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ABSTRACT Aim The aim of this study is to compare the degree of severity of chronic periodontitis in HIVseropositive subjects with chronic periodontitis to control subjects with chronic periodontitis, in the Ga-Rankuwa area in South Africa. Methods Two cohorts of subjects with chronic periodontitis were recruited for this study over a period of time: thirty HIV-seropositive subjects; and 30 control subjects presumed to be HIV - seronegative and apparently in good health. Results When all the periodontal indices were compared and evaluated there was no association between HIV-serostatus and the periodontal indices. When periodontal indices were compared between HIV-seropositive subjects using highly active anti-retroviral therapy (HAART), and HAART-naïve subjects, there was no statistical differences regarding gingival recession, plaque index and bleeding index. However, the mean pocket depth in HAARTnaïve seropositive subjects was slightly greater than in HIV-seropositive subjects using HAART. Correlation coefficient of mean pocket depth in relation to log CD4+ T cell count in the HIV-seropositive HAART-naïve group of subjects showed a significant negative correlation (P = -0.947), but there was no correlation between the mean gingival recession values and the log CD4+ T cell counts in the same group (P=0.303). For the HIVseropositive subjects using HAART the correlation coefficient test failed to show significant statistical relationships between log CD4+ T cell count and mean pocket depth (P=0.903) and mean gingival recession (P=0.312) in HIV-seropositive subjects using HAART. Conclusion HIV-seropositive subjects with chronic periodontitis show clinical manifestations of similar degree of their periodontal disease to those of healthy control subjects with chronic periodontitis, with no differences in the mean pocket depth, gingival recession, plaque index and bleeding index.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / A periodontite crÃnica inflamatÃria (PC) caracteriza-se por um processo inflamatÃrio nos tecidos de suporte dos dentes. à causada inicialmente por bactÃrias, mas sua progressÃo està relacionada à resposta individual do hospedeiro. à uma doenÃa multifatorial e complexa, na qual fatores genÃticos e ambientais interagem, promovendo e modificando a expressÃo clÃnica da doenÃa. Polimorfismos de genes envolvidos no processo inflamatÃrio tÃm sido estudados no intuito de identificar possÃveis marcadores genÃticos e elucidar diferenÃas na expressÃo de citocinas mediadoras da inflamaÃÃo. ApolipoproteÃna E (apoE) à uma proteÃna de importÃncia no metabolismo lipÃdico e està envolvida em processos fisiopatolÃgicos. O objetivo deste estudo foi investigar se hà associaÃÃo do polimorfismo do gene da apoE com a susceptibilidade à PC em indivÃduos que procuraram o serviÃo odontolÃgico da clÃnica de Periodontia da Universidade Federal do Cearà e avaliar achados sociodemogrÃficos relacionados com essa doenÃa. Foram selecionados 109 indivÃduos entre 30 e 70 anos (mÃdia = 44,5  9,64) de ambos os gÃneros e agrupados da seguinte forma: grupo controle n=53 e grupo Periodontite CrÃnica n=56. Foi extraÃdo DNA a partir de um bochecho e esfregaÃo da mucosa oral e o polimorfismo da apoE foi identificado pelo mÃtodo de PCR-RFLP (reaÃÃo de polimerase em cadeia â polimorfismo com restriÃÃo de fragmentos) e submetidos à eletroforese em gel de agarose a 5%. As distribuiÃÃes da frequÃncia alÃlica e dos genÃtipos foram avaliadas pelo teste qui-quadrado (p˂0,05). O risco associado com alelos e genÃtipos foi calculado como odds ratio (OR) com intervalo de confianÃa (IC) de 95%. Para relacionar os achados sociodemogrÃficos com a PC em indivÃduos com alelos especÃficos foi utilizada a anÃlise de regressÃo logÃstica. Os resultados da anÃlise individual do polimorfismo da apoE nÃo evidenciaram associaÃÃo dos alelos e genÃtipos com a susceptibilidade à PC. Observou-se associaÃÃo entre a doenÃa e a renda familiar mensal, de maneira que a chance de adoecer aumenta 3 vezes quando a renda diminui de mais que 3 salÃrios-mÃnimos para a