In vitro assessment of the effect of probiotic lactobacillus reuteri on peri-implantitis microflora.

BACKGROUND: Probiotics affect both the development and stability of microbiota by altering the colonization of pathogens and thus helps in stimulating the immune system of the individual. The aim of the present study is to assess the effect of probiotics on peri-implantitis microflora, by determining the minimum inhibitory concentration (MIC) of Lactobacillus reuteri, that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. Hence, this study will be helpful in finding the MIC of L. Reuteri that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. METHODS: This experimental research was conducted on patients visiting the periodontology department in M. A. Rangoonwala college of dental sciences and research centre. Sub-gingival plaque samples were collected from peri-implantitis patients to identify various peri-implantitis microorganisms. The identified microorganisms were compared to each other and Chi-Square test was used to calculate statistical significance. The isolated microorganisms were subjected to the effect of probiotic Lactobacillus reuteri in-vitro. Minimum inhibitory concentration (MIC) was assessed using serial dilution method. RESULTS: The research results showed the presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Streptococcus salivaris and Staphylococcus aureus in the subgingival samples from peri-implantitis patients. Statistically, significantly higher proportion of samples had Porphyromonas gingivalis. When subjected to the effect of L. reuteri, all the microorganisms were affected by L.reuteri except Aggregatibacter actinomycetemcomitans. CONCLUSION: This study provides the various MIC value for each isolated pathogen against L.reuteri. The authors recommend to avoid using standard guidelines for probiotic dose in the treatment of peri-implant infections as the antimicrobial profile is different for each periodontal pathogen.

Osteotome-mediated sinus floor elevation using an in situ hardening biphasic calcium phosphate bone graft substitute compared to xenograft: A randomized controlled clinical trial.

AIM: To assess osteotome-mediated sinus floor elevation (OMSFE) with simultaneous implant placement using an in situ hardening biphasic calcium phosphate (BCP) compared to xenograft as a control. METHODS: Patient in need for sinus floor augmentation in one or both sinuses were selected for this randomised controlled clinical trial. Sites presenting a residual sinus floor height of 3-6 mm and eligible for OMSFE were randomly assigned to receive either BCP (test) or xenograft particles (control). CBCT scans were performed before and at the time of implant loading (180 days). The difference in sinus floor height gain between the two groups was set as the primary endpoint parameter for equivalence testing. The implant insertion torque (ITV) was recorded and Implant stability quotients (ISQ) was assessed upon implant placement, abutment connection (160 days) and implant loading (180 days). RESULTS: A total of 54 sinus lifts were performed in 42 patients including 12 bilateral cases. Four implants failed (two in each group) and a total of six patients were lost to follow-up. Statistical analysis of sinus floor height revealed no significant differences (p < 0.05) between groups at baseline nor at 180 days after augmentation. There was no statistical difference in sinus floor height gain between the two groups as supported by the 90% confidence intervals of the difference between groups. Good primary implant stability was confirmed in both treatment groups by ITV and ISQ measurements. CONCLUSIONS: Within the limits of this study, it can be concluded that OMSFE using in situ hardening BCP particles results in equivalent sinus floor height gain than using xenograft particles but offers an easier application.

Comparative evaluation of vestibular incision subperiosteal tunnel access with platelet-rich fibrin and connective tissue graft in the management of multiple gingival recession defects: A randomized clinical study.

