Triphala, a New Herbal Mouthwash for the Treatment of Gingivitis: A Randomized Controlled Clinical Trial.

BACKGROUND: An antiplaque agent with minimal side effects that can be used as an effective adjunct to mechanical plaque control is needed. The current study is designed to evaluate efficacy of triphala (TRP) mouthwash in reduction of plaque and gingivitis. METHODS: Ninety individuals with chronic generalized gingivitis were randomly assigned to three groups: 1) group I, placebo mouthwash; 2) group II, TRP mouthwash; and 3) group III, chlorhexidine (CHX) mouthwash. All individuals were instructed to rinse with their respective mouthwash twice daily. 1) Plaque index (PI); 2) gingival index (GI); 3) oral hygiene index-simplified (OHI-S); and 4) microbiologic colony counts were recorded at baseline and at 7, 30, and 60 days. RESULTS: All three groups showed gradual reduction in PI, GI, and OHI-S levels from baseline to 7, 30, and 60 days. There was also significant reduction in microbial counts in all groups at all time intervals except in group I. A significant difference was noticed with respect to reduction in PI, GI, OHI-S, and microbiologic counts in group I compared with groups II and III. However, no significant differences were found between groups II and III for any parameters at any time intervals. CONCLUSIONS: TRP mouthwash was found to decrease inflammatory parameters from baseline to follow-up intervals. Because improvement in gingivitis was comparable with that of CHX mouthwash, TRP mouthwash can be considered a potential therapeutic agent in the treatment of gingivitis.

Platelet-Rich Fibrin Combined With 1.2% Atorvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial.

BACKGROUND: Platelet-rich fibrin (PRF), a second-generation platelet concentrate, and atorvastatin (ATV), a potent member of the statin group, are known to promote tissue regeneration. The current study is designed to evaluate combined efficacy of PRF and 1.2% ATV gel with open flap debridement (OFD) in treatment of intrabony defects (IBDs) in individuals with chronic periodontitis (CP). METHODS: Ninety-six individuals with single defects were categorized into three groups: 1) OFD with PRF; 2) OFD with PRF + 1.2% ATV; and 3) OFD alone. Clinical parameters: 1) site-specific plaque index; 2) modified sulcus bleeding index; 3) probing depth (PD); 4) relative clinical attachment level (rCAL); and 5) gingival marginal level were recorded at baseline before surgery and 9 months postoperatively. Percentage radiographic IBD depth reduction was evaluated at baseline and 9 months. RESULTS: PRF + 1.2% ATV and PRF alone showed significantly greater PD reduction and rCAL gain compared with OFD alone at 9 months. Furthermore, PRF + 1.2% ATV showed a similar percentage radiographic defect depth reduction (50.96% ± 4.88%) compared with PRF alone (47.91% ± 4.79%), and a greater reduction compared with OFD alone (5.54% ± 1.71%) at 9 months. CONCLUSIONS: PRF + 1.2% ATV showed similar improvements in clinical parameters with a greater percentage radiographic defect depth reduction compared with PRF alone in treatment of IBDs in individuals with CP. Thus, 1.2% ATV failed to augment the regenerative potential of PRF alone in periodontal IBDs.

Expression of key executioner of apoptosis caspase-3 in periodontal health and disease.

AIM: A highly-regulated form of programmed cell death is apoptosis, and its perturbation has been associated with periodontal disease. Caspase-3 is one of the key executioners of apoptosis. The present study was designed to evaluate and correlate the levels of caspase-3 in gingival crevicular fluid (GCF) and serum in participants with clinically-healthy periodontium, gingivitis, and chronic periodontitis (CP). METHODS: Forty-four sex- and age-matched participants were enrolled into three groups based on clinical parameters. Group 1 participants had clinically-healthy periodontium, group 2 participants had gingivitis, and group 3 participants had CP. GCF and serum samples were collected to evaluate the levels of caspase-3. RESULTS: The mean caspase-3 concentration in GCF and serum was highest in group 3, followed by group 2, and was significantly correlated with gingival index, probing depth (PD), and clinical attachment level (CAL). CONCLUSION: GCF and the serum concentration of caspase-3 proportionally increases with the progression of periodontal disease, that is, gingival inflammation, PD, and CAL.

