Variations of Serum CRP Levels in Periodontal Health and Diseases: A Clinico-Biochemical Study.

This study aimed to quantify serum C-reactive protein (CRP) values in periodontally healthy people and explore the relationship between serum CRP levels and chronic periodontitis, and the influence of scaling as well as root planing (SRP) on serum CRP levels. The study included 100 systemically healthy adults (n = 100; 50 males and 50 females) who were separated into two groups: Group A (control) n = 50; periodontally healthy subjects and Group B (test) n = 50; subjects with chronic periodontitis. The test group (group B) was further separated randomly into two groups: B1 (n = 25) and B2 (n = 25). The clinical parameters and serum CRP levels were measured only once in Group A and before SRP in Group B1 subjects. In Group B2 subjects the clinical parameters and serum CRP levels were measured only after two months following SRP. For group A, B1, and B2 (the readings recorded after SRP) the mean gingival index scores were 0.146, 2.437, and 1.052, respectively, while the plaque index was 0.414, 2.499, and 0.954, respectively. Probing pocket depth (PPD) and clinical attachment loss (CAL) showed statistically significant differences between three groups, with higher values in patients with periodontitis before intervention (2.196 ± 0.49; 1.490 ± 0.23), respectively. Healthy controls (Group A) had a C-reactive protein level of 0.04820 mg/dL, while group B1 (test) had 1.678 mg/dL and 0.8892 mg/dL (group B2). C-reactive protein levels were observed to be greater in the test group (groups B1 and B2), and these differences were statistically significant (p < 0.001). Chronic periodontitis enhances blood levels of systemic inflammatory markers like CRP, which has been reduced by periodontal treatment with SRP.

Intramarrow penetration synergized with advanced platelet-rich fibrin in periodontal regeneration: A randomized controlled trial.

Background: Intramarrow penetration (IMP) is one of the recent treatment protocol where decortication is performed to stimulate osteogenic cells. IMP improves the blood supply and the inherent osteogenic properties of the vital bone and has the advantages of minimal surgical invasion, time, and cost. Incorporation of IMP in the regeneration of periodontal defects is very scarce. Hence, the present study aimed to evaluate the involvement of IMP and advanced platelet-rich fibrin (A-PRF) in the regenerative outcomes in the treatment of intrabony defects. Materials and Methods: In the present randomized controlled trial, 20 periodontitis patients with 20 defects were randomly allotted into two groups: group I open flap debridement (OFD) and A-PRF, group II OFD, intramarrow debridement, and A-PRF. Clinical parameters recorded were plaque index (PI), gingival index (GI), and clinical attachment level (CAL) probing depth. Radiographic parameters were defect depth, defect resolution, and change in alveolar crest height. Values were tabulated and subjected to statistical analysis. Paired and unpaired t-tests were performed for intra and intergroup comparisons. P <0.05 was set as statistically significant. Results: Intragroup comparisons showed a significant reduction (P < 0.05) in probing pocket depth, GI, PI, gain in CAL, and greater bone fill in both the groups from baseline to 6 months postoperative. Intergroup comparisons were not statistically significant (P > 0.05). Conclusion: Within limitations, both treatment modalities stand good, but utilization of IMP along with A-PRF results in effective regenerative outcome in intrabony defects because of its stimulation of osteogenic properties.

Comparative Evaluation of Locally Administered 2% Gel Fabricated from Lemongrass Polymer and 10% Doxycycline Hyclate Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis-A Randomized Controlled Trial.

Background: Extracts of medicinal plant like lemongrass offer a new choice for optional antimicrobial therapy against various oral microorganisms. The objective of this study was to assess, verify, and compare the antimicrobial effectiveness of locally administered 2% lemongrass gel and 10% doxycycline hyclate gel as an adjunct to scaling and root planing (SRP) in treating chronic periodontitis. Method: This is a double-blind parallel arm randomized controlled study. Forty subjects were randomly divided into Group A and B for 2% lemongrass gel and 10% doxycycline hyclate gel, respectively. The clinical assessments of Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) together with microbial colony counts for Porphyromonas gingivalis, Actinomyces naeslundii, and Prevotella intermedia were done at baseline, 1st month, and 3rd month follow-ups. Results: The results showed there was a significant reduction in the mean scores of GI, PPD, and CAL clinical indices from baseline to the 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Similarly, there was significant reduction in mean CFU scores for all periodontal pathogens from baseline to 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Conclusions: It could be concluded that the local delivery of 2% lemongrass gel as an adjunct to scaling and root planing is effective and comparable to 10% doxycycline gel in the treatment of chronic periodontitis.

Evaluating and comparing the efficacy of the microsurgical approach and the conventional approach for the periodontal flap surgical procedure: A randomized controlled trial.