BACKGROUND: The etiology of gingival recession is often multifactorial. Wide array of surgical techniques are available to manage gingival recession. The aim of the present study was to compare, minimally invasive approach (vestibular incision subperiosteal tunnel access [VISTA]), in combination with platelet-rich fibrin (PRF) and connective tissue graft (CTG) in the management of multiple recession defects in maxillary anterior region. MATERIALS AND METHODS: A total of 32 sites from 10 systemically healthy controls were allocated randomly to VISTA with PRF (VISTA + PRF) and VISTA with CTG (VISTA + CTG). Plaque index, gingival index, Probing probing pocket depth (PPD), relative attachment level (RAL), recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and percentage of root coverage (%RC) were calculated at 6 months postoperatively. RESULTS: Results showed significant improvement in mean PPD, RAL, RD, RW, and KTW. %RC in VISTA + PRF and VISTA + CTG was 83.25% ± 25.02% and 86.43% ± 22.79%, respectively, at 6 months. There were no significant differences in the parameters between the VISTA + PRF and VISTA + CTG groups. CONCLUSION: VISTA is a minimally invasive surgical approach, which can be combined with CTG or PRF in the management of Miller's Class I and Class II recession defects, with predictable outcomes. There were significant improvements in the clinical parameters from baseline to 6 months in both the groups. To match with the CTG, which is the gold standard procedure, PRF can be used as an alternative for treating multiple recession defects.

Effect of Probiotic Lactobacillus salivarius on Peri-Implantitis Pathogenic Bacteria: An In Vitro Study.

Background Varied treatment modalities have been described in the past for the management of peri-implant diseases but the evidence of the use of probiotics for the treatment of peri-implantitis is limited. The aim of this study was to determine the antagonistic growth effects of Lactobacillus salivarius on the growth of peri-implantitis pathogens. Material and method Anin vitroassessment of probiotic L. salivarius on peri-implantitis pathogens was done using the serial tube dilution method. Minimum inhibitory concentration was calculated for five subgingival pathogens namely Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Streptococcus salivarius, and Staphylococcus aureus. Minimum inhibitory concentration (MIC) is defined as the lowermost concentration of any drug that prevents the noticeable growth of the test organism. In vitro assessment to determine the MIC is necessary for an in vivo application. The MIC value will also help to find the drug's accurate dosage. Results Peri-implantitis pathogens were cultured from individuals diagnosed with peri-implantitis. Except for A. actinomycetemcomitans, all other pathogens were susceptible to the probiotic. S. salivarius had the lowest MIC (0.8mg/mL). Conclusion The MIC value for pathogens will help to determine the effective mode and form of probiotic that can be used for the treatment of peri-implantitis.

Obesity and its association with chronic periodontitis: A cross-sectional study.

BACKGROUND: Relationship among periodontitis, obesity, and chronic diseases may be multidirectional. Inflammatory diseases such as periodontitis induce the production of pro-inflammatory cytokines such as TNF-α, IL-1, and IL-6. It has been suggested that the secretion of TNF-α by adipose tissue triggered by lipopolysaccharides from periodontal Gram-negative bacteria promotes hepatic dyslipidemia and decreases insulin sensitivity. AIM: To study the association of obesity with the severity of periodontitis and to compare the blood glucose levels and plasma lipid profile in obese and non-obese subjects with chronic periodontitis. METHODOLOGY: A total of 84 systemically healthy subjects, aged 30-60 years, were included in the study. Periodontal status of the subjects was assessed by recording Community Periodontal Index (CPI) and Gingival Index (Loe and Silness, 1963). Body mass index (BMI) and waist circumference (WC) were used as measures to assess obesity. The fasting plasma lipids level and fasting blood glucose level were measured. Data were analyzed by unpaired 't'test, Fisher's Exact test, and Chi-square test. RESULTS: There was a statistically significant difference in Gingival Index and Community Periodontal Index between the obese and non-obese group. Total cholesterol, triglycerides, and low-density lipoprotein (LDL) levels showed significant difference between the two groups. There was no statistically significant difference in mean age, high-density lipoprotein (HDL) levels, and fasting blood glucose levels between the two groups. CONCLUSION: The present study showed a positive association between obesity and chronic periodontitis. Further long-term studies involving larger sample size are required to confirm this association.

Ridge preservation using an in situ hardening biphasic calcium phosphate (ß-TCP/HA) bone graft substitute-a clinical, radiological, and histological study.

