Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial.

AIM: This study aims to evaluate the efficacy of calcium phosphate-poly(lactide-co-glycolide) composite graft in the regeneration of intrabony defects in chronic periodontitis patients over a period of 12 months. MATERIALS AND METHODS: A total of 11 systemically healthy chronic periodontitis patients with 22 graftable sites were treated with calcium phosphate cement (CPC) bone graft (control group) and CPC-poly(lactic-co-glycolic acid)(PLGA) composite (test group) after flap reflection and debridement. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 3, 6, 9, and 12 months. Bone probing depth (BPD) and radiographic parameters such as defect depth (DD), changes in alveolar crest level (ALR), defect depth reduction (DDR), and percentage in defect depth reduction (PDDR) were calculated at baseline, and 6 and 12 months. The data were recorded and statistically analyzed. RESULTS: On intragroup comparison, there was a significant improvement in all the parameters over a period of 1 year (clinically and radiographically). However, there was no statistically significant difference between the two groups in any of the parameters though there was a slightly higher bone fill noted in the test group. CONCLUSION: Even though the CPC-PLGA composite bone graft showed a slight improvement in clinical and radiographic parameters as compared to the CPC graft, it was not statistically significant. CLINICAL SIGNIFICANCE: A major drawback of Calcium Phosphate cements as bone grafts is their poor degradability. The PLGA microspheres degrade to expose macropores and interconnected pores in the graft substrate which in turn would promote the ingrowth of osteoblasts. Also, this composite graft is mouldable, and resorbable and has been shown to snugly fit into the defects making them a suitable scaffold material. How to cite this article: Ojha M, Pawar Chandrashekara Rao D, Gowda V. Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial. J Contemp Dent Pract 2023;24(12):921-927.

Local delivery of hyaluronic acid as an adjunct to scaling and root planing in the treatment of chronic periodontitis in smokers and non-smokers: A clinical and microbiological study.

Objective: The objective of the study is to assess the effects of adjunctive use of hyaluronic acid (HA), clinically and microbiologically in smokers and nonsmokers, in the management of chronic periodontitis. Material and Methods: 48 sites from 24 chronic periodontitis patients, including smokers and nonsmokers with probing depth >5 mm, were selected for the study. A split-mouth design was followed. Scaling and root planing (SRP) was performed for all the patients. The test sites received 0.8% HA gel whereas the control site received placebo gel. The clinical parameters plaque, gingival and bleeding indices, Pocket Probing Depth (PPD), and clinical attachment level (CAL) were evaluated at baseline, 1 and 3 months. Microbiological parameters were evaluated at baseline and 1 month. Results: The results showed reduction in PPD and gain in CAL in both smokers and nonsmokers at the end of 3rd month. The improvements in the test sites were statistically significant when compared with that of control sites. The microbiological analysis showed a significant reduction in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at the test sites when compared to the controls in both the groups. Conclusion: The findings in both groups suggest that the use of locally delivered 0.8% HA gel may be valuable as an adjunct to SRP in the treatment of chronic periodontitis.

Clinicoradiographic evaluation of hyaluronan-nano hydroxyapatite composite graft in the management of periodontal infrabony defects.

BACKGROUND: Hyaluronan is a naturally occurring polysaccharide in the extracellular matrix of the connective tissue. It imparts antibacterial and osteogenic properties to the nano hydroxyapatite bone graft (NHA). AIM: This study aims to evaluate the efficacy of hyaluronan-NHA (H-NHA) composite in the treatment of infrabony defects in chronic periodontitis patients. MATERIALS AND METHODS: Eight systemically healthy chronic periodontitis patients with 32 graftable sites were included in the study. After flap reflection and debridement, the defect sites in the test quadrant were filled with H-NHA graft and those in the control quadrant were filled with NHA graft alone. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline and 3, 6, 9, and 12 months; bone probing depth (BPD) and radiographic parameters such as amount and percentage of defect depth reduction (DDR, PDDR) and change in alveolar crest level (ALR) were assessed at baseline and 6 and 12 months. STATISTICAL ANALYSIS USED: Descriptive statistics, one-way analysis of variance, and Student's t-test were used for statistical analysis. RESULTS: At the end of 12 months, H-NHA group showed a greater reduction in PPD (5.06 ± 0.582 mm), BPD (4.22 ± 0.371 mm), and gain in CAL (4.00 ± 0.421 mm) as compared to the NHA group (3.21 ± 0.648 mm, 3.21 ± 0.047 mm, and 2.86 ± 0.127 mm, respectively). In addition, DDR, PDDR, and ALR were better in H-NHA group (1.92 ± 0.647 mm 48.22 ± 31.561 mm, and 1.22 ± 0.808 mm, respectively) as compared to the NHA group (1.14 ± 0.602 mm, 20.14 ± 25.349 mm, and 0.89 ± 0.626 mm, respectively). Statistically significant improvements in all the parameters were seen in the test sites when compared to control sites at 12 months. CONCLUSION: H-NHA composite graft can be considered a promising periodontal regenerative material.

