Journal of Indian Society of Periodontology最新文献

Background: Periodontal disease is considered to be the sixth most common complication of diabetes mellitus (DM). Antibiotics (systemic and local) enhance the outcome of conventional mechanical debridement but frequent use of antimicrobials may develop resistance to microorganisms. To overcome this complicacy, the current study assessed the effectiveness of photodynamic therapy (PDT) in chronic periodontitis patients with type 2 diabetes when used as a combination therapy to standard periodontal therapy by assessing the various clinical and glycemic parameters.

Materials and methods: A total of 16 known cases of chronic Periodontitis patients who were suffering from type 2 DM were allocated into two groups. The test group (n = 8) was treated with standard scaling and root planing (SRP) along with PDT while the control group was treated with SRP alone. Various clinical parameters assessed were plaque index, gingival index, pocket probing depth, clinical attachment level, and Glycated hemoglobin level at baseline and 90 days after therapy.

Results: At the end of the study, both the groups showed improvements with regard to all clinical and glycemic parameters compared to baseline. However, the test group presented statistically significant favorable results (all P < 0.05).

Conclusion: Conventional periodontal treatment aided with PDT proved to be a beneficial therapeutic measure and effective alternative in patients with chronic periodontitis with diabetes when compared with standard periodontal therapy alone.

Background: There is a bidirectional link between diabetes and periodontal disease. Control of active periodontal infection is an essential requisite to maintain optimal oral and systemic health in diabetic patients. The purpose of this study was to evaluate the efficacy of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease compared to routine oral hygiene.

Materials and methods: Forty (n = 40) diabetic (HbA1c >7%) patients were enrolled in this parallel, examiner-blind, interventional clinical trial. Patients were randomized into two groups: Group A (sonic toothbrush and irrigation with water twice daily) or Group B (manual toothbrush and mouth rinsing with 0.12% Chlorhexidine gluconate (CHX) twice daily)). All patients received Phase I therapybefore the start of the study. Clinical parameters (plaque index [PI], gingival index [GI], oral hygiene index [OHI], pocket depth [PD], clinical attachment level [CAL], and bleeding index [BI]) were assessed at baseline, 1, 2, and 4 months. Levels of C-reactive protein (CRP), HbA1c, and interleukin (IL)-1 β were assessed at baseline and 4 months only. Verbal and written instructions were provided to each subject specific to their intervention allocation. Descriptive, parametric, and nonparametric analyses were used where appropriate.

Results: Sixteen (n = 16) patients in Group A and fifteen (n = 15) patients in Group B completed the 4-month study. Both groups showed a significant difference in BI, PD, CAL, and HbA1c from baseline to 4 months. There were no differences within groups for OHI, GI, or PI and CRP, IL-1 β. The results are based on an underpowered study due to the drop out of 9 patients reducing the number below the needed 19 patients per group based on the power analysis.

Conclusion: Results from this study provide information for future studies on self-care regimens for individuals living with Type 2 diabetes.

Background: Autogenous soft-tissue graft is the gold-standard approach to augment oral soft tissues. However, tissue engineering is increasingly surveyed to overcome its substantial drawbacks, including the secondary site of operation, patient's pain and discomfort, limited tissue of donor site, and so on. Chitosan and gelatin have been utilized in this field over the years due to their great biological virtues. Zeolite, another remarkable candidate for tissue engineering, possesses outstanding biological and mechanical properties, thanks to its nanostructure. Therefore, this study aimed to investigate the biodegradability and DNA content of seeded human gingival fibroblasts on a New Chitosan-Gelatin-Zeolite Scaffold for the perspective of oral and mucosal soft tissue augmentation.

Materials and methods: DNA contents of the human gingival fibroblast cell line (HGF.1) seeded on the chitosan-gelatin (CG) and CGZ scaffolds were evaluated by propidium iodide staining on days 1, 5, and 8. Scaffolds' biodegradations were investigated on days 1, 7, 14, 28, 42, and 60.

Results: Although both scaffolds provided appropriate substrates for HGF.1 growth, significantly higher DNA contents were recorded for the CGZ scaffold. Among experimental groups, the highest mean value was recorded in the CGZ on day 8. CGZ showed a significantly lower biodegradation percentage at all time points.

Conclusions: The incorporation of zeolite into the CG scaffold at a ratio of 1:10 improved the cell proliferation and stability of the composite scaffold. CGZ scaffold may offer a promising alternative to soft-tissue grafts due to its suitable biological features.

Background: This in vitro study investigated the time-dependent bactericidal effects of cold atmospheric argon plasma treatment of periodontal hand scalers as well as the scanning electron microscopic view of the scaler tip surfaces before and after plasma treatment.

