Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis

BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.

Topical Application of Ascorbic Acid Solution as an Adjunctive Method of Periodontal Therapy among Wet Snuff Users after Prosthodontics Therapy

Background: During several years, ascorbic acid (vitamin C) played a significant role in the health of periodontal tissues. The goals of prosthodontics management are to restore the missing teeth, provide the loss of teeth functions, and establish acceptable dental esthetics, and there are some evidences revealing the passive effects of snuff on the results of prosthodontics and periodontal treatment, so the present study is performed to evaluate the outcomes of topical application of ascorbic acid solution as an adjunctive method of periodontal therapy among wet sniff users after prosthodontics therapy. Methods: The clinical situation was evaluated in 150 moderate periodontitis patients after conventional periodontal and prosthodontics therapy. They were selected from outpatient clinics, college of dentistry, King Khalid University, and from some hospitals Ministry of Health in Tabuk, Jazan and Aseer regions. The study was conducted from September 2020 to December 2020. The time of post-treatment assessment was one year. The study was included 50 patients who don’t use wet snuff as a group I (GI) (control group), 50 patients wet snuff users as group II (GII), and 50 patients wet snuff users were treated with topical application of ascorbic acid solution as group III (GIII). The participants were aged over 20 years, with a mean age of 35 years. The duration of using wet snuff was at least one year. Plaque index (PLI), gingival index (GI), clinical attachment loss (CAL) were recorded at baseline (first visit), then after 4 weeks (second visit) and after 6 weeks (third visit) of conventional periodontal therapy and topical application of ascorbic acid solution. Statistical analysis was done using ANOVA test and paired t-test. Results: According to statistical analysis, there was the inclination of decrease in the mean and standard deviation of plaque index (PLI) from 2.8 ± 1.4 to 2.5 ± 0.51, and 2.7 ± 0.33 in group II, and decrease from 2.7 ± 0.34 to 2.5 ± 0.23 and 2.6 ± 0.65 in group III. Similarly in the gingival index (GI), there was a decrease in the mean and standard deviation from 2.8 ± 0.52 to 2.3 ± 0.62 and 2.5 ± 0.51 in group II and a decrease from 2.5 ± 0.8 to 2.3 ± 0.58 and 2.4 ± 0.47 in group III. Moreover, there was a decrease in the mean and standard deviation of clinical attachment loss (CAL) from 4.5 ± 0.26 to 3.9 ± 0.83 and 4.2 ± 0.83 in group II and from 4.2 ± 0.31 to 3.8 ± 0.46 and 3.8 ± 0.31 in group III;less than group I without significance differences (p > 0. 05) in all study groups at baseline and after 4 weeks, and 6 weeks of follow up except CAL. Conclusion: The results of our study displayed that periodontal parameters vary among wet snuff users after topical application of ascorbic acid solution as an adjunctive method of periodontal therapy

Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis

AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis(CHP).METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters(plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin(HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.RESULTS Both groups were comparable at baseline. Three months after non surgical periodontal therapy(NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was-0.056 ± 0.10 and-1.66 ± 6.04 respectively, which was significant between case and control group(P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT(P < 0.05).CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

Functional biomaterials for comprehensive periodontitis therapy

Periodontitis is an inflammatory disease caused by bacterial infection directly, and the dysregulation of host immune-inflammatory response finally destroys periodontal tissues. Current treatment strategies for periodontitis mainly involve mechanical scaling/root planing(SRP), surgical procedures,and systemic or localized delivery of antimicrobial agents. However, SRP or surgical treatment alone has unsatisfactory long-term effects and is easy to relapse. In addition, the existing drugs for local periodontal therapy do not stay in the periodontal pocket long enough and have difficulties in maintaining a steady, effective concentration to obtain a therapeutic effect, and continuous administration always causes drug resistance. Many recent studies have shown that adding bio-functional materials and drug delivery systems upregulates the therapeutic effectiveness of periodontitis. This review focuses on the role of biomaterials in periodontitis treatment and presents an overview of antibacterial therapy, host modulatory therapy, periodontal regeneration, and multifunctional regulation of periodontitis therapy. Biomaterials provide advanced approaches for periodontal therapy, and it is foreseeable that further understanding and applications of biomaterials will promote the development of periodontal therapy.