[Clinical and microbiological effects of the initial periodontal therapy].

INTRODUCTION: Periodontitis is a destructive inflammatory disease of the tooth-supporting tissues, primarily caused by Gram-negative microorganisms. Thus, the primary objective of cause-related initial periodontal therapy is disruption and removal of the subgingival biofilm. OBJECTIVE: The aim of this study was to evaluate the clinical and microbiological effects of the initial therapy in patients diagnosed with chronic periodontitis. METHODS: Forty patients with chronic periodontitis were included in the study. As a part of the clinical assessment undertaken prior to the initial therapy, as well as one month and three months post-therapy, plaque index, gingival index, papilla bleeding index, probing pocket depth and clinical attachment level were recorded. Microbiological testing was performed prior to the initial therapy and three months after therapy. Polymerase chain reaction assays were used to determine the presence of Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans. RESULTS: All clinical parameters were significantly reduced after therapy. The prevalence of Aggregatibacter actinomycetemcomitans was reduced by 22.5%, which was a statistically significant decrease compared to the baseline. The prevalence of Porphyromonas gingivalis, Tannerella forsythensis and Prevotella intermedia tended to decrease after therapy; however, the difference did not reach statistical significance. CONCLUSION: The results of the present study demonstrated the beneficial effects of the initial periodontal therapy on both the clinical and microbiological parameters.

[Impact of the level of metabolic control on the non-surgical periodontal therapy outcomes in diabetes mellitus type 2 patients--clinical effects].

INTRODUCTION: Diabetes mellitus as a complex metabolic disease influences functioning of numerous organs. Chronic periodontitis is one of frequent diabetic complications. OBJECTIVE: The aim of this study was to compare the clinical effects of non-surgical periodontal therapy between diabetes mellitus type 2 patients (DM type 2) and non-diabetic individuals (control group). METHODS: Our study included 41 DM type 2 subjects and 21 non-diabetic individuals, all of them with chronic periodontitis. The diabetic group was divided into two subgroups based on the level of glycosylated hemoglobin (HbA1c) as follows: D1 - 18 subjects with good metabolic control (HbA1c < 7%), and D2 - 23 subjects with poor metabolic (HbA1c > or = 7%). State of oral hygiene and periodontal clinical parameters of subjects, such as: plaque index (PI), gingival index (GI), papilla bleeding index (PBI), probing pocket depth (PPD) and clinical attachment level (CAL), were evaluated at the baseline and 3 months after scaling and root-planning. RESULTS: ANOVA test showed that there was no statistically significant difference of treatment success between studied groups in relation to GI (p = 0.52), PBI (p = 0.36) and CAL (p = 0.11). Reduction of PI and PPD in the control group (deltaPI = 0.84; deltaPPD = 0.35 mm) was significantly higher (p < 0.05) than the reduction of PI and PPD in patients with the diabetes (group D1 deltaPI = 0.60, deltaPPD = 0.11 mm; group D2 deltaPI = 0.53, deltaPPD = 0.11 mm). CONCLUSION: Although there were differences in treatment success between DM subjects and non-diabetic individuals, they were not significant for the most measured parameters. The results of this study did not absolutely support the assumption that the level of glycemic control significantly affected the periodontal therapy outcome in diabetics.