renda de 1 a 3 salÃrios-mÃnimos. Ainda, hà um aumento significativo na chance de desenvolver a doenÃa em 5,1% a cada ano de vida. IndivÃduos que reportaram hipertensÃo arterial tiveram uma chance quase 2,5 vezes maior de ter a PC do que o grupo controle apesar de nÃo ter dado significado estatÃstico. Da mesma forma, foi encontrada maior chance de desenvolver a doenÃa em indivÃduos com baixo nÃvel de escolaridade (OR=3,7). O polimorfismo da apoE nÃo està associado à PC na populaÃÃo estudada. / Chronic periodontitis (CP) is characterized by an inflammation in the supporting tissues of the teeth. It is primarily caused by bacteria, but progression is associated with individual host response. CP is a complex and multifactorial disease. Genetic and environmental factors interacting can modify the clinical cause of the disease. Genetic polymorphisms have been studied to identify possible genetic markers and explain differences in the inflammatory cytokines expression. Apolipoprotein E (apoE) is an important protein in lipid metabolism and is also envolved in pathophysiological processes. The aim of this study was to investigate whether there is an association of the APOE polymorphisms with the CPÂs susceptibility in subjects that sought periodontal treatment at Dental School of Federal University of Ceara and evaluate sociodemographic status related with the disease. A sample of 109 subjects between 30 and 70 years (mean age = 44,5  9,64) were grouped into: 53 controls and 56 subjects with CP. DNA was obtained through a mouthwash and oral mucosa scraping and genotyped by PCR-RFLP method (Polimerase Chain Reaction â Restrict Fragment Length Polymorphism). Differences in the allele and genotype frequencies were assessed by Chi-squared test (p˂0.05). The risk associated with alleles and genotypes was calculated as odds ratio (OR) with 95% confidence intervals (CI). Logistic regression was used to associate sociodemographic status with CP and genotypes. No differences were observed in the apoE allelic distribution regarding control and periodontitis groups. Age and socio-economic status increase the risk for having CP, since individuals with lower socio-economic status was about 3-fold more likely to develop periodontitis (OR=3.1) and increase in age enhances the risk in 5.1% to develop disease in each year of age. Hypertension was a factor of clinic importance in development of CP, since subjects who self-reported hypertensive have 2,5-fold more likely to develop disease than individuals who not self-reported hypertension, although no statistic difference was reached. Similarly, CP was also associated with lower education level (OR=3.7). The polymorphism in the APOE gene was not associated with the susceptibility to CP in the studied population.

A Periodontite é uma doença de etiologia multifatorial que acomete os tecidos de suporte dentário resultando em perda progressiva de inserção e perda óssea. Este estudo clínico controlado, aleatorizado e duplo-cego avaliou a eficácia da Terapia Fotodinâmica antimicrobiana (TFDa), em aplicações múltiplas, como terapia adjuvante ao tratamento periodontal cirúrgico em pacientes com Periodontite Crônica Avançada (PCA). Dezesseis voluntários foram submetidos ao modelo de estudo do tipo boca dividida, recebendo tratamento de acesso cirúrgico associado a raspagem e alisamento radicular (RAR) adjunto à TFDa em protocolo de aplicação nos períodos de 0, 2, 7 e 14 dias pós-operatórios (Grupo Teste - GT), ou apenas tratamento de acesso cirúrgico associado a RAR (Grupo Controle - GC). Todos os pacientes receberam orientação de higiene oral e acompanhamento por 90 dias pós-cirúrgicos. Os seguintes parâmetros clínicos e microbiológicos foram avaliados: Nível clínico de inserção (NCI), Profundidade de sondagem (PS), Recessão gengival (RG), Sangramento à sondagem (SS), Índice de placa (IP) e contagem de 40 espécies microbianas subgengivais (checkerboard DNA-DNA hybridization). Os dados foram coletados nos períodos baseline (pré-terapia básica), 60 dias (30 dias após terapia não cirúrgica) e 150 dias (90 dias pós-cirurgia). Uma redução significativa na