Evaluation of Different Local Drug Delivery Systems in the Management of Chronic Periodontitis: A Comparative Study.

AIM: The present study aimed to assess the use of various local drug delivery systems in the management of chronic periodontitis. MATERIALS AND METHODS: A total of 60 patients aged around 30-55 years were included. The subjects who were enrolled under took a phase I therapy that included scaling and root planing (SRP). Patients who satisfied the conditions for selection to enter the trial were assigned randomly to three groups, with each group consisting of 20 participants as follows: group I: controlled-release drugs-chlorhexidine gel, group II: metronidazole gel, group III: tetracycline fibers. The plaque index (PI), gingival index (GI), and periodontal pocket depth (PPD) were recorded after 1st week as the baseline data and were recorded again after 15 days and 30 days post-baseline. RESULTS: The mean GI scores were 1.32 ± 0.10, 0.88 ± 0.16, and 0.76 ± 0.12, at baseline, 15 days, and 30 days, respectively, in group I. In group II, the mean GI score reduced to 1.09 ± 0.83 at 30 days from 1.48 ± 0.27 at baseline. Likewise, in group III the mean GI score reduced to 0.90 ± 0.62 at 30 days from 1.38 ± 0.06 at baseline. All the groups demonstrated a statistically significant difference at various intervals. The mean PI score decreased to 0.90 ± 0.78 at 15 days from 1.46 ± 0.22 at baseline in group III. A statistically significant difference at different intervals was seen in group III only. In all groups, the intergroup comparison of PPD was found to be statistically significant. CONCLUSION: This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered chlorhexidine gel, metronidazole gel, and tetracycline fibers. CLINICAL SIGNIFICANCE: The use of the adjunctive local drug delivery system along with mechanical cleansing in the treatment of periodontal pockets in chronic periodontitis is therapeutically beneficial.

Effectiveness of Mentha piperita Leaf Extracts against Oral Pathogens: An in vitro Study.

AIM: The study aims to assess the Mentha piperita leaf extract's effectiveness against oral pathogens. MATERIALS AND METHODS: The leaf extract of M. piperita was prepared using cold water method. The three microbial strains, i.e., Streptococcus mutans, Aggregatibacter actinomycetem-comitans, and Candida albicans were used as microbiological materials. Chlorhexidine 0.2% was used as positive control. The digital caliper was used to measure the zone of inhibition to know the antimicrobial activity at 24 and 48 hours. To compare the activity within and between the different microbial strains, one-way analysis of variance (ANOVA) was used. To analyze the data, Statistical Package for the Social Sciences (SPSS) software version of 21.0 was used. The p-value ≤0.05 was considered as statistically significant. RESULTS: Maximum inhibition zone was seen in both M. piperita extracts and 0.2% chlorhexidine with S. mutans at 24 and 48 hours, followed by A. actinomycetemcomitans, and C. albi-cans respectively. The statistical analysis ANOVA reveals the statistically significant association of M. piperita extracts with p-value <0.001. The comparison with 0.2% chlorhexidine at 24 hours showed a p-value of <0.04 and at 48 hours, it showed a p-value <0.001, which was statistically significant. CONCLUSION: The present study concluded that M. piperita showed antimicrobial activity against the oral microorganisms which are causing major less or more severe oral diseases and it can be administered as an alternative medicine for the conventional treatment. CLINICAL SIGNIFICANCE: The study results serve as a guide in selecting and providing information about the efficacy of M. piperita extracts to the dental professionals. The discovery of a potential herbal medication would be a great development in the field of antimicrobial therapies.

Comparative Evaluation of Cone-beam Computed Tomography versus Direct Surgical Measurements in the Diagnosis of Mandibular Molar Furcation Involvement.

AIM: Periodontists frequently experience inconvenience in accurate assessment and treatment of furcation areas affected by periodontal disease. Furcation involvement (FI) most commonly affects the mandibular molars. Diagnosis of furcation-involved teeth is mainly by the assessment of probing pocket depth, clinical attachment level, furcation entrance probing, and intraoral periapical radiographs. Three-dimensional imaging has provided advantage to the clinician in assessment of bone morphology. Thus, the present study aimed to compare the diagnostic efficacy of cone-beam computed tomography (CBCT) as against direct intrasurgical measurements of furcation defects in mandibular molars. SUBJECTS AND METHODS: Study population included 14 patients with 25 mandibular molar furcation sites. CBCT was performed to measure height, width, and depth of furcation defects of mandibular molars with Grade II and Grade III FI. Intrasurgical measurements of the FI were assessed during periodontal flap surgery in indicated teeth which were compared with CBCT measurements. Statistical analysis was done using paired t-test and Bland-Altman plot. RESULTS: The CBCT versus intrasurgical furcation measurements were 2.18 ± 0.86 mm and 2.30 ± 0.89 mm for furcation height, 1.87 ± 0.52 mm and 1.84 ± 0.49 mm for furcation width, and 3.81 ± 1.37 mm and 4.05 ± 1.49 mm for furcation depth, respectively. Results showed that there was no statistical significance between the measured parameters, indicating that the two methods were statistically similar. CONCLUSION: Accuracy of assessment of mandibular molar FI by CBCT was comparable to that of direct surgical measurements. These findings indicate that CBCT is an excellent adjunctive diagnostic tool in periodontal treatment planning.