Materials and methods: The study used 34 periodontal hand scalers which were divided into test and control groups. The scaler tips were inoculated with Escherichia coli and Staphylococcus aureus bacteria, following which the scalers in the control and test groups were subjected to conventional sterilization and argon plasma sterilization, respectively. Varying exposure times of plasma treatment were done on the test group samples to evaluate the minimum time required for complete sterilization. Subsequently, streaks were made on plate count agar using each of these instruments. The agar plates were then kept in an incubator for 24 h, following which bacterial colony count was assessed (colony-forming units/mL). Furthermore, the scanning electron microscopic (SEM) view of the scaler tip was studied before and after plasma treatment.

Results: A complete elimination of bacterial load (Gram-positive as well as Gram-negative) from the instrument surface was achieved by the plasma exposure time of 15-20 s. SEM analysis did not show a significant difference before and after plasma treatment as not many organic residues were present on the scaler tip.

Conclusion: Cold atmospheric pressure plasma is an efficient and time-saving method of sterilization, capable of destroying both Gram-positive and Gram-negative bacteria.

Background and objective: Periodontitis is a multifactorial disease initiated by periodontal pathogens and progresses further in destruction of periodontium. Hence, the objective of this study was to test the efficacy of Ocimum basilicum seeds extract on periodontal pathogens.

Materials and methods: O. basilicum seeds were authenticated from a recognized taxonomist. They were coarsely powdered; ethanol-based extract preparation was done by the Soxhlet method and aqueous-based extract by hot infusion procedure. Extracts so obtained were assessed for minimum inhibitory concentration, minimum bactericidal concentration, zone of inhibition, and time-kill assay of O. basilicum seeds extract on periodontal pathogens, and comparatively evaluated the effectiveness against 0.12% chlorhexidine (CHX) gluconate in triplicates. Kruskal-Wallis Test was employed wherein the statistical significance was set at P ≤ 0.05.

Results: The concentration of O. basilicum ethanolic extract against periodontal pathogens was determined to be 10 mg/ml, whereas 4.7 mg/ml of aqueous extract was proven effective against periodontal pathogens. Similarly, aqueous extract of O. basilicum developed a wider zone against periodontal pathogens compared to ethanol-based O. basilicum extract. Statistically significant difference found in the effectiveness between both extract and CHX.

Conclusion: The antibacterial activity was evident in both the extracts of O. basilicum against anaerobic periodontal pathogens. However, it was more pronounced in aqueous extract, but lower compared to CHX.

Background: As current ethical codes preclude determining whether the clinical improvements obtained with the use of three-dimensional (3D)-printed scaffolds represent true periodontal regeneration, the histological proof of evidence for regeneration must be demonstrated in animal models. Thus, this systematic review investigated the regenerative potential of 3D-printed scaffolds in animal models of periodontal defects.

Materials and methods: A systematic search was performed in four databases (Medline, Embase, Web of Science, and Scopus) to identify preclinical controlled studies that investigated the use of 3D-printed scaffolds for periodontal regeneration. Studies limited to periodontal defects treated with 3D scaffolds were eligible for inclusion. The primary outcome was periodontal regeneration, assessed histologically as new bone, cementum, and periodontal ligament (PDL). This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quality was assessed according to the SRYCLE score.

Results: Six studies met the inclusion criteria. Scaffolds were designed using computer-aided design software. While the absence of a scaffold resulted in defects repaired mainly with fibrous connective tissue, the use of nonguiding 3D scaffolds promoted some bone formation. Notably, the regeneration of cementum and functional PDL fibers perpendicularly inserted into the root surface and the alveolar bone was limited to the defects treated with multi-compartment fiber-guiding or ion-containing 3D scaffolds. Nevertheless, the quality of the evidence was limited due to the unclear risk of bias.

Conclusions: Despite the limitations of the available evidence, the current data suggest that the use of printed multi-compartment fiber-guiding or ion-containing 3D scaffolds improves periodontal regeneration in animal models.

Background: Periodontitis is the most common type of periodontal condition, primarily affecting middle-aged people and resulting in tooth loss; when combined with diabetes, it becomes a debilitating condition. The aim of this study is to compare the residual periodontal ligament length in periodontitis patients with and without diabetes.

