Electrocautery-Assisted Management of Unilateral Pyogenic Granuloma: A Case Report.

Pyogenic granuloma (PG) refers to an acquired benign proliferation most commonly seen within the oral cavity involving lips, palate, and gingiva. The term is misleading since it is a type of lobular capillary haemangioma but not an infection. It frequently recurs but lacks the capacity for malignant alteration. Depending on where the PG is located, one may experience discomfort or irritation. PGs often lead to differential diagnoses by clinicians, which include capillary hemangioma, neurofibroma, melanoma, and hyperplasia. Therefore, one must confirm a PG by diagnosing and analysing it by clinical and histopathological examinations, and treatment options should be formulated according to the evaluation. Sometimes, a biopsy of the lesion can be taken for final diagnosis. Various treatment approaches are available, including conventional scalpel excision, laser, electrocautery, and cryotherapy. Surgical excision is preferable due to the likelihood of malignancy, as it provides the best cosmetic appearance and produces a specimen for pathologic assessment. After confirming all the clinical evaluatory parameters and routine haematological examinations, which proved satisfactory and within normal ranges, this case of a 45-year-old female with soft tissue growth of the gingival origin was managed by electrocautery, and the PG was confirmed by a clinical-histopathological examination.

Management of Aberrant Frenum by Z-plasty Procedure: A Case Report.

During or after the orthodontic closure, persistent diastemas are frequently the result of a high frenum attachment. A labial frenectomy is a complete removal of the frenum attachment, which typically attaches to the space between the upper two anterior teeth and the centre of the upper lip. It might be required if there is space between the teeth due to a frenulum positioned too high on the gums. Many surgical technique modifications, including Miller's technique, Z-plasty, and V-Y-plasty, have been established since the conventional classical frenectomy procedure was initially presented to cope with the difficulties associated with an aberrant labial frenum. This case report demonstrates that a Z-plasty approach was used to remove the 21-year-old female patient's high papillary-type labial frenum attachment and how orthodontic treatment led to the closure of the midline diastema. For several reasons, the frenectomy procedure with Z-plasty proved to be reliable and yielded outstanding aesthetic outcomes for the removal of the aberrant labial frenum connection. Understanding Z-plasty will enable primary intention-based tissue healing, reduce the risk of tissue contractures, shorten the patient's recovery, and enhance the patient's aesthetic outcomes.

Recent Modalities in Pain Control and Local Anesthesia in Dentistry: A Narrative Review.

Pain in the orofacial region or within the tooth is one of the most common complaints patients report to a dental office. An efficient practitioner must have adequate knowledge and tools to address and remedy the problem. Pain control in dentistry has a rich history and learning about it gives an insight into how the current modalities being used came into existence. As dentistry keeps evolving, newer and more efficient modalities have been developed for pain control. Dental pain is primarily remedied by dental practitioners and clinicians involved in emergency medicine; it may result due to various causes, mainly insulting the tooth or complications involved in and after oral surgery. Several modalities have been developed to reduce and eliminate this, including pharmacological and non-pharmacological treatment modalities. Pharmacological modalities include using drugs. Many medications are used for pain management, such as non-steroidal anti-inflammatory drugs, corticosteroids, and muscle relaxants. Non-pharmacological modalities include behavior control methods based on several theories of pain. These modalities are used mainly for children, but some can also be used for adult patients. Several advances in delivery systems for local anesthesia involve using newer technologies to deliver a sustained dose of anesthetic agent. This review aims to enlist both modalities of pain control management in dental practices along with the newer advancements in this field.

Management of Peripheral Cemento-Ossifying Fibroma Associated With Maxillary Anterior Teeth: A Case Report.

The peripheral cemento-ossifying fibroma (PCOF) lesion primarily affects females in their second decade of living. These lesions are more frequently associated with the gingival margin, the anterior surface of the molars, and the maxilla. On clinical examination, PCOF typically appears as a well-differentiated, slowly expanding gingival mass in the interdental papilla region that is less than 2 cm in size. The surface may seem ulcerated, the base may be sessile or sometimes pedunculated, and the colour is either the same as the gingiva or reddish. The histological examination, which identifies cellular connective tissue and the focal presence of bone or calcifications, provides the basis for the final diagnosis. Treatment modalities for the PCOF include surgical excision of the lesion. A 38-year-old female reported slow-growing swelling associated with the maxillary anterior region. Removal of the lesion is done by using a scalpel, and histopathological examination revealed the peripheral type of cemento-ossifying fibroma. This case report demonstrates the management of PCOF lesions with the conventional scalpel approach with the help of proper clinical examination, radiological findings, and histopathological examination, which reveals favourable outcomes in the patient regarding esthetics and improves mastication-related issues and speech.

