The effects of autologous platelet concentrate on the healing of intra-bony defects: a randomized clinical trial.

PURPOSE: The present study aimed to evaluate the clinical and radiographic effects of autologous platelet concentrate (APC) on the healing of intra-bony defects filled with ß-tricalcium phosphate (ß-TCP) and covered with collagen membranes. SUBJECTS AND METHODS: This study included 30 defects of 14 systemically healthy subjects. All of them had, at least, two deep intra-bony, inter-proximal periodontal defects. Minimum probing pocket depth (PPD) was 6 mm. Clinical and imaging examination was performed both at baseline and at 3, 6, and 9 months after surgery. RESULTS: Both the test and control group revealed a significant reduction in all variables when compared with the base line. Mean reduction of the PPD in two groups at each follow-up time point showed no significant difference. Means of the clinical attachment gain of the same groups were significantly different (p<0.05). Mean gingival recession at 3 month was not significant. However, the means of gingival recession coverage of two groups were significantly different at 6 and 9 months (p<0.05 for both). CONCLUSION: Sites treated with APC are more likely to demonstrate more clinical attachment gain and recession coverage at the end of 9 month compared to those without APC.

Clinical Efficacy of Subgingivally Delivered 1.2 mg Simvastatin in the Treatment of Patients with Aggressive Periodontitis: A Randomized Controlled Clinical Trial.

Simvastatin (SMV) is a specific competitive inhibitor of 3-hydroxy-2-methylglutaryl coenzyme A reductase that promotes bone formation. The present clinical trial was designed to investigate the effectiveness of 1.2 mg SMV as a local drug delivery system and as an adjunct to scaling and root planing (SRP) in the treatment of aggressive periodontitis (AgP). A total of 68 intrabony defects from 24 patients with AgP were treated either with 1.2 mg SMV gel or placebo gel. The subjects were randomly assigned to SRP + placebo (group 1; n = 12) or SRP + SMV (group 2; n = 12). Clinical parameters were recorded at baseline and at 3 and 6 months and included bleeding index, Plaque Index, probing depth (PD), and clinical attachment level (CAL). At baseline and after 6 months, radiologic assessment of bone defect fill was done. The mean decrease in PD at 6 months was 1.14 ± 0.04 mm and 3.78 ± 0.62 mm in groups 1 and 2, respectively. Significant gain in mean CAL was found between the groups (P < .05). Furthermore, significantly greater mean percentage of bone fill was found in group 2 (34.01%) compared to group 1 (2.62%). Locally delivered SMV provides a comfortable method to improve clinical parameters and promotes bone formation.

Clinical and microbiological efficacy of 3% satranidazole gel as a local drug delivery system in the treatment of chronic periodontitis: A randomized, controlled clinical trial.

AIM: The present clinical trial was designed to investigate the effectiveness of subgingivally delivered satranidazole (SZ) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. MATERIALS AND METHODS: Seventy subjects with probing depth (PD) ≥5 mm were selected. Thirty-five subjects each were randomly assigned to SRP + placebo (Group 1) and SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index, gingival index, clinical attachment level (CAL), and PD at baseline; 1 month, 3 months, and 6 months interval. Furthermore, microbial analysis using polymerase chain reaction was done to estimate the number of sites harboring periodontopathogens. RESULTS: Sixty four subjects were evaluated up to 6 months. At 6 months, the Group 2 resulted in greater mean reduction (4.10 mm) in PD as compared to Group 1 (1.49 mm), and also a greater mean CAL gain (4.20 mm) in Group 2 as compared to Group 1 (1.13 mm). These subjects also showed a significant reduction in the number of sites harboring periodontopathogens. CONCLUSION: The use of 3% SZ gel, when used as an adjunct to nonsurgical periodontal therapy in subjects with periodontitis, achieved better results than initial periodontal treatment alone.

Efficacy of irrigation with different antimicrobial agents on periodontal health in patients treated for chronic periodontitis: A randomized controlled clinical trial.

INTRODUCTION: Periodontitis is inflammation of supporting tooth structure. Most individuals get affected by this disease if oral hygiene is not maintained. There are various mechanical and chemical methods for oral hygiene maintenance. In recent past, interest has been diverted toward the herbal/traditional product in oral hygiene maintenance as they are free from untoward effect. AIM: To assess the efficacy of subgingival irrigation with herbal extract (HE) as compared with 0.2% chlorhexidine (CHX) on periodontal health in patients who have been treated for chronic periodontitis, and still have residual pocket of 3-5 mm. MATERIALS AND METHODS: This was a controlled, single-blind, randomized study for 3 months. Patients were allocated in two groups (n = 15 each): (1) 0.2% CHX (control group); (2) HE consisting of Punica granatum Linn. (pomegranate), Piper nigrum Linn. (black pepper), and detoxified copper sulfate (test group). Solutions were used for the irrigation using pulsated irrigating device, WaterPik. Clinical outcomes evaluated were plaque index (PI), sulcus bleeding index (SBI), probing depth at baseline, 15th, 30th, 60th, and 90th day. Microbiologic evaluation was done at baseline and 90th day. RESULTS: Significant reduction in PI was seen in the group of irrigation with HE. While comparing SBI, irrigation with CHX shows a better result. Other parameters such as probing pocket depth and microbiological counting were similar for both groups. CONCLUSION: Irrigation with HE is a simple, safe, and noninvasive technique with no serious adverse effects. It also reduces the percentage of microorganism in periodontal pocket.

Periodontal pathogens and respiratory diseases- evaluating their potential association: a clinical and microbiological study.

OBJECTIVE: To evaluate whether any potential association exists between respiratory diseases such as chronic obstructive pulmonary disease (COPD) and periodontal health status clinically and or microbiologically. MATERIALS AND METHODS: Fifty patients of COPD (test group) and 50 Patients without COPD (control group) were recruited for the study with more than 20 years of age with at least six natural teeth. All the patients were nonsmokers. Periodontal health was assessed by measuring clinical attachment loss (CAL) and gingival bleeding by using William's graduated periodontal probe. Microbiological evaluation was done by collecting sputum samples of the subjects with respiratory diseases to find out any periodontal pathogen in the lung fluid. RESULT AND CONCLUSION: The results showed that the subjects with COPD had significantly more bleeding sites (i.e. >20%) and had more of the clinical mean attachment loss (2.84 ± 0.66) than those without COPD. On the basis of the observed results of the study, we can hypothesize that the risk for COPD appeared to be significantly elevated when attachment loss was found to be severe. CLINICAL SIGNIFICANCE: It is conceivable that oral interventions that improve oral health status may prove to lower the severity of lung infection in susceptible populations.

Periodontal vaccine: A dream or reality.

Recent advances in cellular and molecular biology have led to the development of new strategies for vaccines against many types of infectious diseases. It has long been recognized that individuals who recovered from a disease developed subsequent resistance to the same. In the late 18th century, Edward Jenner developed and established the principle of vaccination using the cross protection conferred by cowpox virus, which is non-pathogenic in humans. With the rapid growth of microbial genome sequencing and bioinformatics analysis tools we have the potential to examine all the genes and proteins from any human pathogen. This technique has the capability to provide us with new targets for anti-microbial drugs and vaccines. However, to realize this potential new bioinformatics and experimental approaches to select these targets from the myriad of available candidates are required. Vaccination is a process that induces specific immune resistance to a bacterial or viral infection.