth of 4-6 mm, in each of the 20 subjects with chronic periodontitis, were subjected to four different modalities of treatment. A total of 80 teeths were divided into four groups of 20 teeth each taken from separate quadrants, on the basis of one of the following four treatments: (1) Root planning alone in first quadrant (RP group); (2) tetracycline-containing gel in the second quadrant (TCG group); (3) root planning plus tetracycline-containing gel in third quadrant (RP + TCG group); (4) root planning plus a mixture of tetracycline and citric acid-containing gel in fourth quadrant (RP + TC-CAG group). Plaque index (PI), sulcular bleeding index, probing pocket depth, and clinical attachment level were measured for 0 day, 8 th week, and 12 th week, respectively. Subgingival plaque samples from each site were collected at the same visits and examined with dark field microscope for proportions of motile rods and spirochetes. Results: From 0 day to 12 th week, PI, sulcular bleeding index, probing pocket depth, and clinical attachment levels decreased significantly in all the groups. From 0 day to 12 th week, RP + TC-CAG group showed a significantly higher change in the PI score. From 0 day to 12 th week, RP group showed a significantly higher change in sulcular bleeding index score. A significant decrease in probing pocket depth and gain in clinical attachment level was noted at 12 th week in RP + TC-CAG group compared to the other groups. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group. There was a decrease in the proportion of spirochetes in all the groups. Conclusion: The results indicated that the use of a mixture of tetracycline and citric acid-containing gel was effective in improving gingival health and in changing subgingival microflora.
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The purpose of this study was to assess the tissueresponse of Type 2 diabetic subjects towards non surgicalperiodontal therapy as compared with matched, nondiabeticsubjects. This was a retrospective, comparativestudy using periodontal case notes of 40 subjects attendingundergraduates’ periodontal clinics (20 diabetics, 20 nondiabetics),who were selected based on the inclusionand exclusion criteria. Response towards non surgicalperiodontal therapy was assessed through three clinicalperiodontal parameters, namely plaque score, gingivitisscore and number of periodontal pocket ≥5mm at thebaseline and after initial non surgical periodontal therapy.Data obtained was then analyzed by SPSS Version 12.Both diabetic and non-diabetic subjects showed significantimprovements (p-value = 0.021; 0.000; 0.001 and 0.010;0.014; 0.001) in all three parameters after the therapy.However, when comparison was made between the twogroups, there was no significant difference (p-value = 0.913;0.892 and 0.903) in any of the parameters. Periodontalconditions improved clinically in both diabetic and nondiabeticsubjects after non-surgical periodontal therapy.Therefore, both groups responded similarly towards thetherapy and thus it can be postulated that well-controlleddiabetic status does not have a significant effect on theoutcome of periodontal therapy.
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An association between diabetes and periodontitis hasbeen long suspected and has now been reasonably welldocumented for both type I insulin dependent diabetesmellitus and type II non insulin dependent diabetesmellitus. Diabetes mellitus is a systemic complicationaffecting both the quality and length of life. The interrelationshipbetween periodontitis and diabetes provides anexample of systemic disease predisposing to oral infectionand once the infection is established, the oral infection canexacerbate the systemic disease. Diabetes induced changesin immune functions which provide an inflammatory cellphenotype. This predisposes to chronic inflammation,progressive tissue break down and diminished tissuerepair capacity. Periodontal tissues frequently manifestthese changes because they are constantly wounded bysubstances emanating from bacterial bio films. The wellinformed dentist has the opportunity to be at the forefrontof diagnosing diabetes. Studies have shown that nonsurgicalperiodontal treatment is associated with improvedglycemic control in type II diabetes mellitus patient.Periodontal treatment should be undertaken along withstandard measures for diabetic control and care. Preventionand control of periodontal disease must be considered anintegral part of diabetes mellitus.KeywordsDiabetes mellitus; periodontitis; non surgical periodontaltherapy; glycemic control
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La enfermedad periodontal afecta la salud del paciente comprometiendo la forma, función y estética del sistema estomatognático, llevando a un deterioro notable de la calidad de vida de las personas. En este caso clínico se presenta el tratamiento integral de unpaciente de sexo masculino de 43 años de edad con periodontitis crónica avanzada generalizada que incluyó: tratamiento periodontal no quirúrgico, quirúrgico y de rehabilitación oral, hecho durante dieciocho meses por un estudiante de último año del pregrado y un grupo de docentes especialistas en periodoncia y rehabilitación oral bajo la modalidad docencia-asistencial de la Facultad de Odontología de la Universidad de Antioquia (Medellín, Colombia.