BACKGROUND: Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/ß-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane. METHODS: A total of 15 patients reported for tooth extraction were enrolled in this study. Implants were placed in average 5.2 ± 2 months after socket grafting. At this visit, Cone Beam CT (CBCT) images and core biopsies were taken. Implant stability (ISQ) was assessed at the insertion as well as at the day of final restoration. RESULTS: CBCT data revealed 0.79 ± 0.73 mm ridge width reduction from grafting to implant placement. Histomorphometric analysis of core biopsy samples revealed in average 21.34 ± 9.14% of new bone in the grafted sites. Primary implant stability was high (ISQ levels 70.3 ± 9.6) and further increased until final restoration. CONCLUSIONS: The results of this study show that grafting of intact post-extraction sockets using a biphasic in situ hardening bone graft substitute results in an effective preservation of the ridge contour and sufficient new bone formation in the grafted sites, which is imperative for successful implant placement.

Awareness, knowledge, and attitude of patients toward dental implants - A questionnaire-based prospective study.

BACKGROUND: In developing nations like India awareness and education about dental implants as a treatment modality is still scanty. AIM: The study was conducted to determine the awareness, knowledge, and attitude of patients toward dental implants as a treatment modality among the general population and to assess the influence of personality characteristics on accepting dental implants as a treatment modality in general and as well as treatment group. MATERIALS AND METHODS: A structured questionnaire-based survey was conducted on 500 randomly selected participants attending the outpatient department. The study was conducted in 2 parts. In the first part of the study, level of awareness, knowledge, and attitude was assessed. In the second part of the study, interactive educational sessions using audiovisual aids were conducted following which a retest was conducted. The participants who agreed to undergo implant treatment were followed up to assess their change in attitude towards dental implants posttreatment. Thus pain, anxiety, functional, and esthetic benefits were measured using visual analog scale. They were further followed up for 1 year to reassess awareness, knowledge, and attitude towards dental implants. RESULTS: A total of 450 individuals completed the questionnaires. Only 106 individuals agreed to participate in the educational sessions and 83 individuals took the retest. Out of these, only 39 individuals chose implants as a treatment option. A significant improvement in the level of information, subjective and objective need for information, was noted after 1 year. CONCLUSION: In this study, a severe deficit in level of information, subjective and objective need for information towards, dental implants as a treatment modality was noted. In the treatment group, a significant improvement in perception of dental implant as a treatment modality suggests that professionally imparted knowledge can bring about a change in the attitude.

Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study.

BACKGROUND: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. AIM: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. SETTINGS AND DESIGN: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. MATERIALS AND METHODS: A pilot study was conducted on 21 adolescent patients between the age group of 13-19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal-lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. RESULTS: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. CONCLUSION: Direct correlation between estradiol, testosterone, and gingival enlargement was seen.

Estimation and correlation of salivary thiocyanate levels in periodontally healthy subjects, smokers, nonsmokers, and gutka-chewers with chronic periodontitis.

AIM: This study was conducted to estimate and correlate salivary thiocyanate (SCN) levels in periodontally healthy subjects, smokers, nonsmokers, and gutka-chewers with chronic periodontitis. METHODOLOGY: The study population consisted of 40 systemically healthy subjects in the age group of 18-55 years that was further divided into four groups: Control, smokers, nonsmokers, and gutka-chewers with chronic periodontitis. Gingival index (GI) (Loe and Silness-1963), probing depth (PD), clinical attachment loss was assessed. Estimation of SCN was performed by ultraviolet spectrophotometer at 447 nm wavelength. Statistical analysis was performed using the one-way ANOVAs Welch test and Pearson's correlation test using SPSS version 17 software. RESULTS: Results showed statistically significant increase in SCN levels in smokers as compared to gutka-chewers with chronic periodontitis, control, and nonsmokers with chronic periodontitis subjects. Significantly higher PD and loss of attachment were seen in smokers group compared with other groups. A negative correlation observed between the GI and thiocyanate levels. CONCLUSION: The present study revealed a significant increase in SCN levels in smokers with periodontitis as compared to nonsmokers.

