BACKGROUND: Gingival inflammation, a hallmark of periodontal diseases, serves as a critical focus in oral health research. Characterized by redness, swelling, and bleeding of the gingival tissues, it reflects the body\'s response to bacterial biofilms accumulating on the tooth surfaces. This inflammatory process, initiated by the interaction between oral bacteria and the host immune system, can lead to a spectrum of periodontal conditions ranging from mild gingivitis to severe periodontitis. Understanding the efficacy of various methods to treat gingival inflammation is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival inflammation.
OBJECTIVE: The objective of the study was to evaluate the efficacy of employing the microneedling technique with olive oil on gingival inflammation and plaque accumulation in individuals with gingivitis.  Materials and methods:Twenty-four individuals diagnosed with plaque-induced gingivitis were selected from Saveetha Dental College, Chennai. Participants were randomly assigned to one of two groups: Group A, comprising 12 individuals who received mechanical periodontal treatment only and Group B, consisting of 12 individuals treated with dermapen and topical olive oil. This involved the creation of microholes in the gingival tissue to enhance the concentration and penetration of the oils through the gingival tissues. Post-intervention assessments of gingival and plaque status were conducted using a gingival index and a plaque index at baseline, one, two, and four weeks. Statistical analysis was done using IBM SPSS Statistics for Windows, version 23 (IBM Corp., Armonk, NY, USA). Intergroup analysis was done using Mann-Whitney test and intra-group analysis was done using Kruskal-Wallis test for all the study parameters. Statistical significance was set at a p-value of less than 0.05.
RESULTS: The mean plaque index scores were 2.02 ± 0.12 and 2.29 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively in baseline. The scores were 1.83 ± 0.29 and 0.57 ± 0.16 in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of plaque index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*. The mean gingival index scores were 2.09 ± 0.16 and 2.37 ± 0.17 in the subgingival scaling and microneedling with olive oil group in the baseline respectively. The scores were 1.88 ± 0.23 and 0.96 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of gingival index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*.
CONCLUSIONS: Our research showcased a novel and effective technique, unveiling a significant enhancement in gingival health accompanied by a reduction in both the average gingival index and plaque index.

OBJECTIVE: To determine the potential of gingival crevicular fluid (GCF) volume, E-cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.
BACKGROUND: NSPT is the gold-standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis-associated tissue destruction is evidenced by the increased level of soluble E-cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of NSPT.
METHODS: Patients with periodontitis (n = 24) were included in this clinical trial and full-mouth periodontal charting was recorded for each patient. GCF samples from periodontal pockets with probing pocket depth (PPD) 4-6 mm from the interproximal surfaces of anterior and premolar teeth were obtained. These sites subsequently received NSPT and were clinically re-evaluated after 1 and 3 months. Levels of GCF E-cadherin and TAC levels were assayed using ELISA.
RESULTS: All clinical periodontal parameters were significantly improved 3 months after completion of NSPT. These outcomes were associated with a significant decrease in E-cadherin levels and GCF volume, while TAC levels were significantly increased in samples obtained in follow-up appointments. Binary regression model analysis showed that PPD, GCF volume, E-cadherin, and TAC levels could significantly (p < .05) predict the outcomes of NSPT. The cut-off points for PPD, GCF volume, E-cadherin and TAC were 5 mm, 4 × 10-3, 1267.97 pg/mL and 0.09 μmol/g, respectively.
CONCLUSIONS: NSPT improved clinical parameters along with increased antioxidants capacity and epithelial pocket lining integrity. Discrimination of favorable/unfavorable responsiveness of periodontally diseased sites to NSPT could be possible by using GCF volume, PPD, E-cadherin and TAC level assessments.

