Clinical and radiographic evaluation of 0.8% hyaluronic acid as an adjunct to open flap debridement in the treatment of periodontal intrabony defects: randomized controlled clinical trial.

OBJECTIVES: Present study aimed to evaluate and compare the clinical and radiographic efficacy of 0.8% hyaluronic acid (HA) gel as an adjunct to open flap debridement (OFD) versus open flap debridement (OFD) alone in the treatment of periodontal intrabony defects. MATERIALS AND METHODS: This randomized, controlled, split-mouth, clinical trial included 20 chronic periodontitis (stage II or III (grades A to B)) patients, having at least two contralateral intrabony defects. Forty bilateral intrabony defects (20 in each group) were randomly divided into test (0.8% HA gel + OFD) and control (OFD + placebo) groups. Clinical parameters evaluated at baseline, 6-months, and 12-months were plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and gingival recession (GR). Using cone beam computed tomography (CBCT), radiographic parameters were evaluated at baseline and 12 months. This included bone defect fill (DF), alveolar crest changes (ACC), and defect resolution (DR). CAL served as the primary outcome variable. RESULTS: After 12 months, the test group showed significantly greater CAL gain (5.1 ± 1.2 versus 4.05 ± 1.19 mm) and bone defect fill (DF) (5.67 ± 2.01 versus 4.49 ± 1.78 mm) compared to the control group. Mean PD reduction in the test group (5.3 ± 1.2 versus 4.35 ± 0.81 mm) was statistically significant compared to the control group at 12-month period. The control group showed statistically significant increase in GR (1.2 ± 0.76 versus 0.7 ± 0.73 mm) compared to the test group after 12 months. CONCLUSION: Application of hyaluronic acid gel in conjunction with open flap debridement resulted in enhanced clinical and radiographic outcomes compared to open flap debridement alone. CLINICAL RELEVANCE: Adjunctive application of HA gel in open flap debridement may improve clinical and radiographic outcomes. CLINICAL TRIAL REGISTERED NUMBER: CTRI/2018/03/012334.

Impact of different platelet-rich fibrin (PRF) procurement methods on the platelet count, antimicrobial efficacy, and fibrin network pattern in different age groups: an in vitro study.

OBJECTIVES: Platelet-rich fibrin (PRF) procuring protocols have been suggested, differing in speed and time duration. Since different derivation protocols may alter PRF characteristics, the present study was conducted to evaluate the variations in the fibrin network pattern, platelet count, and antimicrobial efficacy of PRF procured using variable centrifugation speeds and time durations in different age groups. MATERIALS AND METHODS: Sixty healthy subjects participated in the study and were equally divided into three age groups (20-34 years, 35-49 years, 50-65 years). From each age group, total of 6 PRF membranes were fabricated from 10 ml tubes. Three PRF membranes were obtained at 1400, 2800, and 3500 rpm for 8 min while other 3 membranes were obtained after 15 min of centrifugation respectively. The relative centrifugal force (RCF) values were within the spectrum of 228-1425 g. PRF membranes were then subjected to platelet count estimation, antimicrobial activity against oral bacteria, and changes in fibrin network pattern with respect to different age groups and different centrifugation protocols. RESULTS: Highest platelet concentration, antimicrobial activity, and dense fibrin network were obtained in 20-34 years age group. Intragroup analysis within each group revealed highest platelet count and antimicrobial activity in PRF membranes, obtained at 1400 rpm for 8 min. Denser fibrin network pattern was demonstrated by PRF membranes procured at 3500 rpm for 15 min. CONCLUSIONS: PRF properties, i.e., platelet count, antimicrobial efficacy, and fibrin network, are influenced by technical aspects of PRF preparation (RCF value, centrifugation speed, and time) and patient age. CLINICAL RELEVANCE: Based on the finding of present study, it can be implied that lower centrifugation speed and time can increase the platelet concentration and antimicrobial activity of the PRF membrane. Contrarily, lowering the speed and time leads to lesser density fibrin network pattern. Centrifugation protocols thus need to be adapted accordingly.

Subgingivally delivered coenzyme Q10 in the treatment of chronic periodontitis among smokers: A randomized, controlled clinical study.

BACKGROUND: Coenzyme Q10 is an antioxidant whose efficacy in periodontal diseases is well known. However studies regarding its efficacy in smokers with periodontitis are few. Coenzyme Q10 serves as an endogenous antioxidant and its increased concentration in the diseased gingiva effectively suppresses advanced periodontal inflammation. OBJECTIVES: The aim of this study is to evaluate the efficacy of coenzyme Q10 as an adjunct to scaling and root planing in smokers with chronic periodontitis. METHODS: Total of 40 patients were enrolled for the study. The subjects were divided into control (Scaling and root planing only) and test group (Coenzyme Q10 plus Scaling and root planing). Clinical parameters such as plaque index, modified sulcular bleeding index, probing pocket depth and clinical attachment level. These were assessed at baseline, at 1 month and 3 month. The results were subjected to appropriate statistical analysis. RESULTS: There was a significant improvement in all clinical parameters in the test sites seen at the end of the 1 month and 3 month period. CONCLUSIONS: Coenzyme Q10 can be said to have a beneficial effect on smokers with periodontitis when used as an adjunct to scaling and root planing.

Antimicrobial photodynamic therapy using indocyanine green as a photosensitizer in treatment of chronic periodontitis: A clinico-microbial study.

BACKGROUND: Photodynamic therapy (PDT) has gained much attention in recent years in the treatment of periodontitis. Number of photosensitizer have been developed and has been used in various clinical studies. However, the use of recently developed photosensitizer has been limited. AIM: The present study aims at comparing and evaluating the effects of photodynamic therapy using Indocyanine green in the treatment of chronic periodontitis. MATERIALS AND METHODS: In present randomized clinical trial, 30 subjects were equally divided into two groups i.e. test group (SRP + Photodynamic therapy) & control group (SRP). Clinical parameters evaluated at baseline and 3 month follow up were, Plaque index, Sulcus Bleeding Index, Probing Pocket Depth, Clinical Attachment Level, Gingival Recession. Microbiological analysis of plaque sample was also done to check for anaerobic mixed flora. RESULTS: Significant reduction was seen in all the clinical parameters in the test group. Anaerobic culture of plaque samples of test group also revealed significant reduction of microorganisms in comparison with control group. CONCLUSION: Indocyanine Green can act as an alternative to other photosensitizers in photodynamic therapy as an adjunct to SRP in the treatment of chronic periodontitis.