Implications of Gene Therapy in Dentistry and Periodontics: A Narrative Review.

The relentless march of technological progress entails constant evolution and adaptation. A concerted effort is underway in medical research to unravel various diseases' cellular and molecular underpinnings. The traditional approaches to disease treatment often fall short of delivering entirely satisfactory outcomes, which has prompted a shifting spotlight on gene therapy as a versatile solution for many inherited and acquired disorders. Genes, intricate sequences of genetic code, are the complicated blueprints dictating the production of essential proteins within the human body. Remarkably, each individual's genetic makeup is uniquely distinct, with variations in these genetic sequences serving as the bedrock of our diversity. Gene therapy represents an innovative medical strategy that harnesses the power of genes themselves to function as therapeutic agents. It serves as a conduit through which defective genes are either substituted or mended with the introduction of remedial genetic material. This groundbreaking method can tackle various illnesses, from conditions originating from single-gene abnormalities to intricate disorders influenced by multiple genes. In dentistry and periodontics, gene therapy finds a promising array of applications. It contributes significantly to managing salivary gland disorders, autoimmune diseases, and the regeneration of damaged bone tissue, as well as addressing cancerous and precancerous conditions. Moreover, the possibilities extend into DNA vaccination and broader areas of oral health. The advent of gene therapy in dentistry represents a new era of significant progress, offering substantial advancements in the management of periodontal disease and the reconstruction of the dental alveolar apparatus. The aim of this narrative review is to provide a comprehensive overview of the landscape of gene therapy investigations in these disciplines, shedding light on its potential implications for oral health and treatment. With its potential to rectify the genetic underpinnings of various conditions, gene therapy offers a novel frontier in healthcare that continually shapes the landscape of medicine and holds the promise of more effective and personalised treatments.

Conventional Scalpel and Diode Laser Approach for the Management of Traumatic Fibroma.

An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral fibrous hyperplasia, and traumatic fibroma. Chronic irritation from things like biting one's lips or cheek, orthodontic treatments, rubbing against a hard tooth, or wearing dentures or other dental prostheses is frequently the cause. It is often the same colour as the surrounding mouth lining, but occasionally, it can be paler or appear darker if it has bled. Trauma can cause the surface to become rough and scaly or ulcerated. It is primarily dome-shaped and similar to a pedunculated polyp. A traumatic fibroma most frequently occurs on the inside of the cheek. The inside of the lower lip, the gingiva, and the sides of the tongue are other frequent locations. The given case series reported traumatic fibroma associated with anterior teeth and buccal mucosa treated with a conventional scalpel and diode laser techniques, respectively. Diagnosing and treating the aetiology and educating the patient about the same is essential in fibroma cases. The clinical features of both claims and mere aetiology confirmed the diagnosis. The sole option available when therapy is needed is a surgical fibroma excision. Surgical excision is the most popular method for treating oral or traumatic fibromas. Two ways are available for the surgical removal of an oral fibroma: with a scalpel or using a diode laser. Both case presentations demonstrate that surgical excision with a scalpel and diode laser was discovered to be a simple, efficient, and affordable method for treating traumatic fibroma in this report, which presents two traumatic fibromas with different locations with varying aetiology. Traumatic fibromas reported here were in the aesthetic zones, which need to be treated as they can cause traumatic occlusion and difficulty chewing and speech. The patients reviewed for the next three months revealed complete satisfactory healing and no recurrence in both cases.

Management of Tongue-Tie Using Diode Laser for Speech Clarity: A Case Report.