PS foi observada aos 150 dias para o GT, quando comparado ao GC no mesmo período (p < 0,05). O ganho do NCI foi significativamente maior no GT entre os tempos de 60 e 150 dias (p < 0,05). As mudanças da microbiota subgengival foram similares entre os grupos (p > 0,05), mas o Grupo Teste apresentou quantidades mais elevadas de bactérias compatíveis com saúde periodontal no período final do experimento em relação ao GC (p < 0,05). Concluiu-se que a utilização da TFDa em aplicações múltiplas, como terapia adjuvante ao tratamento cirúrgico periodontal, produziu melhoras significativas nos parâmetros clínicos no período de 90 dias de avaliação / Chronic Periodontitis is a multifactorial disease which results in tooth supporting tissues loss. This double-blind randomized controlled clinical trial assessed the efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT) as an adjunct to surgical periodontal treatment in patients with severe chronic periodontitis (SCP). Sixteen volunteers were selected into this Split-mouth study. They were subjected to scaling and root planning in open flaps (SRP) combined with aPDT at 0, 2, 7, and 14 postoperative days (Test Group - TG), or only SRP (Control Group CG). All patients were instructed about oral hygiene and were followed up for 90 days after surgery. The following clinical and microbiological parameters were assessed: clinical assessment level (CAL), probing depth (PD), gingival recession (GR), bleeding on probing (BOP), plaque index (PI). Levels of 40 subgingival species were measured by checkerboard DNA-DNA hybridization at baseline, 60 (30 days after non-surgical therapy) and 150 days (90 days post-surgery). Data were collected at baseline (pre-intervention), at 60 days (30 days after the end of nonsurgical therapy), and at 150 days (90 days after surgery). A significant reduction in PD was observed at 150 days for the TG, when compared to the CG (p < 0.05). CAL gain was significantly higher in the TG at 60 and 150 days (p < 0.05). Changes in the subgingival microbiota were similar between the groups (p > 0.05), but the TG revealed a larger number of bacteria associated with periodontal disease at the end of the experiment compared to the CG (p < 0.05). In conclusion, multiple sessions of aPDT as an adjunct to surgical periodontal treatment significantly improved clinical parameters at 90 postoperative days

O propósito deste estudo foi avaliar o efeito adjuvante da terapia probiótica (TProb) no tratamento periodontal não cirúrgico em pacientes com Periodontite Crônica generalizada (PCg). Em um estudo clínico aleatorizado, duplo-cego e placebo-controle, 41 pacientes com PCg foram tratados com TProb associada à raspagem e alisamento radicular (RAR Grupo Teste) ou apenas RAR (Grupo Controle). Os pacientes do Grupo Teste consumiram pastilhas contendo Bifidobacterium animalis subsp. lactis (B. lactis) HN019 durante 4 semanas. Os pacientes do Grupo Controle receberam pastilhas placebo (sem probiótico). Parâmetros clínicos periodontais foram avaliados no baseline (período pré-intervenção) e em 30 e 90 dias após a RAR. Nestes mesmos períodos foram coletadas amostras de placa subgengival para contagem de 40 espécies bacterianas (checkerboard DNA-DNA hybridization) e detecção do genoma de B. lactis HN019 (Reação em cadeia da polimerase em tempo real - q-PRC), amostras do fluido crevicular gengival para avaliação dos níveis de Interleucina (IL)-1beta, IL-8 e IL-10 (Imunoensaios multiplex) e amostras de saliva para avaliação dos níveis de Imunoglobulina A (IgA) (Nefelometria). Foram realizadas, também, biópsias de tecido gengival para determinação da expressão de beta-defensina (BD)-3 e receptores do tipo Toll (TLR)-4 (reações imunohistoquímicas - estreptavidina-biotina-peroxidase). Os dados obtidos foram estatisticamente analisados (p<0,05). O Grupo Teste apresentou, aos 90 dias, redução de profundidade de sondagem (PS) e ganho de inserção clínica significativamente maiores que aqueles do Grupo Controle. O Grupo Teste também apresentou menor quantidade de bolsas periodontais moderadas (aos 30 e 90 dias) e profundas (aos 90 dias) que