Periodontal disease affects the patients health altering the form, function, and esthetics of the stomatognathic system andproducing huge deterioration in the persons quality of life. This clinical case presents the comprehensive treatment of a 43-year-old male patient with generalized advanced chronic periodontitis including: non-surgical and surgical periodontal treatment and oral rehabilitation during a period of eighteen months by a senior undergraduate student and a group of professors specialized in periodontics and oral rehabilitation under the modality of teaching-social assistance at the School of Dentistry of Universidad de Antioquia (Medellín, Colombia
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Humans , Chronic Periodontitis , Dental Prosthesis , DisinfectionABSTRACT
Objetivos: Evaluar la composición microbiológica y los parámetros clínicos de bolsas periodontales >5 mm de profundidad al inicio, 1 semana, 3 y 12 meses post raspado y alisado radicular. Materiales y Métodos: Se tomaron registros clínicos y muestras de placa subgingival de 44 sitios de pacientes con diagnóstico de periodontitis crónica. Se identificaron por técnica de Reacción en Cadena de la Polimerasa (PCR) patógenos putativos periodontales: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf) y Prevotella intermedia (Pi). Los pacientes recibieron terapia mecánica periodontal y fueron reevaluados a los 7 días, 3 y 12 meses. Resultados: Luego del tratamiento, todos los parámetros clínicos (Placa Bacteriana, Hemorragia, Supuración, Profundidad al Sondaje y Nivel de Inserción Clínica) se redujeron significativamente y los valores obtenidos se mantuvieron hasta los 12 meses. Al inicio, las especies bacterianas prevalentes fueron Pg, presente en 66 por ciento de los sitios, Tf (55 por ciento) y Td (41 por ciento). Los sitios más profundos se relacionaron con las asociaciones Tf-Td (6.8 mm) y Tf-Td-Pi (7 mm). Post terapia, el número de sitios positivos para Td, Tf y Pg se redujo significativamente. Conclusiones: El raspado y alisado radicular mejoró significativamente los parámetros clínicos y redujo la prevalencia de los patógenos periodontales Pg, Tf y Td en bolsas periodontales profundas. Los resultados obtenidos se mantuvieron hasta los 12 meses. No se detectaron mayores pérdidas de inserción clínica en el 86 por ciento de los sitios a 3 meses y en 79 por ciento a los 12 meses. Los sitios en los que el tratamiento no fue efectivo en la eliminación de patógenos a los 12 meses desarrollaron mayores profundidades de sondaje.
Objectives: To evaluate the microbial composition and clinical parameters of periodontal pockets with probing depth >5 mm at baseline, 1 week, 3 and 12 months after scaling and root planning. Methods: Clinical parameters were measured and bacterial samples were collected from 44 sites in 11 patients with chronic periodontitis. By means of Polymerase Chain Reaction (PCR) the presence of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf) and Prevotella intermedia (Pi) was estimated. The patients received mechanical periodontal therapy and were evaluated after 1 week, 3 months and 12 months. Results: After treatment, all clinical parameters (Plaque, Bleeding on Probing, Supuration, Probing Pocket Depth and Clinical Attachment Level) were significantly reduced, and the values obtained were maintained up to the 12 months that the study lasts. At baseline, the most prevalent species were Pg, present in 66 percent of the sites, Tf (55 percent) and Td (41 percent). The deepest sites were related to the association Tf-Td (6.8 mm) and Tf-Td-Pi (7 mm). The number of positive sites for Td, Tf and Pg was significantly reduced after therapy. Conclusions: Scaling and root planning improve significantly clinical parameters as well as reduce the prevalence of periodontal pathogens Pg, Td and Tf in deep periodontal pockets. The results obtained were maintained up to 12 months. No further clinical attachment loss was found in 86 percent of the sites at 3 months and 79 percent at 12 months. The sites where the treatment failed in removing pathogens developed at 12 months greater probing pocket depths.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Dental Scaling , Periodontitis/microbiology , Periodontitis/therapy , Aggregatibacter actinomycetemcomitans/isolation & purification , Periodontal Pocket/microbiology , Periodontal Pocket/therapy , Dental Plaque , Polymerase Chain Reaction , Porphyromonas gingivalis/isolation & purification , Treatment Outcome , Treponema denticola/isolation & purificationABSTRACT
While contemporary periodontics has witnessed the continued emergence of sophisticated techniques to resolve esthetic concerns through various periodontal procedures, frequently the early stages of periodontal diseases are best treated with non-surgical periodontal therapy. This short communication presents a case of reactive positioning of pathologically migrated anterior tooth following non-surgical periodontal therapy.