A congenital condition called ankyloglossia, or tongue tie, is characterized by an excessively short or tight lingual frenum that restricts the tongue's movement and flexibility. Although ankyloglossia, or tongue tie, is not a serious sign, it can cause a variety of challenges, such as difficulty with newborn feeding, speech problems, and many mechanical and social problems since there are restricted tongue movements, such as protrusion of the tongue. It is recommended to get a lingual frenectomy to treat ankyloglossia. A 24-year-old female patient reported to the Department of Periodontics with class II, moderate lingual tie, or ankyloglossia. Under local anesthesia, the lingual frenectomy is performed with a diode laser by placing a hemostat across the frenal attachment at the base of the tongue, and an incision is made. The laser surgery took less time and was more comfortable for the patient because there was less discomfort. There was no postoperative pain or hemorrhage. The above case report can appreciate the normal frenal attachment that is more than 16 mm, and the patient can hold the tip of the tongue and function comfortably. A follow-up visit after three months revealed normal frenal attachment and complete healing of the frenum. This case report demonstrates unequivocally that lingual frenectomy using a diode laser has advantages over traditional procedures in that it reduces or eliminates postoperative pain and minimizes hemorrhage and swelling.

Mucous Extravasation Cyst Associated With the Lower Lip and Its Management: A Case Report.

A 15-year-old female patient was reported with swelling on the right side of the lower lip for 15 days. A provisional diagnosis of mucocele was obtained based on the patient's history and clinical examination. Under all aseptic conditions and administration of local anesthetic, surgical mucocele removal was done using a scalpel. An excised soft tissue specimen was given for histopathological examination, confirming the final diagnosis of mucous extravasation phenomena or mucocele. Recall examination after seven days reveals satisfactory lesion healing and no discomfort. This case report demonstrates that surgical excision is a simple, efficient, and affordable method for treating mucoceles and giving aesthetic and functional clearance.

Immunomodulators and Their Applications in Dentistry and Periodontics: A Comprehensive Review.

The intricate interplay between the immune system and oral health has revealed opportunities for novel therapeutic interventions in dentistry and periodontics. This review article delves into the pivotal role of immunomodulators in orchestrating immune responses within the oral cavity and their applications in managing various oral and periodontal conditions. The oral environment faces many challenges, from microbial infections to tissue injuries, necessitating a precise immune response for optimal oral health maintenance. Characterized by their ability to modulate immune reactions, immunomodulators emerge as versatile tools for maintaining immune equilibrium. This is a comprehensive overview of the mechanisms through which immunomodulators exert their effects, shedding light on their dual role as regulators of both pro-inflammatory and anti-inflammatory pathways. The diverse applications of immunomodulators within dentistry are explored in depth. Immunomodulators exhibit promising outcomes from managing common oral conditions like gingivitis, periodontitis, and oral ulcers to enhancing the integration of dental implants and promoting wound healing post-surgery. This article highlights the various types of immunomodulatory agents utilized in dental practice, elucidating their mechanisms of action, routes of administration, dosages, and potential side effects.

Ligaplants: Uprising Regimen in the Glebe of Implant Dentistry.

A dental implant is an alloplastic framework inserted into the bone, either straight through the alveolar bone or beneath the mucosa or periosteum, to support and hold a permanent or removable dental prosthesis. Osseointegration is a striking phenomenon in which bone directly opposes the implant surface without any interposing collagen or fibroblastic matrix. Although titanium metallic implants were the subject of "osseointegration" at first, it is now used to refer to any biomaterial that can osseointegrate. The science of tissue engineering allows for regenerating complete biological components outside the body for possible replacement treatment or therapy. It uses cells, organic or synthetic scaffold materials, and bioactive molecules. The combination of periodontal ligament (PDL) cells with implant biomaterial is known as Ligaplants. When placed in regions with significant periodontal bone defects, ligaplants can promote the development of new bone. PDL implants, inserted into the missing teeth extraction socket, facilitate surgery. To protect the PDL cell cushion, ligaplants are fitted initially loosely. However, they firmly integrate without interlocking or making direct contact with the bones. Osseointegrated implants affixed directly to the alveolar bone encircling them cannot serve the same purpose as healthy teeth because natural periodontal tissue deteriorates over time. To create a biological connection capable of performing specific physiological tasks, a tissue-engineered PDL must be constructed in conjunction with a dental implant that is well thought out.

Fibronectin and Its Applications in Dentistry and Periodontics: A Cell Behaviour Conditioner.

