Clinical Evaluation of Diode Laser-Assisted Surgical Periodontal Therapy: A Randomized Split-Mouth Clinical Trial and Bacteriological Study.

Background: Stage 3 grade C periodontitis (S3GCP) has always been a challenge for clinicians. However, it is proposed that the use of lasers in addition to periodontal therapy can result in a more efficient therapy outcome. Objective: The aim of this clinical study was to determine the effects of additional application of diode laser (DL, 810 nm ±5) on clinical and microbiological values during Modified Widman Flap (MWF) periodontal surgery in the S3GCP patients. Methods: A total of 18 patients were randomly assigned to the test site (MWF + activeDL) and the control site (MFW alone). Clinical parameters and microbial samples were taken preoperatively, and postoperatively at 6 weeks, 3 months, and 6 months. Visual analog scale (VAS), tissue edema (TE), tissue color (TC), and pain medication (PM) consumption, were evaluated postoperatively at 10th day. Results: All bacteria were significantly decreased at follow-up times compared with preoperative amounts in both therapy sites (p < 0.05). Bacterial amounts of Treponema denticola, Prevotella intermedia, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans at 6 weeks, Porphyromonas gingivalis and T. denticola at 3 months, T. denticola and A. actinomycetemcomitans at 6 months were statistically lower in the test site than the control site. All clinical parameters significantly improved after MWF surgery at follow-up times compared with preoperative values in intragroup comparisons, but a significant difference was not detected in the intergroup comparison. No differences were found in terms of VAS, PM, TE, and only TC was statistically more pink in the test site than the control site. Conclusions: The present study findings suggest that the use of DL together with MWF may have positive effects in the therapy of S3GCP patients by reducing the microbial load. Clinical Trial.org: NCT05108727.

Growth factor membranes in treatment of multiple gingival recessions: a randomized clinical trial.

OBJECTIVE: The aim of this study was to assess the clinical effects of concentrated growth factor (CGF) in combination with coronally advanced flap (CAF) compared with platelet rich fibrin (PRF)+CAF for the treatment of multiple adjacent gingival recessions (GRs). METHOD AND MATERIALS: 18 subjects with total of 76 Type I GRs in the maxilla were included. Recessions were randomly treated according to a split-mouth design by means of CGF+CAF (39 defects, CGF side), or PRF+CAF (37 defects, PRF side). Clinical outcomes were evaluated at 6 months. RESULTS: The mean root coverage was 86.32% and 80.86%, and complete root coverage was 61.53% (24/39) and 51.35% (19/37) for CGF side and PRF side, respectively, at 6 months. Statistically significant gains were observed in the terms of clinical attachment level, recession depth, keratinized gingiva width, gingival thickness, and recession width in the both sides at 6 months compared to baseline values; no statistically significant difference was observed in these parameters between the two sides at 6 months. CONCLUSIONS: According to results, the use of CGF+CAF was not superior to PRF+CAF in providing additional benefits in clinical parameters. Keratinized gingiva width and gingival thickness significantly increased with the use of CGF and PRF membranes together with CAF.

Chemerin as a Novel Crevicular Fluid Marker of Patients With Periodontitis and Type 2 Diabetes Mellitus.

BACKGROUND: The objectives of the present study are to: 1) determine whether gingival crevicular fluid (GCF) chemerin is a novel predictive marker for patients with chronic periodontitis (CP) with and without type 2 diabetes mellitus (t2DM); 2) analyze the relationship between chemerin and interleukin (IL)-6 in periodontally healthy individuals and in patients with CP and with and without t2DM; and 3) evaluate the effect of non-surgical periodontal therapy on GCF chemerin levels. METHODS: Eighty individuals were split into four groups: 20 who were systemically and periodontally healthy (CTRL), 20 with t2DM and periodontally healthy (DM-CTRL), 20 systemically healthy with CP (CP), and 20 with CP and t2DM (DM-CP). Individuals with periodontitis were treated with non-surgical periodontal therapy. GCF sampling procedures and clinical periodontal measures were performed before and 6 weeks after treatment. Enzyme-linked immunosorbent assay was used to measure chemerin and IL-6 levels. RESULTS: Greater values for GCF chemerin and IL-6 levels were found in CP groups than in periodontally healthy groups, in DM-CP than in CP, and in DM-CTRL than in CTRL (P <0.008). GCF chemerin and IL-6 levels decreased following therapy in CP groups (P <0.02). A comprehensive overview of all groups showed a statistically significant positive correlation of chemerin with IL-6, glycated hemoglobin, sampled-site clinical attachment level, and gingival index (P <0.05). CONCLUSIONS: In this study, periodontitis and t2DM induced aberrant secretion of chemerin, and non-surgical periodontal therapy influenced the decrease of GCF chemerin levels in patients with CP with and without t2DM. Furthermore, it suggests GCF chemerin levels may be considered a potential proinflammatory marker for diabetes, periodontal disease, and treatment outcomes.

Evaluation of Clinical Parameters and Levels of Proinflammatory Cytokines in the Crevicular Fluid Around Dental Implants in Patients with Type 2 Diabetes Mellitus.

PURPOSE: Diabetes mellitus is considered a relative contraindication for dental implant therapy, depending on levels of glycemic control. The purpose of this research was to evaluate the peri-implant conditions and measure the levels of interleukin 1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) in the peri-implant crevicular fluid (PICF) in patients with glycemic-controlled type 2 diabetes (T2DM). MATERIALS AND METHODS: Thirteen patients with well-controlled T2DM and seven systemically healthy patients were recruited for this study. Clinical measurements were recorded, and samples of gingival crevicular fluid (GCF) and PICF were collected from the sulci of both adjacent teeth and implants at baseline (after implant placement), 1 month, 4 months, and 7 months. Levels of IL-1ß and TNF-α in the GCF and PICF were analyzed by enzyme-linked immunosorbent assay. Standardized intraoral radiographs were taken at baseline (after implant placement), 4 months, and 7 months. Implant stability was assessed by resonance frequency analysis at baseline, at 1 month, and at 4 months. RESULTS: Glycosylated hemoglobin levels in the T2DM group were significantly increased at 7 months compared to baseline levels. Implant stability quotient levels at 4 months were increased significantly compared to baseline in both groups. Alveolar bone levels around implants were statistically lower at 4 and 7 months compared to baseline and statistically decreased at 7 months compared to 4 months in the T2DM group. There were no significant differences between groups in bone levels around implants, and no significant differences were found in levels of IL-1ß and TNF-α at either teeth or implants or between the groups. CONCLUSION: The results suggest that dental implant therapy can be offered to patients with well-controlled T2DM, as there were no significant differences between control and diabetic patients in terms of clinical parameters or GCF and PICF cytokine levels.