BACKGROUND: Invisibility of subgingival scaling is the most important negative factor affecting the performance of periodontal treatment. A multisensory teaching strategy is used in the preclinical training of undergraduates in order to increase the haptic-auditory-visual feedback, aiming to overcome the invisibility and achieve minimal postoperative complications, improving patients\' treatment experience.
METHODS: One hundred undergraduate dental students in grade 5 were divided into a multisensory teaching strategy group (MTS: n = 50) and a conventional training pattern group (CTP: n = 50). All participants attended a lecture on using an ultrasonic subgingival scaler (USS) and Gracey curettes (GRA), followed by a 3-week training programme. Students in the MTS group were trained in a haptic/auditory-visual feedback manner, whereas students in the CTP group were trained conventionally. After the training phase, paired students in the 2 different groups performed subgingival scaling in paired patients with equivalent teeth of periodontitis using USS and GRA. Objective and subjective postoperative evaluations were recorded. Probing depth (PD) and gingival index (GI) were evaluated before and 4 weeks after scaling by the same periodontal specialist.
RESULTS: MTS significantly reduced treatment time and ameliorated postoperative complications (gingival injury, haemorrhage and root surface roughness; P < .05). Postoperative sensitivity was reduced in the MTS group from day 1 to day 7 (D1-D5: P < .001; D6: P = .002; D7: P = .003), whereas postoperative pain was reduced on day 1 (P = .006), compared with that in the CTP group. The PD reduction was not significant between the groups (MTS: 3.17 ± 0.95 mm vs CTP: 3.07 ± 0.97 mm, P > .05), whereas the GI change showed a significant difference between the groups (MTS: 1.71 ± 0.41 vs CTP: 1.67 ± 0.41, P < .05).
CONCLUSIONS: Multisensory teaching strategies in the preclinical periodontal training of undergraduates can reduce postoperative complications (gingival injury, postoperative haemorrhage, and root surface roughness) and provide a better treatment experience (decreased treatment time and postoperative pain and sensitivity) for patients.

OBJECTIVE: To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets.
METHODS: A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared.
RESULTS: A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment (P<0.001). For sites in a single-rooted tooth, sites with PD≥5 mm, and sites without vertical alveolar bone resorption and furcation involvement, the PD in endoscopy group was significantly lower than that in the control group at 6 weeks and 3 months after treatment (P<0.05).
CONCLUSIONS: Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.
目的: 探究牙周内窥镜辅助龈下刮治和传统龈下刮治对非手术治疗后残存牙周袋的临床疗效差异。方法: 收集2019年6—12月于四川大学华西口腔医院牙周病科就诊的牙周炎患者13例，以基础治疗后4~6周再评估时探诊深度（PD）≥4 mm、附着丧失（AL）≥4 mm且探诊出血的残存牙周袋为研究对象，进行分口设计的单盲随机对照试验，口内一侧行传统龈下刮治（对照组），另一侧行牙周内窥镜辅助龈下刮治（内窥镜组）。在基线、治疗后6周和治疗后3月分别测量菌斑指数（PLI）、PD、AL及出血指数（BI），比较治疗前后2组各项牙周指标的变化和组间差异，并比较2组患者报告结局的差异。结果: 共251颗患牙的694个位点纳入临床试验。治疗后6周和3月2组各项牙周指标均显著改善（P<0.001）。对于单根牙、探诊深度≥5 mm的位点以及牙槽骨无角形吸收且无根分叉病变的位点，治疗后6周及3月内窥镜组的PD均低于对照组（P<0.05）。结论: 牙周内窥镜辅助龈下刮治对单根牙、PD≥5 mm及牙槽骨无角形吸收且无根分叉病变的残存牙周袋的疗效优于传统龈下刮治。.

(-)-Epigallocatechin Gallate (EGCG) as green tea catechins possessed antibacterial and anti-inflammatory effects on periodontal disease. This study was designed to evaluate the clinical and microbiological efficacy of scaling and root planing (SRP) using EGCG aqueous solution as coolants through a new-type ultrasonic scaler tip on chronic periodontitis.
This split-mouth, randomized clinical trial included 20 patients (2 drop-outs) with chronic periodontitis and the maxillary contra-lateral sides were allocated into test and control groups randomly. Through the new-type scaler tip, 762 sites with probing depth (PD) ≥ 4 mm were treated by SRP using EGCG solution or distilled water as coolants respectively. Clinical parameters and red complex pathogens in subgingival microbiome were evaluated at baseline, 3 and 6 months after treatments.
During 6 months, the SRP plus EGCG medication contributed to additional PD reduction as 0.33 mm and gain of clinical attachment level as 0.3 mm compared with SRP alone, and approximate 8% more sites obtained PD reduction ≥ 2 mm (p < 0.05). Meanwhile, the mean relative abundance of Tannerella forsythia was significantly lower in the combined treatment group (p < 0.05).
The purified EGCG showed the potential to improve the outcome of periodontal non-surgical treatment and the new-type scaler tip provided an alternative vehicle for subgingival medication. Trial registration The trial was registered in Chinese Clinical Trial Registry on 15 February 2020 (No.: ChiCTR2000029831, retrospectively registered). http://www.chictr.org.cn/showprojen.aspx?proj=49441 .

Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment.
English-language databases (PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Medline, and ClinicalTrials.gov, by January, 2019) were searched. Weighted mean differences in primary outcomes, PPD and clinical attachment loss (CAL) reduction, were estimated by random effects model. Secondary outcomes, bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus, were analyzed by comparing the results of each study. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The GRADE approach was used to assess quality of evidence.
Ten randomized controlled trials were included out of 1434 identified. Initial PPD and follow-up periods formed subgroups. For 3-months follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-months follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus.
When initial PPD was 4-6 mm, PPD reduction proved manual subgingival scaling was superior, but CAL results showed no statistical differences between the two means. When initial PPD was ≥6 mm, PPD and CAL reductions suggested that manual subgingival scaling was superior.

OBJECTIVE: The objective of this study was to assess the microbiological effects and recolonization patterns after non-surgical periodontal treatment protocol based on the adjunctive use of erbium-doped yttrium aluminium garnet (Er:YAG) laser.
METHODS: Patients diagnosed with chronic periodontitis were randomly assigned to two different treatment protocols: test, full-mouth subgingival ultrasonic instrumentation followed by Er-YAG laser application 1 week later to sites with initial probing pocket depth ≥4.5 mm; and control, full-mouth ultrasonic subgingival instrumentation within 1 week. Clinical (at sampled sites) and microbiological (culture-based) parameters were recorded at baseline and 3 and 12 months. Microbiological variables included total counts, frequency of detection, proportions and counts of target species.
RESULTS: Results from 19 test and 21 control patients were compared. Minor changes were observed for total colony-forming units, with no differences between groups. For the frequency of detection, a limited and similar impact in both groups was observed for the most prevalent (over 80 %) periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum). For proportions, reductions in P. gingivalis occurred at 3 months, both in the test and control groups (from 16.3 to 10 % and 16 to 14.8 %, respectively), although these differences were not statistically significant. At 12 months, the test group showed a statistically significant greater reduction in probing depth for the sampled sites.
CONCLUSIONS: The adjunctive use of Er:YAG laser when compared with conventional ultrasonic debridement did not provide a microbiological added benefit.
CONCLUSIONS: Even though some clinical benefits with the adjunctive laser application were identified when comparing both treatment protocols, there were no differences in microbiological outcomes or in the bacterial recolonization patterns.

BACKGROUND: Simplified periodontal therapy might be a pragmatic strategy for public health programmes targeting Indigenous Australian adults. The objective of this randomized controlled trial was to evaluate oral health effects of single-visit, non-surgical periodontal therapy compared to no treatment.
METHODS: This parallel-group, randomized, open label clinical trial enrolled 273 Indigenous Australians aged ≥18 years with periodontitis. Intervention participants received full-mouth periodontal scaling and root planing during a single visit while the control group received no treatment. Endpoints were summary variables derived from clinical assessments of probing depth, clinical attachment loss, plaque, calculus and gingival bleeding before treatment and 3 months later.
RESULTS: Endpoints could be calculated for 169 participants with follow-up data. Compared to the control group, there were statistically significant reductions in extent of shallow pockets: PD ≥4 mm (mean difference -2.86, [95% CI -5.01 to -0.71], p = 0.009) and gingival bleeding (mean difference -0.25, [95% CI -0.43 to -0.08], p = 0.005) but not deeper pockets PD ≥5 mm (mean difference -0.48, [95% CI -1.78 to 0.82], p = 0.468) or plaque scores.
CONCLUSIONS: Periodontal therapy produced improvements in shallow periodontal pockets and measures of gingival bleeding in these Indigenous Australians.