Clinical and microbiological effects of systemic azithromycin in adjunct to nonsurgical periodontal therapy in treatment of Aggregatibacter actinomycetemcomitans associated periodontitis: a randomized placebo-controlled clinical trial.

OBJECTIVE: This study aimed to evaluate clinical and microbiological effects of systemic azithromycin (AZM) in adjunct to nonsurgical periodontal therapy (NSPT; or scaling root planing - SRP) in treatment of Aggregatibacter actinomycetemcomitans associated periodontitis (AAAP). METHODS AND MATERIALS: Seventy individuals with moderate to severe periodontitis and subgingival detection of A. actinomycetemcomitans were randomly allocated to two groups. Thirty-five individuals were allocated to full mouth SRP+AZM (500 mg oral delivery (OD) × 3 days) while 35 individuals were allocated to SRP+Placebo (OD × 3 days) group. The clinical variables evaluated were probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and percent bleeding on probing sites (%BOP), while microbiologic variables included percentage of subjects positive for A. actinomycetemcomitans at baseline, 3, 6, and 12 months. RESULTS: The AZM group showed statistically significant reduction in mean PD (2.91 ± 0.88 mm) as compared to placebo (1.51 ± 0.98 mm) (P < 0.001), while CAL gain was significant in the AZM group (2.71 ± 1.15 mm) as compared to the placebo group (1.71 ± 1.29 mm) (P < 0.001). There was also a statistically significant reduction in the number of subjects positive for A. actinomycetemcomitans in the AZM group (P < 0.0001). CONCLUSION: Azithromycin was found to significantly improve the clinical and microbiological parameters in AAAP individuals.

Periodontal health condition in patients with Alzheimer's disease.

OBJECTIVE: To compare periodontal health status in individuals with and without Alzheimer's disease (AD). METHODS: A total of 58 individuals with AD and 60 cognitively normal (ND) adult individuals, ranging in age from 50 to 80 years, were assessed for periodontal health status. Individuals with AD were further divided as mild, moderate, and severe, based on degree of cognitive impairment as evaluated using Mini-Mental State Examination. Gingival index (GI), plaque index (PI), probing depth (PD), clinical attachment level (CAL), and percentage of bleeding sites (%BOP) were evaluated. RESULTS: All the evaluated periodontal parameters were higher in individuals with AD than that in ND individuals, and the periodontal status deteriorated with the progression of AD. There were significant differences in mean GI, PI, PD, CAL, and %BOP between all the groups. CONCLUSION: The periodontal health status of individuals with AD deteriorates with disease progression and was closely related to their cognitive function.

Correlation of human S100A12 (EN-RAGE) and high-sensitivity C-reactive protein as gingival crevicular fluid and serum markers of inflammation in chronic periodontitis and type 2 diabetes.

OBJECTIVE: The aim of the present study was to evaluate the levels and correlation of human S100A12 and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid (GCF) and serum in chronic periodontitis (CP) subjects with and without type 2 diabetes mellitus (DM). MATERIALS AND METHODS: A total of 44 subjects were divided into three groups: group 1 had 10 periodontally healthy subjects, group 2 consisted of 17 CP subjects and group 3 had 17 type 2 DM subjects with CP. GCF and serum levels of human S100A12 and hs-CRP were quantified using enzyme-linked immunosorbent assay and immunoturbidimetric analysis, respectively. The clinical outcomes evaluated were gingival index, probing depth and clinical attachment level and the correlations of the two inflammatory mediators with clinical parameters were evaluated. RESULTS: Both human S100A12 and hs-CRP levels increased from group 1 to group 2 to group 3. The GCF and serum values of both these inflammatory mediators correlated positively with each other and with the periodontal parameters evaluated (p < 0.05). CONCLUSION: Human S100A12 and hs-CRP can be considered as possible GCF and serum markers of inflammatory activity in CP and DM.