o Grupo Controle (p<0,05), bem como menor quantidade de pacientes (p<0,05) apresentando 3 ou mais sítios com PS &ge; 6 mm ou PS = 5mm e sangramento à sondagem (SS) positivo. O Grupo Teste apresentou menor SS (aos 30 e 90 dias) e menor IP (aos 30 dias) quando comparado ao Grupo Controle (p<0,05). Na análise microbiológica, o Grupo Teste apresentou proporções significativamente menores de espécies microbianas dos complexos vermelho (ao 30 e 90 dias) e do complexo laranja (aos 30 dias), bem como maiores proporções de espécies do complexo azul (aos 90 dias) quando comparado ao Grupo Controle. A análise por meio de q-PCR mostrou que o Grupo Teste apresentou um aumento no número de cópias/&mu;L do genoma da cepa probiótica B. lactis HN019 no biofilme subgengival aos 30 e 90 dias (p<0,05). Na análise imunológica, o Grupo Teste apresentou menor razão (valores ajustados ao baseline) de IL-1&beta; (aos 30 e 90 dias) e de IL-8 (aos 30 dias) do que o Grupo Controle (p<0,05). Apenas o Grupo Teste apresentou valores de IL-10 significativamente maiores que aqueles do baseline aos 30 dias. Não foram observadas diferenças entres os grupos nas razões de IgA aos 30 e 90 dias. Na análise imunohistoquímica, o Grupo Teste apresentou expressões significativamente maiores de BD-3 e TLR-4 em sítios doentes quando comparado ao Grupo Controle aos 30 dias. Pode-se concluir que a utilização do probiótico B. lactis HN019 como recurso adjuvante à RAR promove benefícios clínicos, microbiológicos e imunológicos adicionais no tratamento de pacientes com PCg / The purpose of this study was to evaluate the adjuvant effect of probiotic therapy (ProbT) in non-surgical periodontal treatment in patients with generalized chronic periodontitis (GCP). In this randomized, double-blind, placebo-control, 41 patients with GCP were treated with ProbT associated with scaling and root planing (SRP - Test Group) or SRP only (Control Group). The patients in the Test Group consumed lozenges containing Bifidobacterium animalis subsp. lactis (B. lactis) HN019 during 4 weeks. The patients in the Control Group received placebo (lozenges without probiotic). Periodontal clinical parameters were evaluated at baseline (pre-intervention) and at 30 and 90 days after SRP. Samples of subgingival plaque were collected to count 40 bacterial species (checkerboard DNA-DNA hybridization) and detection of genome of B. lactis HN019 (polymerase chain reaction in real time - q-PCR). Gingival crevicular fluid samples were collected for assessing levels of interleukin (IL)-1beta, IL-8 and IL-10 (multiplex immunoassays). Saliva samples were collected to measure levels of immunoglobulin A (IgA) (nephelometry). Also, biopsies of gingival tissues were performed to determine the expression of beta-defensina (BD)-3 and Toll-Like receptors (TLR)-4 (immunohistochemical reactions - streptavidin-biotin-peroxidase). The data obtained were statistically analyzed (p < 0.05). The Test Group presented, at 90 days, reduction of probing pocket depth (PPD) and clinical attachment gain significantly higher when compared to the Control Group. The Test Group also presented a lower number of moderate (at 30 and 90 days) and deep (90 days) periodontal pockets than the Control Group (p < 0.05), as well as a lower number of subjects (p < 0.05) with 3 or more sites with PPD &ge;6 mm or PPD = 5mm and bleeding on probing (BOP) positive. The Test Group presented lower BOP (at 30 and 90 days) and lower PI (at 30 days) when compared to the Control Group (p<0.05). In the microbiological analysis, the Test Group showed significantly lower proportions of microbial species of red (at 30 and 90 days) and the orange (at 30 days) complexes, as well as higher proportions of species of blue complex (at 90 days) when compared to the Control Group. q-PCR analysis showed that the Test Group presented an increase in the number of copies/&mu;L of the genome of the probiotic strain B. lactis HN019 in subgingival biofilm at 30 and 90 days (p < 0.05). In the immunological analysis, the Test Group presented a lower ratio of IL-&beta;1 (at 30 and 90 days) and IL-8 (30 days) than the Control Group (p < 0.05). Only the Test Group presented values of IL-10 significantly higher than those of the baseline at 30 days. No differences were observed between the groups on the ratios of IgA at 30 and 90 days. In the immunohistochemical analysis, the Test Group showed significantly higher expression of BD-3 and TLR-4 in sites with periodontitis when compared to the Control Group at 30 days. It can be concluded that the use of probiotic B. lactis HN019 as an adjuvant to SRP promotes clinical, microbiological and immunological additional benefits in the treatment of patients with GCP