Assessment of salivary calcium, phosphate, magnesium, pH, and flow rate in healthy subjects, periodontitis, and dental caries.

AIM: This study was conducted to estimate and compare inorganic salivary calcium, phosphate, magnesium, salivary flow rate, and pH of unstimulated saliva and oral hygiene status of healthy subjects, subjects with periodontitis and dental caries, and to correlate salivary calcium level with number of intact teeth. MATERIALS AND METHODS: The study population consisted of 48 systemically healthy subjects in the age group of 18-55 years, which was further divided into three groups: healthy, periodontitis, and dental caries. Oral hygiene index-simplified, probing pocket depth, clinical attachment level, the number of intact teeth, and active carious lesions were recorded. Estimation of inorganic salivary calcium, phosphate, and magnesium was performed spectrophotometrically using Vitros 5.1 FS. Statistical analysis was performed using the one-way analysis of variance test at 5% significance level. RESULTS: There was a statistically significant increase in inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene status in periodontitis group compared to dental caries and healthy group. CONCLUSION: Subjects with increased inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene are at a higher risk of developing periodontitis. Since there is increased remineralization potential, these subjects have more number of intact teeth compared to the dental caries group.

Comparative analysis of gingival crevicular fluid ß-glucuronidase levels in health, chronic gingivitis and chronic periodontitis.

BACKGROUND AND OBJECTIVES: Current methods available for periodontal disease diagnosis are seriously deficient in terms of accuracy, in the ability to predict ongoing or future disease activity and indeed in determining whether previously diseased sites are in an arrested phase or still active. One area that is receiving a great deal of attention is the biochemical investigation of gingival crevicular fluid (GCF). ß-glucuronidase (ßG) is one of the enzymes found in GCF that is involved in degradation of the ground substance and fibrillar components of host connective tissue. GCF ßG activity might be a good indicator or predictor of periodontal disease activity. This study was conducted to estimate and compare the GCF ßG levels in patients with healthy periodontium, chronic gingivitis, and chronic periodontitis. METHODOLOGY: Subjects were classified into three groups of 20 patients each; healthy individuals, chronic gingivitis, and chronic periodontitis. After recording the plaque index, gingival index and probing pocket depth, 1 µL GCF was collected by placing a calibrated microcapillary pipette extracrevicularly and transferred to sterile plastic vials containing 350 µL of normal saline with 1% bovine serum albumin. Analysis of ßG was done by spectrophotometry. RESULTS: ßG levels in GCF were significantly higher in chronic periodontitis group (mean value - 2.04743), followed by chronic gingivitis group (mean - 1.11510) and healthy group (0.53643). CONCLUSION: Increased ßG levels were observed in patients with increased periodontal destruction, hence GCF ßG levels can be used as biochemical marker for periodontal disease activity.

Quantitative Assessment of Calcium Profile in Whole Saliva From Smokers and Non-Smokers with Chronic Generalized Periodontitis.

BACKGROUND: Measures of in vivo calcium status are important in understanding the mineralization capacity as it is an essential mineral component of both teeth and bone; and also play a vital role in the lipid profile and hormonal balance. AIM: To evaluate the existence of any disturbances in calcium metabolism and absorption induced by smoking, by quantitatively assessing the variations in the salivary calcium level between smokers and non-smokers with periodontitis and relating to their periodontal status. MATERIALS AND METHODS: A total of 50 male patients were selected and categorized as Group I (smokers with chronic generalized periodontitis) and Group II (non-smoker/ non-tobacco users with chronic generalized periodontitis). Clinical parameters such as Calculus Index and Community Periodontal Index were assessed. Subsequently two ml of unstimulated whole saliva was collected and subjected to biochemical analysis for the estimation of salivary calcium which was carried out in the next 20 min. RESULTS: Salivary calcium levels were significantly higher in Group I (2.2700) compared to Group II (1.7260). Higher calculus index and CPI index score were also seen in Group I when compared to Group II. CONCLUSION: Elevated salivary calcium level among the Group I emphasize the decreased calcium absorption efficiency among the smokers. High salivary calcium content hardens plaque more rapidly, indirectly influencing the level of oral hygiene.