Materials and methods: The cross-sectional observational study was conducted in the department of periodontics over 5 months. The patients in the study were divided into two groups. Group 1 comprised patients with periodontitis without type 2 diabetes and Group 2 comprised patients with periodontitis with type 2 diabetes. A total of 100 teeth 50 from each group were collected. The teeth were stained, and the Residual Periodontal Ligament (RPL) of all tooth aspects and surfaces to a total of 544 were measured. Two points were identified for measuring the RPL. The first point was from the apex of the tooth and the second point was the highest marking of the stain. The length from these two points was recorded as the RPL. Following which, means from Groups 1 and 2 were calculated to determine the rate of destruction. The average of the values for each tooth was calculated to determine the percentage of RPL in each tooth and surface. The Mann-Whitney test was used to compare the RPL of the teeth surfaces and Group 1 and Group 2 and P < 0.05 was considered statistically significant.

Results: The RPL was higher in nondiabetic patients, with a mean value of 23.66 mm, when compared to diabetic patients, with a mean RPL of 17.05 mm, implying that diabetic patients showed greater periodontal destruction. Buccal tooth surfaces displayed a mean RPL of 4.24 mm and 6.00 mm, lingual/palatal tooth surfaces with 4.02 mm and 5.91 mm, mesial tooth surfaces with 3.82 mm and 5.64 mm, and distal tooth surfaces showed 4.14 mm and 5.67 mm (diabetic and nondiabetic, respectively) with (P < 0.001) found to be statistically significant.

Conclusion: This study observed that the destruction rate of the periodontal ligament was higher in diabetic teeth than in nondiabetic teeth, implying that patients with metabolic diseases such as type 2 diabetes influence the response of periodontal tissues to periodontitis and that hyperglycemia impacts the periodontal ligament either directly or indirectly.

Background: When it comes to surgical site infection (SSI), it has been shown that two-thirds of wound infections starts around the incision line and the number is even greater in the presence of sutures. Therefore, a number of compounds have been used to coat the suture materials which tend to decrease the SSI some of which include ciprofloxacin, Aloe vera, and chlorhexidine.

Objective: The objective of this study was to assess the antibacterial properties of neem oil-coated sutures in anaerobic culture media when compared to triclosan-coated sutures and uncoated sutures.

Materials and methods: The phosphate-buffered saline solution containing the plaque samples of the patients was transferred evenly onto the sterile agar media. Equal segments of 100% neem oil coated (Group 1), 50% neem oil coated (Group 2), triclosan-coated (Group 3), and uncoated (Group 4) sutures were placed on the agar plate. These were then incubated at 37°C for 24 h. The inhibition zone was calculated in mm by measuring of the zone of inhibition (ZOI) in terms of length, breadth, and area.

Results: The results were calculated following the incubation. The mean length for 100% neem oil-coated suture was 2.61 mm ± 0.2 and for 50% neem oil-coated suture was 2.49 mm ± 0.24. The mean breadth for 100% neem oil-coated suture was 1.5 mm ± 0.41 and for 50% neem oil-coated suture the mean was 0.95 mm ± 0.58. The mean area for 100% neem oil-coated suture was 77 mm ± 32.9 and for 50% neem oil-coated suture was 16.8 mm ± 11.14. Triclosan and uncoated sutures did not show any ZOI.

Conclusion: The 100% neem oil-coated sutures had the largest length, breadth, and area of ZOI in the anaerobic culture media, followed by 50% neem oil-coated sutures. Triclosan-coated and uncoated sutures did not show any ZOI. Therefore, neem oil-coated suture can be used in the overall healing and prevention of postoperative discomfort after oral surgical procedures.

Background: The traditional treatment procedures which aimed at treating periodontal disease did not result in true periodontal regeneration. Unpredictability about osseous defect fill after periodontal flap surgery has stemmed in the research of a variety of regenerative materials. This randomized clinical trial was conducted to compare regenerative potential of Biostite^® bone graft material with and without Paroguide^® a bioresorbable membrane in the treatment of periodontal osseous defects.

Materials and methods: Twenty sites from a total of from ten patients were chosen for the study. Those sites were divided into experimental site A (Biostite^®) and experimental site B (Biostite^® with Paroguide^®) at random. Plaque index and gingival index (GI) were the clinical parameters noted at baseline, 3^rd, 6^th and 9^th months, whereas the probing pocket depth, clinical attachment level and gingival recession were noted at baseline, 6^th and 9^th months. Radiographic evaluation was made by using computer-assisted densitometric analysis. Intrasurgical measurements were done at baseline and 9 months. Statistical analysis was done using paired t-test and un-paired t-test.

Results: Both experimental site A and B showed a significant reduction in plaque and GI. All clinical parameters as well as radiographic image analysis showed highly significant improvement from baseline to 9 months for both sites. Inter-group comparison does not show statistically significant improvement.

Conclusion: The results of this study suggested that both Biostite^® bone graft and Paroguide^® membrane have promised encouraging results in the management of periodontal intrabony defects, however, the groups did differed to each other statistically.