Magister Chirurgiae Dentium (MChD) / Chlorhexidine has been established as the gold standard against which new chemical plaque control agents are tested (Jones, 1997). The addition of alcohol in a chlorhexidine mouthwash had been widely used, however the comparative efficacy of alcohol free chlorhexidine mouthwash had not fully been explored in this study, two chlorhexidine mouthwash preparations were tested to evaluate their comparative efficacy in the treatment of periodontal disease. Aims: To assess the efficacy of alcohol-free chlorhexidine mouth wash in comparison to alcohol containing chlorhexidine mouth wash. Objectives: To determine pre- and post- operative clinical parameters and microbial load in the management of patients with chronic periodontitis. Methodology: A double blinded randomised control trial was conducted. Patients diagnosed with active chronic periodontitis were included in the study and randomised to either a test (chlorhexidine without alcohol) or control group (chlorhexidine with alcohol). A total of 50 patients were selected for the study. Results: The Wilcoxon Signed Rank test was used to test the difference between the pre-post pair per clinical indicator and Bana-Zyme. The differences between before and after treatment per indicator were significant at P<0.001 for respectively Paroex and Peridex. These values demonstrated the difference between the clinical parameters taken before the treatment and six weeks post treatment. Conclusion: Both mouth wash solutions with and without alcohol had proven to reduce the microbial load as shown by the BANA-Zyme test, with the alcohol containing solution having been more effective.

O objetivo geral deste estudo foi monitorar a atividade da doença periodontal e sugerir potenciais biomarcadores salivares relacionados a esta atividade em pacientes com periodontite crônica associada ou não Diabetes mellitus tipo 2, a partir da avaliação do perfil da expressão gênica de sítios periodontais progressivos e de proteínas inflamatórias salivares. Foram incluídos 56 pacientes, sendo 21 com periodontite crônica (DP), 20 com periodontite crônica associada ao Diabetes mellitus tipo 2 (DP+DM) e 15 periodontal e sistemicamente saudáveis (controle). Foi realizado exame radiográfico antes e dois meses após a terapia periodontal básica, e posteriormente foi feita a subtração radiográfica a partir dos pares das radiografias. As medidas das áreas com perda de densidade foram registradas. Coleta de saliva não estimulada, verificação da hemoglobina glicada (HbA1c) e exame clínico periodontal profundidade de sondagem (PS), nível clínico de inserção relativo (NCIR), sangramento à sondagem (SS) e índice de placa (IP) também foram realizados antes e dois meses após a terapia periodontal básica. Os sítios periodontais com perda de inserção progressiva 1 mm na reavaliação foram considerados ativos de acordo com uma adaptação do método de tolerância. Biópsias de tecido gengival de sítios ativos e inativos com parâmetros clínicos semelhantes foram analisadas com real time PCR Array para análise do perfil de expressão gênica da resposta imune-inflamatória. As amostras de saliva foram submetidas ao imunoensaio Multiplex Cytokine Profiling para análise de expressão de proteínas. No grupo DP, 9% dos sítios foram classificados como ativos e no grupo DP+DM, 12% (p > 0,05). A média de perda de inserção clínica foi maior no grupo DP+DM (1,34 mm) em relação ao grupo DP (1,21 mm) (p < 0,05). Houve correlação entre a perda de inserção clínica e a área da