Etiology and occurrence of gingival recession - An epidemiological study.

OBJECTIVES: Gingival recession is the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth. It is frequently observed in adult subjects. The occurrence and severity of the gingival recession present considerable differences between populations. To prevent gingival recession from occurring, it is essential to detect the underlying etiology. The aim of the present study was to determine the occurrence of gingival recession and to identify the most common factor associated with the cause of gingival recession. METHODS: A total of 710 subjects aged between 15 years to 60 years were selected. Data were collected by an interview with the help of a proforma and then the dental examination was carried out. The presence of gingival recession was recorded using Miller's classification of gingival recession. The Silness and Loe Plaque Index, Loe and Silness gingival index, community periodontal index were recorded. The data thus obtained were subjected to statistical analysis using Chi-square test and Student's unpaired t-test. RESULTS: Of 710 subjects examined, 291 (40.98%) subjects exhibited gingival recession. The frequency of gingival recession was found to increase with age. High frequency of gingival recession was seen in males (60.5%) compared to females (39.5%). Gingival recession was commonly seen in mandibular incisors (43.0%). Miller's class I gingival recession was more commonly seen. The most common cause for gingival recession was dental plaque accumulation (44.1%) followed by faulty toothbrushing (42.7%). CONCLUSION: Approximately half of the subjects examined exhibited gingival recession. The etiology of gingival recession is multifactorial, and its appearance is always the result of more than one factor acting together.

A comparison of dentifrices for clinical relief from dentin hypersensitivity using the Jay Sensitivity Sensor Probe.

PURPOSE: To evaluate the clinical relief from dentin hypersensitivity among subjects provided with a dentifrice formulated with 8% arginine, calcium carbonate and 1,000 ppm fluoride [sodium monofluorophosphate (MFP)] in comparison to those issued a commercially available dentifrice containing 1,000 ppm fluoride [as sodium monofluorophosphate (MFP)]. Clinical evaluations for hypersensitivity were performed with a novel tactile hypersensitivity measuring instrument--the Jay Sensitivity Sensor (Jay) Probe--in conjunction with evaporative triggers by air blast (Schiff scale) and Visual Analog Scores (VAS). METHODS: Qualified adults from the Mangalore, India area who presented two teeth with dentin hypersensitivity were enrolled for this double-blind, randomized, parallel, controlled clinical trial conducted in an outpatient clinical setting. At baseline, dentin hypersensitivity was evaluated by the Jay Probe (tactile), air blast and VAS methods. Subjects were randomly issued a study dentifrice and instructed to brush their teeth for 1 minute twice daily with the provided dentifrice. Clinical evaluations for hypersensitivity were repeated after 2, 4 and 8 weeks of product use. RESULTS: 86 subjects (35 males and 51 females) complied with the study protocol and completed the entire study. At each recall visit, both treatment groups demonstrated significant reductions in dentin hypersensitivity from their corresponding baselines (P < 0.05). Subjects assigned the 8% arginine, calcium carbonate and 1,000 ppm fluoride dentifrice demonstrated statistically significant reductions in responses to tactile stimuli, air blast, and VAS responses in comparison to those using the dentifrice containing 1,000 ppm fluoride after 2, 4, and 8 weeks, respectively.

Clinical evaluation of porous hydroxyapatite bone graft (Periobone G) with and without collagen membrane (Periocol) in the treatment of bilateral grade II furcation defects in mandibular first permanent molars.

