Probiotic mouthwash as an adjunct to mechanical therapy in the treatment of stage II periodontitis: A randomized controlled clinical trial.

OBJECTIVES: Dysbiosis of oral microbiome play an integral role in periodontitis. Bacterial balance is an important aspect of host defence. Mechanical debridement alone is insufficient to manage many cases. Probiotics are a novel adjunctive strategy, but the beneficial effects of probiotics in the management of moderate periodontitis have not been evaluated before. The objective of the present study was to assess the efficacy of probiotic mouth rinse of Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum and Saccharomyces boulardii as an adjunct to mechanical debridement in grade II periodontitis. The study also evaluated change in salivary pH and IgA in both groups. METHODS: The study was registered under Clinical Trial Registry of India (CTRI NO: CTRI/2019/10/021630). 60 patients with stage II periodontitis were randomized into probiotic and placebo group (n = 30 in each group) after mechanical debridement. Patients were instructed to use mouth rinse twice a day for 30 days. Periodontal parameters (Plaque index, Gingival index, Pocket depth and clinical attachment level) were recorded at baseline, after 1 and 3 months. Salivary pH was tested using a pH metre and IgA using enzyme linked immunosorbent assay. RESULTS: Significant improvement in all clinical parameters were noted in both the groups after 1 and 3 months. Intergroup comparison revealed significant difference in gingival index, probing depth and clinical attachment gain. Significant elevation of salivary IgA and pH was noticed in probiotic group in contrast to placebo group. CONCLUSION: The present study supports the use of probiotic mouthwash as an adjunct to mechanical therapy for the management of stage II periodontitis.

Adjunctive benefit of ozonized water irrigation with mechanical debridement in the management of Stage III periodontitis: A randomized controlled clinical and biochemical study.

OBJECTIVE: Periodontitis is a chronic inflammatory disease initiated by dysbiotic microbiota. Conventional mechanical debridement often needs adjunctive measures to control the disease process. The objective of the present study was to find out benefit of ozonized water irrigation along with nonsurgical periodontal therapy for the management of periodontitis. METHODS: We have conducted a randomized controlled, triple-blinded, parallel-group clinical trial. The test group (n = 25) was treated with ozonized water irrigation, whereas the control group (n = 25) received normal saline irrigation along with mechanical debridement. Full mouth plaque score, bleeding score, probing pocket depth and clinical attachment loss were evaluated at baseline and 4 weeks after treatment. Salivary interleukin 1 beta was analysed using enzyme linked immunosorbent assay. Analysis of covariance, t test and chi-square test were used for intergroup comparison. Intragroup comparison was done using the paired t test. RESULTS: Adjunctive ozone water irrigation resulted in significant improvement in all clinical parameters, except probing pocket depth after adjusting the extraneous effects due to initial confounding factors (p < 0.001). But as per subgroup analysis, ozone water irrigation resulted in significant reduction in pocket depth in deep pockets (p = 0.01) and the number of sites with a pocket depth ≥4 mm with bleeding on probing. Salivary interleukin 1 beta also reduced significantly in the test group after therapy. CONCLUSION: Ozone irrigation provides adjunctive benefit along with nonsurgical periodontal therapy in reducing clinical parameters and inflammatory mediators in saliva. But long-term benefits need to be assessed with future studies. The study was registered in the Clinical Trial Registry of India (CTRI no: CTRI/2020/06/026275).

Detection of cervical lesions by multivariate analysis of diffuse reflectance spectra: a clinical study.

Diffuse reflectance (DR) spectroscopy is a non-invasive, real-time, and cost-effective tool for early detection of malignant changes in squamous epithelial tissues. The present study aims to evaluate the diagnostic power of diffuse reflectance spectroscopy for non-invasive discrimination of cervical lesions in vivo. A clinical trial was carried out on 48 sites in 34 patients by recording DR spectra using a point-monitoring device with white light illumination. The acquired data were analyzed and classified using multivariate statistical analysis based on principal component analysis (PCA) and linear discriminant analysis (LDA). Diagnostic accuracies were validated using random number generators. The receiver operating characteristic (ROC) curves were plotted for evaluating the discriminating power of the proposed statistical technique. An algorithm was developed and used to classify non-diseased (normal) from diseased sites (abnormal) with a sensitivity of 72 % and specificity of 87 %. While low-grade squamous intraepithelial lesion (LSIL) could be discriminated from normal with a sensitivity of 56 % and specificity of 80 %, and high-grade squamous intraepithelial lesion (HSIL) from normal with a sensitivity of 89 % and specificity of 97 %, LSIL could be discriminated from HSIL with 100 % sensitivity and specificity. The areas under the ROC curves were 0.993 (95 % confidence interval (CI) 0.0 to 1) and 1 (95 % CI 1) for the discrimination of HSIL from normal and HSIL from LSIL, respectively. The results of the study show that DR spectroscopy could be used along with multivariate analytical techniques as a non-invasive technique to monitor cervical disease status in real time.