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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0043-1772567
Original Article

Anti-infective Efficacy of Mechanical Debridement with Adjunctive Modalities on Clinical and Cytokine Parameters in Treatment of Chronic Periodontitis: Randomized Controlled Clinical Trial

Anjale Rajagopal
1   Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Jothi Varghese 
1   Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Vinutha Bhat
2   Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Vibha Acharya
2   Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Vinayak Kamath
3   Department of Public Health Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
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Abstract

Objectives Periodontal debridement involves conventional scaling and root planing (SRP) along with variant forms of adjunctive therapies. In the present clinical trial, we investigated if the adjunctive use of HybenX gel or diode laser along with SRP could provide a favorable outcome for the treatment of chronic periodontitis.

Materials and Methods The present study involved 60 subjects diagnosed with chronic periodontitis who were randomly assigned as test groups (laser or HybenX) or control group (SRP alone). The primary outcomes of the clinical trial were pocket probing depth (PPD) and clinical attachment level (CAL), which was evaluated at baseline and at third-month time interval. Additionally, secondary outcomes included estimation of reduction in inflammatory mediators interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in gingival crevicular fluid using enzyme-linked immunosorbent assay at baseline and third-month intervals.

Statistical Analysis Normality determination was checked using Shapiro–Wilk test. Since the data was not normally distributed, nonparametric tests were applied. The comparison of clinical parameters between the groups was analyzed with Kruskal–Wallis test. Wilcoxon sign rank test was used to compare the pairwise comparison of clinical parameters among the groups from baseline to third-month follow-up. The inflammatory mediators at various time points were compared using a One-way analysis of variance test, and the inflammatory mediators in each study group were compared using a paired t-test.

Results Both the test groups demonstrated a decrease in PPD and CAL. However, the HybenX group exhibited statistically significant reduction at the end of the third-month study interval compared to the laser group and SRP alone. Further, the secondary outcome IL-1β and TNF-α analysis exhibited statistically significant reduction in all the groups posttherapy.

Conclusion The adjunctive application of HybenX gel yielded an advantage compared to laser and SRP for the treatment of chronic periodontitis.

Clinical Relevance Adjunctive use of the oral tissue desiccant (HybenX gel) combined with SRP improved the periodontal pocket disinfection process and enhanced tissue healing devoid of adverse effects.

Keywords

lasers - tissue desiccant - inflammatory mediators - mechanical debridement - chronic periodontitis

Ethical Approval Statement

The study was approved by the institutional ethical review board that was conducted in accordance with the Helsinki Declaration of 1975 further revised in 2013 and prospectively registered in the Clinical Trials Registry.


Authors' Contribution

J.V.: conceptualization, methodology, study design, analysis/interpretation of data and critical revision, manuscript editing, reviewing, and final draft. A.R.: study design, data acquisition, data analysis and interpretation, and drafted the manuscript. V.B., V.A., V.K.: study design and analysis/interpretation of data. All authors gave final approval and agreed to be accountable for all aspects of the work.




Publication History

Article published online:
17 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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