BACKGROUND: Furcation invasions represent one of the most demanding therapeutic challenges in periodontics. This investigation assessed and compared the clinical efficacy of hydroxyapatite bone graft material when used alone and with collagen membrane in the treatment of grade II furcation defects. MATERIALS AND METHODS: Ten patients with comparable bilateral furcation defects in relation to mandibular first molars were selected and treated in a split-mouth design. After the hygiene phase of therapy was completed, the groups were selected randomly either for treatment with hydroxyapatite bone graft (Periobone G) alone or with a combination of bone graft and guided tissue regeneration (GTR) membrane (Periocol). Clinical parameters like plaque index, gingival index, vertical probing depth, horizontal probing depth, clinical attachment level, position of marginal gingiva, and the amount of bone fill were used at baseline and at 3 and 6 months postoperatively. RESULTS: At 6 months, both surgical procedures resulted in statistically significant reduction in vertical and horizontal probing depths and gain in the clinical attachment level. CONCLUSION: The use of combination technique yielded superior results compared to sites treated with bone graft alone. However, the difference was not statistically significant.

Influence of personality traits on gingival health.

BACKGROUND: The maintenance of good oral hygiene is considered a salient issue in dental health promotion. Personality is the combination of characteristics or qualities that form an individual's distinctive character. Various personality traits have been proposed to influence the oral health. The purpose of the present study was to assess the influence of personality characteristics using questionnaire on oral hygiene performance and gingival health. MATERIALS AND METHODS: In total, 155 patients were subjected to personality questionnaire using Eysenck Personality Questionnaire. Clinical parameters such as Patient oral hygiene performance index and gingival index were recorded. Based on Eysenck Personality Questionnaire, the subjects were divided into three groups: Psychoticism, extroversion, and neuroticism. RESULTS: Data analysis showed that subjects in psychoticism and neuroticism groups displayed moderate gingivitis, whereas subjects in extroversion group had severe gingivitis. Subjects in all the three groups demonstrated poor oral hygiene status. No statistically significant relation was found. CONCLUSIONS: A considerable clinical correlation was observed between the different personality traits and gingival health status of the subjects. It was not statistically significant. Further trials need to be conducted so as to ascertain this association so that psychological interventions may be undertaken to improve the oral hygiene condition of the population.

Poor periodontal health: A cancer risk?

Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

Two stage surgical procedure for root coverage.

Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva.

Assessment of the alkaline phosphatase level in gingival crevicular fluid, as a biomarker to evaluate the effect of scaling and root planing on chronic periodontitis: An in vivo study.

CONTEXT: Clinical evaluation of gingivitis and/or periodontitis does not predict the progression or remission of the disease. Due to this diagnostic constraint, clinicians assume that the pathology has an increased risk of progression and plan treatments, despite the knowledge that all inflamed sites are not necessarily progressing. Extensive research has been carried out on gingival crevicular fluid (GCF) components that might serve as potential diagnostic markers for periodontitis. Among them alkaline phosphatase (ALP) levels in GCF has shown promise as a diagnostic marker. AIM: This study compares the levels of GCF alkaline phosphatase in patients with chronic periodontitis before and after scaling and root planing. MATERIALS AND METHODS: This study is an in vivo longitudinal study conducted on twenty patients with localized periodontitis. The GCF was collected from the affected site prior to scaling and root planing and ALP level estimated. The probing depth and plaque index at the site were also measured for correlation. Patients were recalled after 7, 30, and 60 days for reassessment. RESULTS: The GCF ALP values showed a sustained, statistically significant decrease after treatment. There was a positive correlation with probing depth but not with plaque index measured at each interval. CONCLUSION: The assessment of level of periodontal disease and effect of mechanical plaque control on the progression and regression of the disease can be evaluated precisely by the corresponding GCF ALP levels. Thus, alkaline phosphatase level is not only a biomarker for the pathology but also an indicator of prognosis of periodontitis.