The formation of biomaterials is a physical phenomenon that is primarily influenced by the material's chemical and physical characteristics, as well as by the availability of proteins and their mutual interactions. A common extracellular matrix (ECM) glycoprotein called fibronectin (FN) is a biomaterial that is essential for tissue repair. Cellular FN (cFN), also known as the "large external transformation sensitive (LETS) protein" or "galactoprotein," was found during the quest for tumour markers twenty-five years ago and was later identified as the surface fibroblast antigen. Twenty different isoforms of the FN protein can be created by alternative splicing of a single pre-messenger ribonucleic acid (pre-mRNA) molecule. FN is an outstanding illustration of an ECM protein that intricately influences cell activity. FN is necessary for cell behaviours like cell adhesion, cell migration, and differentiation of cells as well as highly coordinated tissue processes like morphogenesis and wound repair. Plasma FN is absorbed by tissues and deposited in extracellular matrix fibrils along with locally generated cellular FN. cFN is produced by a wide range of cell types, including fibroblasts, endothelial cells, chondrocytes, synovial cells, and myocytes. FN and other cell adhesion proteins can promote cell attachment to tooth surfaces. Periodontal ligament (PDL) cell-ECM interactions, and consequently the regeneration of periodontal tissues, depends on FN. Specific FN segments serve as indicators of periodontal disease status and provide evidence for their potential involvement in the pathophysiology of the condition. FN is an all-purpose biomaterial that may be utilised for clinical applications ranging from tissue engineering to disease biology. Therefore, it would be desirable to develop materials that specifically bind to FN.

Pre-procedural Antimicrobial Mouth Rinse: A Concise Review.

Mouth rinses are therapeutic solutions utilized for gargling and rinsing the oral cavity. Several oral disorders need a mouth rinse, which can differ from halitosis to diseases of the periodontium. It is essential for the management of secondary infections, for example, oral mucositis. A mouth rinse may be suggested as an anti-inflammatory, antibacterial agent, topical analgesic, or for caries prevention. Several different mouth rinses are accessible nowadays. Selection of a suitable mouth rinse depends on the patient's requirement, disease threat and competence, and safety of mouth rinse. The application of antiseptics to the skin or mucous membranes before surgery or injections has been practised for many years. The goal of such an application is to reduce the number of microorganisms on the surface to prevent their entry into underlying tissues, which could cause bacteremia, septicemia, or harmful local infections. A similar idea of minimizing oral bacteria underlies the patient's usage of an antibiotic mouthwash before dental treatments. This decrease in microflora also reduces the possibility of pathogens entering the patient's mouth through direct contact, splatter, or aerosols during dental treatment. The main aim of this review is to aid oral health care professionals in making the correct selection of mouthwash while dealing with different conditions of the oral cavity.

Injectable and Self-Invigorating Hydrogel Applications in Dentistry and Periodontal Regeneration: A Literature Review.

Hydrogels are thought of as unique polymers utilized to build new materials, and two key factors that impact their features are their hydrophilicity and the degree of cross-linking of the polymer chains. An injectable hydrogel is based on the hypothesis that certain biomaterials can be injected into the body as a liquid and progressively solidify there. The scientific research community was intrigued and interested by its discovery. The hydrophilic polymers that are used to make hydrogels can typically be split into two groups: natural polymers derived from tissues or other sources of natural materials, and synthetic polymers produced by combining principles from organic chemistry and molecular engineering. A variety of organic and synthetic biomaterials, such as chitosan, collagen or gelatin, alginate, hyaluronic acid, heparin, chondroitin sulfate, polyethylene glycol, and polyvinyl alcohol, are used to generate injectable hydrogels. A promising biomaterial for the therapeutic injection of cells and bioactive chemicals for tissue regeneration in both dentistry and medicine, injectable hydrogels have recently attracted attention. Since injectable scaffolds can be implanted with less invasive surgery, their application is seen as a viable strategy in the regeneration of craniofacial tissue. Treatment for periodontitis that effectively promotes periodontal regeneration involves injecting a hydrogel that contains medications with simultaneous anti-inflammatory and tissue-regenerating capabilities. The advantages of injectable hydrogel for tissue engineering are enhanced by the capability of three-dimensional encapsulation. A material's injectability can be attributed to a variety of mechanisms. The hydrogels work well to reduce inflammation and promote periodontal tissue regeneration.

Third-Generation Platelet Concentrates in Periodontal Regeneration: Gaining Ground in the Field of Regeneration.