Evaluation of dietary supplementation of omega-3 polyunsaturated fatty acids as an adjunct to scaling and root planing on salivary interleukin-1ß levels in patients with chronic periodontitis: A clinico-immunological study.

CONTEXT: Host modulation with omega-3 polyunsaturated fatty acids (ω-3 PUFAs) has anti-inflammatory and pro-resolution actions through replacing and inhibiting metabolism of arachidonic acid (AA). AIM: This study was aimed at evaluating clinical parameters and salivary levels of interleukin-1 beta (IL-1ß) after scaling and root planing (SRP) in chronic periodontitis patients, with and without dietary supplementation of ω-3 PUFAs. SETTINGS AND DESIGN: Forty otherwise healthy participants with severe chronic periodontitis were included. Full-mouth periodontal examination and scaling and root planing were done for test and control group (20 participants each). MATERIALS AND METHODS: The control group received SRP alone while test group received daily dose of 700 mg ω-3 PUFA capsules for 3 months. All clinical parameters were checked at baseline, 1 month, and 3 months' duration, whereas levels of IL-1ß were checked in saliva at baseline and 3 months after therapy. STATISTICAL ANALYSIS USED: T-test and repeated measure analysis of variance were used with Statistical Package for the Social Science Windows software. RESULTS: Improvements in all clinical outcomes were similar in both groups over 3 months. Improvements in clinical parameters were not statistically significant on intergroup comparison, except for improvement in Bleeding Index and reduction in levels of IL-1ß, which were statistically significant in test group as compared to control group (P < 0.05). CONCLUSION: Even though adjunct therapy with ω-3 PUFAs can modulate cytokine levels and show proresolution properties, its importance on clinical outcomes may be controversial. Thus, this may be used as an adjunctive management of chronic periodontitis.

Comparison of glycosylated hemoglobin levels in severe periodontitis patients and healthy controls: a study in an Indian population.

BACKGROUND: Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine if glycosylated hemoglobin is elevated in patients with severe periodontitis who are nondiabetic adults. METHODS: A total of 60 patients were selected and were divided into test and control groups. The test group included 30 adults without diabetes but with severe periodontitis (more than 30% of the sites showing clinical attachment loss [CAL] >= 5 mm and bleeding on probing [BOP]), and the control group included 30 healthy adults (probing depth ≤ 4 mm, BOP ≤ 15% and no CAL). Glycosylated hemoglibin (HbA1c) was assessed in the laboratory for these patients. Groups were compared using the t test, Mann-Whitney U test, chi-square test, and Pearson's correlation. RESULTS: There was a slight increase in mean HbA1c scores in the test group (cases 5.76%, controls 5.63%, P= .071). Mean body mass index (BMI) among cases and controls were similar. On intragroup comparison among BMI subgroups of the test group. HbA1c levels in the overweight subgroup were significantly higher compared to the normal BMI subgroup (overweight 5.89%, normal 5.68%, P=.017). Among controls, values were similar. Intergroup comparison showed that among overweight patients, the test group showed a significant increase in the mean HbA1c value compared to controls (cases 5.89%, controls 5.65%, P = .016). Pearson's correlation comparing plaque scores and HbA1c values of the entire sample was positive and revealed significance at the level of 0.01. CONCLUSION: There was no clear-cut link between severe periodontitis and glycemic control in nondiabetic individuals. Severe periodontitis patients who were also overweight showed significantly higher HbA1c values compared to their normal counterparts.