The effectiveness of using the perioscope as an adjunct to non-surgical periodontal therapy: Clinical and radiographic results.

BACKGROUND: It is well known that following root surface debridement (RSD) residual deposits remain. Periodontal endoscopy has provided a method of directly visualizing root surfaces during periodontal debridement in an intact pocket without the need for surgical incision. The aim of this study was to determine if periodontal debridement using endoscopic visualization was more effective in improving clinical and radiographic parameters as compared to RSD. METHODS: Thirty-eight subjects were randomized into RSD with perioscope (n = 19) or RSD only (n = 19) groups. A full-mouth evaluation included probing pocket depths (PPDs), clinical attachment levels (CAL), bleeding on probing (BOP) and plaque scores (PI) recorded at baseline, 3 and 12 months and compared among groups. Radiographs were taken at sites with deepest pockets at baseline and 12-month and the change in radiographic bone levels (RBL) compared. An independent samples T-test was used to assess statistical significance. RESULTS: Both groups had significant improvements in clinical outcomes. The test (T) group had a significantly lower percentage of PPDs 7 to 9 mm at three (0.72 ± 1.2%) and 12 months (0.5 ± 1.0%) as compared with the control (C) group (2.25 ± 2.9%; 1.84 ± 2.3%). At 12 months, the test group recorded a significantly lower mean PPD (T: 2.70 + 0.2 mm; C: 2.98 ± 0.4 mm), BOP% (T: 4.3 ± 3.2%; C: 11.95 ± 7.1%), PI% (T: 25.61 ± 3.9%; C: 30.11 ± 6.3%) and less change in gingival recession (T: -0.13 ± 0.2 mm; C: -0.50 ± 0.6 mm) (P < 0.05). More radiographic bone gain was observed in the test group (0.69 ± 0.3 mm) as compared with the control group (0.49 ± 0.2 mm). This was also observed around multi-rooted teeth (T: 0.83 ± 0.45 mm; C: 0.46 ± 0.36 mm). CONCLUSION: The adjunctive use of the perioscope provided a slight benefit to the outcomes of non-surgical therapy particularly at deeper probing depths.

Mass spectrometric analyses of peptides and proteins in human gingival crevicular fluid.

Gingival crevicular fluid (GCF) is a pathophysiological fluid that flows into the oral cavity. Human GCF was collected using sterile glass microcapillary tubes from inflamed periodontal sites in patients who had a history of periodontal disease and were in the maintenance phase of treatment. Samples from individual sites were analyzed using MS techniques both before and following HPLC. GCF samples were also pooled and subjected to SDS-PAGE, in-gel digestion and MS analyses using both MALDI-TOF/TOF MS and nanoLC-ESI-MS/MS. MS spectra were used to search human protein sequence databases for protein identification. With these approaches, 33 peptides and 66 proteins were positively identified in human GCF. All of the peptides discovered in this study are reported in GCF here for the first time. Forty-three of the identified proteins, such as actin and the actin binding proteins profilin, cofilin and gelsolin, have not been reported in GCF before.