Platelets are important for hemostasis and the healing of wounds. In clinical settings, healing cytokines including insulin-like growth factors (IGF), platelet-derived growth factors (PDGF), and transforming growth factors (TGF) are commonly implemented. The regenerative approach in dentistry frequently employs platelet concentrates (PCs) that are "autologous in origin" and have a high concentration of platelets, growth factors, and leukocytes. First-generation PCs is made of platelet-rich plasma (PRP), while second-generation PC is made of platelet-rich fibrin (PRF). Both have limitations, so modification protocols and development in PRP and PRF derivatives are required for advancement mechanisms, strength, biodegradability, retention ability in the field of regenerative dentistry, and so on. As third-generation PC, newer genera kinds of PRF, such as advanced-PRF (A-PRF), advanced-PRF+ (A-PRF+), injectable-PRF (i-PRF), and titanium-PRF (T-PRF), were introduced. A-PRF matrices in their solid form were introduced using the low-speed centrifugation concept (LSCC). The applied relative centrifugal force (RCF) for A-PRF is reduced to 208 g as a result of this improved preparation process. A-PRF features a greater number of neutrophil granules in the distal region, especially at the red blood cells-buffer coat (RBC-BC) interface, and the A-PRF clot has a more porosity-like structure with a bigger interfibrous space than PRF. Since the PRF is in a gel form and is difficult to inject, i-PRF was formulated to address this problem. Compared to the other two protocols, the i-PRF protocol requires far less time, and this is the advantage of this PC. This is because i-PRF just needs the blood components to be separated, which happens within the first two to four minutes. Compared to normal L-PRF, T-PRF creates fibrin that is thicker and more densely woven. Titanium has a higher hemocompatibility than glass, which could lead to greater polymerized fibrin formation. In periodontal regenerative operations, oral surgery, and implant dentistry, PRF and its newer advanced modifications have demonstrated promising results and desirable results in both soft and hard tissue regenerative techniques.

A Comparison Between the Efficacy of Scalpel and Laser Procedures for Treating Gingival Hyperpigmentation: A Case Report.

Gingival hyperpigmentation is a hereditary feature in populations. Gingival pigmentation not only affects aesthetics but also has a negative psychological effect. For many people, gingival hyperpigmentation is a severe cosmetic problem. Although black gums are not a medical issue, many individuals find them unsightly. The pigmentation of gingiva contributes to the harmony of the smile in a significant way. A periodontal plastic surgery procedure called gingival depigmentation eliminates or reduces hyperpigmentation. Different treatment approaches for gingival depigmentation have been documented, such as scalpel, electrosurgery, diamond burs, chemical methods, cryosurgery, and lasers. According to studies, cryosurgery and lasers are the best procedures since they provide better aesthetic outcomes and low recurrence rates. The coordination of treatment plans and the choice technique are influenced by the patient's skin tone, the degree of gingival pigmentation, the lip line, the upper lip curvature, aesthetic concern, and treatment expectations. This case report, which involves a 23-year-old female patient, provides a comparison between the efficacy of scalpel and laser procedures for treating gingival hyperpigmentation. The patient's left side received diode laser treatment, while the right received scalpel treatment. Scalpel depigmentation caused the treated area to recover without incident. The benefits of laser depigmentation include a bloodless surgical field and recovery without complications. No postoperative pain, bleeding, infection, or scars were seen on the first and consequent visits. The recovery went smoothly. The patient was satisfied with the treatment modality, and the outcomes were outstanding, according to the patient. There was no re-pigmentation throughout the follow-up period. This split-mouth study will provide information regarding soft tissue healing using two different approaches in the same patient.

Platelet-Rich Fibrin Combined With a Porous Hydroxyapatite Graft for the Treatment of 3-Wall Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial.