BACKGROUND: The use of the magnification approach for the periodontal flap surgical procedure helps in better visualization and better handling of soft tissues, which results in early wound healing. OBJECTIVES: The aim of the present study was to compare the conventional macroscopic approach for periodontal flap surgery with the microsurgically modified approach in a randomized controlled clinical trial. MATERIAL AND METHODS: A total of 60 subjects were randomly divided into 2 groups: group A (test group), in which the subjects underwent the conventional open flap debridement procedure; and group B (control group), in which the subjects underwent open flap debridement with the use of a microsurgical loupe. The plaque index (PI), the gingival index (GI), the probing pocket depth (PPD), the clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline, and at 3, 6 and 9 months postoperatively. Also, the early wound-healing index (EHI) was recorded at 10 days postoperatively. RESULTS: Both the conventional and the microsurgical technique provided a statistically significant reduction in PI, GI and PPD as well as gain in CAL. However, the microsurgical technique demonstrated a statistically significant decrease in postoperative GR as well as reduced pain perception and EHI scores. CONCLUSIONS: The use of the microsurgical approach provides better clinical results with less discomfort, and thus makes the periodontal treatment more acceptable for the patient.

Influence of maternal periodontitis on adverse pregnancy outcome: An observational study.

Background: Adverse pregnancy outcome is due to deviation from the normal physiological and immunological process. There is conflicting evidence in support of maternal periodontitis as a risk factor for preterm low birth weight (PTLBW). Thus, the aim of the present study is to evaluate the correlation between PTLBW and periodontitis in postpartum mothers based on clinical and microbiological parameters. Materials and Methods: An observational retrospective study was conducted. A total of 103 women with singleton births were included in the study, which was divided into two groups, i.e., Group I-PTLBW and Group II-normal term normal birth weight (NTNBW). Clinical parameters such as oral hygiene index simplified, gingival bleeding index (BOP %), periodontal probing depth (PPD) and and clinical attachment loss (CAL) were recorded on the next day of postpartum. Two samples from each group, i.e., placental extract and the subgingival plaque were collected and transported to the laboratory in an anaerobic medium for microbiological analysis. The statistical analysis was performed using an unpaired t-test and Wilcoxon Mann-Whitney U-test. The P < 0.001 was considered statistically significant. Results: PTLBW group showed significantly higher amounts of periodontal destruction in terms of clinical parameters. The pathogens were also in higher quantities in the PTLBW group compared to the NTNBW group. Conclusion: Periodontitis is related to PTLBW in pregnant women of the studied population. Maternal oral hygiene status delivering PTLBW babies are compromised compared to mothers delivering NTNBW babies. Hence, periodontitis during pregnancy phase is an important health concern for the growing fetus.

Clinical and microbiological evaluation of the synergistic effects of diode laser with nonsurgical periodontal therapy: A randomized clinical trial.

CONTEXT: Nonsurgical and surgical therapies along with local and systemic antibiotic regimens have been advocated in the treatment of periodontitis. Due to increasing risk of developing antibiotic resistance and inability of nonsurgical periodontal therapy to completely eradicate the pathogenic microorganisms, lasers have been used as an adjunct to conventional therapy. AIM: The aim of the present study is to evaluate the effectiveness of the use of diode lasers as adjunct to scaling and root planing (SRP) compared to SRP alone on various clinical and microbiologic parameters in chronic periodontitis patients. SETTINGS AND DESIGN: Patients were taken from the department of periodontology and implantology, who were having chronic periodontitis. MATERIALS AND METHODS: A total of forty patients participated in the study and they were divided into Group I - the test group (SRP + diode laser) and Group II - the control group (SRP alone). The following clinical parameters were assessed: oral hygiene index simplified; clinical attachment level (CAL); probing pocket depth (PPD); bleeding on probing (BOP) at baseline, 4 weeks, and 12 weeks after the treatment; and colony-forming units (CFUs) 1 week postoperatively. STATISTICAL ANALYSIS USED: The statistical analysis was performed using paired t-test, unpaired t-test, Wilcoxon signed-rank test, and Mann-Whitney test. RESULTS: There was reduction in BOP, PPD, and gain in CAL from baseline to 3 months and also a reduction in CFU 1 week postoperatively. CONCLUSION: There was a significant improvement in clinical parameters in test group (SRP + laser) as compared to the control group (SRP alone).

Versatility of platelet rich fibrin in the management of alveolar osteitis-A clinical and prospective study.

OBJECTIVE: To assess the efficacy of Platelet Rich Fibrin (PRF) on the pain and healing of the extraction socket associated with Alveolar Osteitis (Dry Socket, AO) after removal of maxillary and mandibular molars. STUDY DESIGN: 100 adult patients with age group ranging from 18 to 40 years along with established dry socket after maxillary and mandibular molar extractions who have not received any treatment for the same were included in the study. PRF was placed in the maxillary and mandibular molar extraction sockets after adequate irrigation of the socket. All the patients evaluated for the various study variables which include pain, degree of inflammation, and healthy granulation tissue formation at 1st, 3rd, 7th, and 14th post operative day. Data were analyzed using Shapirowilk's test, chi square test and/or student-t test, Friedman's test, Wilcoxson's signed rank test, and Bonferroni test, with the significance level set at P < 0.05. RESULTS: There was significant reduction in pain associated with AO at the 3rd and 7th postoperative day along with better wound healing by the end of 2nd week. CONCLUSION: Use of PRF in this study illustrates the promising results in terms of reduced pain and better healing in the patients with Alveolar Osteitits.