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Introduction Low-level laser therapy (LLLT) has a beneficial effect on pain relief and wound healing. This study aims at a clinical evaluation of early wound healing and a biochemical evaluation of inflammatory mediators in gingival crevicular fluid (GCF) following LLLT with an open flap debridement (OFD) in periodontal therapy. Material and methods This randomized controlled trial included 40 chronic periodontitis patients with bilateral attachment loss, pocket depths of 5 mm affecting at least two quadrants, and radiographic evidence of horizontal bone loss. 120 control sites were randomly selected to receive OFD, and contralateral 120 test sites received bio-stimulation with a diode laser (890 nm) after OFD. The wound healing index was recorded at the 1st and 2nd weeks, and clinical parameters such as the plaque index, gingival index, pocket probing depth, clinical attachment level, and GCF inflammatory mediators were evaluated at baseline, 3, and 6 months. Results From the start of the study to 6 months later, there was a statistically significant drop in plaque index, gingival index, probing pocket depth, and gain clinical attachment levels in both groups. However, when the two groups were compared, there were no significant differences at any time intervals. GCF inflammatory mediators tumor necrosis factor (TNF) alpha and matrix metalloproteinases (MMP-8) decrease, and osteoprotegerin (OPG) levels increase in both the test group and control group from baseline to 3 months and 6 months. In intergroup comparisons, there was a statistically significant reduction in the test group as compared to the control group at 6 months. There was a decline in gingival crevicular fluid - interleukin-6 (GCF IL-6) levels from baseline to 3 months and 6 months in both the groups but when analysed statistically, the results were not significant on intergroup and intragroup comparison at any time interval. The Landry Wound Healing Index values in the 1st and 2nd weeks were showing statistically significant improved healing in the test group as compared to the control group. There was significantly better wound healing at sites where a diode laser was used. Conclusion LLLT increases early wound healing after periodontal surgical procedures.
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Context: Smokeless tobacco (SLT) has been consumed in India since times immemorial. It is the need of an hour to emphasise about awareness and harmful effects of SLT in relation to periodontium. Aim: The aim of the study was to access the prevalence of periodontitis and its association with SLT amongst the adult population of Greater Noida, India. Settings and Design: Hospital-based study and cross-sectional design. Methods and Material: This cross-sectional study included 512 SLT subjects between the ages of 18 and 79 years. The study was carried out from December 2019 to January 2022. A self-designed questionnaire was used for recording demographic details, forms of SLT, frequency, duration of use, and sites of retention of SLT products. The clinical periodontal parameters such as periodontal pocket depth (PPD) and clinical attachment level (CAL) were recorded in a given point of time. Statistical Analysis Used: Chi-square test and logistic regression analysis. Results: The prevalence of periodontitis among SLT was 81.6% with the highest occurrence of Stage III Periodontitis (35.4%). The use of SLT for ≥10 years [odds ratio (OR) = 3.05, 95% confidence interval (CI) 1.86-6.27] showed threefold the risk for periodontitis compared to others who consumed SLT for 4-5 years. Gutkha consumers [OR = 2.56 (95% CI = 0.75-3.48)] were 2.56 times more prone to have periodontitis as compared to other forms of SLT. Conclusions: Periodontitis is positively associated with SLT use. Awareness, timely intervention, and periodic screening in the SLT users will help to prevent the progression of periodontitis.