BACKGROUND: Porous hydroxyapatite (HA) bone grafting material has been used to fill periodontal intrabony defects (IBDs), resulting in clinically acceptable responses. Platelet-rich fibrin (PRF) is a leukocyte and platelet preparation that concentrates various polypeptide growth factors and, therefore, has the potential for use as regenerative treatment for periodontal defects. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF + HA in treatment of IBDs in patients with chronic periodontitis. METHODS: Ninety IBDs were treated with autologous PRF with open-flap debridement (OFD), PRF + HA with OFD, or OFD (controls) alone. Clinical and radiologic parameters, including probing depth (PD), clinical attachment level (CAL), IBD depth, and percentage defect fill were recorded at baseline and 9 months postoperatively. RESULTS: Mean PD reduction was greater in PRF (3.90 ± 1.09 mm) and PRF + HA (4.27 ± 0.98 mm) groups than the control group (2.97 ± 0.93 mm), and mean CAL gain was greater in PRF (3.03 ± 1.16 mm) and PRF + HA (3.67 ± 1.03 mm) compared to controls (2.67 ± 1.09 mm). Furthermore, significantly greater percentage of mean bone fill was found in the PRF (56.46% ± 9.26%) and PRF + HA (63.39% ± 16.52%) groups compared to controls (15.96% ± 13.91%). CONCLUSIONS: Treatment of IBD with PRF results in significant improvements of clinical parameters compared to baseline. When added to PRF, HA increases the regenerative effects observed with PRF in the treatment of 3-wall IBDs.

Comparative evaluation of autologous platelet-rich fibrin and platelet-rich plasma in the treatment of mandibular degree II furcation defects: a randomized controlled clinical trial.

BACKGROUND: The treatment of molar furcation defects remains a considerable challenge in clinical practice. The identification of clinical measurements influential to treatment outcomes is critical to optimize the results of surgical periodontal therapy. The present study aimed to explore the clinical and radiographical effectiveness of autologous platelet-rich fibrin (PRF) and autologous platelet-rich plasma (PRP) in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis. MATERIAL AND METHODS: Seventy-two mandibular degree II furcation defects were treated with either autologous PRF with open flap debridement (OFD; 24 defects) or autologous PRP with OFD (25), or OFD alone (23). Clinical and radiological parameters such as probing depth, relative vertical clinical attachment level and horizontal clinical attachment level along with gingival marginal level were recorded at baseline and 9 mo postoperatively. RESULTS: All clinical and radiographic parameters showed statistically significant improvement at both the test sites (PRF with OFD and PRP with OFD) compared to those with OFD alone. Relative vertical clinical attachment level gain was also greater in PRF (2.87 ± 0.85 mm) and PRP (2.71 ± 1.04 mm) sites as compared to control site (1.37 ± 0.58 mm), and relative horizontal clinical attachment level gain was statistically significantly greater in both PRF and PRP than in the control group. CONCLUSIONS: The use of autologous PRF or PRP were both effective in the treatment of furcation defects with uneventful healing of sites.

Efficacy of local drug delivery of 0.5% clarithromycin gel as an adjunct to non-surgical periodontal therapy in the treatment of current smokers with chronic periodontitis: a randomized controlled clinical trial.

BACKGROUND: The relationship between cigarette smoking and periodontal disease has been examined extensively. Local delivery of antimicrobials into periodontal pockets improves periodontal health. The present study is designed to investigate the adjunctive effects of subgingivally delivered 0.5% clarithromycin (CLM) as an adjunct to scaling and root planing for treating chronic periodontitis in smokers. METHODS: Sixty-one patients were randomized and categorized into two treatment groups: group 1, in which 31 individuals received scaling and root planing plus 0.5% CLM, and group 2, in which 30 individuals received scaling and root planing plus placebo gel. Clinical parameters were recorded at baseline and at 1, 3, and 6 months; they included plaque index (PI), modified sulcus bleeding index (mSBI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL). The mean concentration of 0.5% CLM in gingival crevicular fluid (GCF) was estimated by reverse-phase high-performance liquid chromatography. RESULTS: Both therapies resulted in significant improvements. At the end of 6 months, the mean GI, PI, mSBI, PD, and CAL for the CLM group were 1.06 ± 0.28, 2.82 ± 0.64, 1.36 ± 0.24, 4.64 ± 0.63, and 4.90 ± 0.46, respectively, versus 1.38 ± 0.41, 3.22 ± 0.57, 1.44 ± 0.27, 6.07 ± 0.88, and 5.69 ± 0.46, respectively, for the placebo group. Using an individual-based analysis, individuals in group 1 showed enhanced clinical outcome (P <0.05) over a period of 6 months compared with those in group 2. CLM was detected in GCF until a period of 7 weeks after the local drug delivery. CONCLUSION: Although both treatment strategies seemed to benefit the individuals, the adjunctive use of 0.5% CLM as a controlled drug delivery system enhanced the clinical outcome.