perda de densidade radiográfica tanto nos sítios ativos do grupo DP (R = 0,79; p = 0,001), quanto do grupo DP+DM (R = 0,86; p < 0,001). Ambos os grupos DP e DP+DM apresentaram um perfil down-regulated em relação aos pacientes saudáveis (grupo controle). Quando comparado o grupo DP+DM ao grupo DP, pacientes diabéticos apresentaram um perfil up-regulated. Sítios ativos do grupo DP mostraram nove genes (ABCF1, CD40LG, IL10, IL5, CCR2, CCR4, CCR7, CCL18 e CXCL1) diferencialmente expressos (p < 0,05) com um perfil up-regulated. Sítios ativos do grupo DP+DM mostraram seis genes (LTA, CXCR1, CCL19, CCL8, CCL17 e CXCL12) diferencialmente expressos (p < 0,05) com um perfil up-regulated. Após a terapia periodontal básica, houve uma significante redução de algumas proteínas salivares (IL1b, IL1ra, IL10, IL17, TGFb, IL8, eotaxin e MCP-3) nos grupos DP e DP+DM, mas sem diferença estatisticamente significante (p > 0,05). Concluindo, este estudo foi capaz de monitorar a atividade da doença periodontal em pacientes com e sem diabetes após a terapia periodontal básica; foi possível identificar genes diferencialmente expressos em sítios ativos de ambos os grupos, que podem ser úteis na indicação de potenciais biomarcadores para diagnóstico da doença periodontal na fase ativa; as proteínas salivares analisadas mostram uma tendência em diferenciar o padrão de saúde e de doença, podendo ser futuramente utilizadas como potenciais biomarcadores de periodontite associada ou não ao diabetes. / The overall aim of this study was to monitor the periodontal disease activity and suggest potential salivary biomarkers related to this activity in chronic periodontitis patients with or without type 2 Diabetes mellitus (DM), based on the evaluation of gene expression profile of progressive periodontal sites and salivary inflammatory proteins. Fifty-six patients were enrolled, 21 with chronic periodontitis (PD group), 20 with chronic periodontitis and DM (PD+DM group) and 15 periodontal- and systemically healthy (control). Radiographs were taken before and two months after non-surgical periodontal therapy, and radiographic subtraction was performed from pairs of these radiographs. Measurements of the areas with density loss were recorded. Unstimulated saliva collection, glycated hemoglobin (HbA1c) measurement and periodontal examination probing pocket depth (PPD), relative clinical attachment level (rCAL), bleeding on probing (BOP) and plaque index (PI) were also conducted before and two months after non-surgical periodontal therapy. The periodontal sites with progressive attachment loss 1 mm at the recall visit were considered active sites according to the adapted method of tolerance. Gingival biopsies of active and non-active sites with similar clinical parameters were harvested for gene expression analysis of the immune-inflammatory response with Real Time PCR Array. Saliva samples were analyzed by Multiplex Cytokine Profiling Immunoassay for analysis of protein expression profile. In PD group, 9% of the sites were classified as active and in PD+DM group, 12% (p > 0.05). The clinical attachment loss mean was higher in the PD+DM group (1.34±0.23 mm) compared to the PD group (1.21±0.16 mm) (p < 0.05). There was a correlation between clinical attachment loss and darkened radiographic areas in active sites of the PD group (R = 0.79, p = 0.001) and PD+DM group (R = 0.86, p < 0.001). Both PD and PD+DM groups showed a down-regulated profile compared to healthy subjects (control group). When compared PD group to PD+DM, patients with diabetes had an upregulated profile. Active sites of the PD group showed nine genes (ABCF1, CD40LG, IL10, IL5, CCR2, CCR4, CCR7, CCL18 and CXCL1) differentially expressed (p < 0.05) with an up-regulated profile. Active sites of the PD+DM group showed six genes (LTA, CXCR1, CCL19, CCL8, CCL17 and CXCL12) differentially expressed (p < 0.05) with an up-regulated profile. After non-surgical periodontal therapy, there was a significant reduction of clinical parameters and HbA1c levels (p < 0.05), accompanied by a reduction of some salivary proteins (IL1b, IL1ra, IL10, IL17, TGFb, IL8, eotaxin and MCP-3) in groups PD and PD+DM, but without statistically significant difference (p > 0.05). In conclusion, this study was able to monitor the periodontal disease activity in periodontal patients with or without diabetes after the non-surgical periodontal therapy; it was possible to identify genes differentially expressed in active sites from both groups, which may be considered useful in indicating potential biomarkers for the diagnosis of active periodontal disease; salivary proteins show a trend in distinguishing the standard of health and disease and may be used in the future as potential biomarkers of periodontitis with or without diabetes.

Background: In this study, we enhanced a diagnostic questionnaire which had been previously developed to measure stress and social support. Methods: 101 patients with chronic periodontitis and 50 healthy control subjects completed our questionnaire package after which we analyzed the data for trends and associations. Results: Our enhanced questionnaire provided a valid and reliable measure of stress and social support in patients with chronic periodontitis. Conclusion: Our enhanced questionnaire provided both a valid and a reliable measure of stress and social support in patients with chronic periodontitis however requires further refinement to predict periodontal disease experience and severity.

Background: In this study, we enhanced a diagnostic questionnaire which had been previously developed to measure stress and social support. Methods: 101 patients with chronic periodontitis and 50 healthy control subjects completed our questionnaire package after which we analyzed the data for trends and associations. Results: Our enhanced questionnaire provided a valid and reliable measure of stress and social support in patients with chronic periodontitis. Conclusion: Our enhanced questionnaire provided both a valid and a reliable measure of stress and social support in patients with chronic periodontitis however requires further refinement to predict periodontal disease experience and severity.

Magister Chirurgiae Dentium - MChD / This mini-thesis assessed whether a diode laser with a wavelength of 810 ± 10nm can be utilized as an adjunct to conventional management (i.e. scaling, root planing and polishing) of chronic periodontitis during initial phase therapy. Ethical approval and study registration (Reg no: 14/9/6) was finalized prior to commencement of the study. A split mouth randomised control trial was performed on 25 participants (who presented at the Oral Medicine and Periodontology Department of the University of the Western Cape) diagnosed with active, chronic periodontitis. In order to standardise the split mouth design the quadrants 1 & 4 were assessed together as a set and quadrants 2 & 3 were assessed as a set. A set of these quadrants were randomly assigned to either the test or control quadrants after conventional management was performed in all four quadrants. The base line bacterial colony collection (Micro-IDent®-11, Hain Lifescience GmbH, Nehren, Germany) and the clinical parameters were assessed prior to the commencement of conventional management and were reassessed at the 6 week re-evaluation visit. The set of test quadrants were treated with the diode laser as an adjunct to the preceding conventional management. The control quadrant only received the conventional management. Evaluation of the results demonstrated that the diode laser produced no statistical decrease in the bacterial parameters in the periodontal pockets and resulted in a statistical increase of C. showae (Cs) and T. denticola (Td). The clinical parameters resulted in no statistical difference for any clinical parameter, with the exception of the reduction in BOP that was statistically significant (p< 0,05) with the laser as an adjunct. It is the recommendation that within the limitations of this study, that the utilization of the diode laser (810 ± 10nm) as an adjunct at the initial visit had no statistical effect in the reduction of the bacterial parameters nor resulted in an overall improvement of the clinical parameters.