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"[ABSTRAKLatar Belakang: Minosiklin merupakan antibiotik dengan sifat bakteriostatikyang potensial mengeliminasi bakteri patogen periodontal. Kesembuhanperawatan periodontitis kronis umumnya ditunjukkan secara klinis danmikrobiologis. Tujuan: Menganalisis parameter klinis (penurunan kedalamanpoket dan indeks perdarahan gingiva, peningkatan perlekatan klinis) dan jumlahT. forsythia sebelum dan sesudah aplikasi gel Minosiklin HCl 2%. Metode:Empat puluh dua subjek menerima aplikasi gel Minosiklin HCl 2% sebanyakempat kali, kemudian dievaluasi parameter klinis dan T. forsythia dengan Real-Time Polymerase Chain Reaction (RT-PCR). Hasil: Terdapat perbedaanbermakna dari parameter klinis dan T. forsythia antara pemeriksaan awal dankontrol bulan ke-6 (p<0,05). Terdapat perbedaan bermakna antara hubunganpenurunan indeks perdarahan gingiva dengan jumlah T. forsythia (p<0,05).Kesimpulan: Aplikasi gel Minosiklin HCl 2% secara klinis dan mikrobiologisefektif dalam perawatan periodontitis kronis.

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ABSTRACTBackground: Minocycline is known as one of the antibiotics with greatbacteriostatic effect to eliminate periodontal pathogen. Healthier periodontalenvironment is usually shown with better clinical and microbiological response.Objective: To clinically and microbiologically (T. forsythia) analyze the effect ofMinocycline HCl 2% for treatment of chronic periodontitis within six months.Methods: Forty-two subjects applied with Minocyline HCl 2% for four times.Clinical and microbiological examinations were evaluated on baseline, month-2,month-3, and month-6. T. forsythia was examined with Real-Time PolymeraseChain Reaction (RT-PCR) techniques. Result: There were significant differencesbetween Probing Pocket Depth, Papilla Bleeding Index, Clinical AttachmentLevel, and amount of T. forsythia in baseline compare to six months period(p<0.05). There was an association between the amount of T. forsythia and PapillaBleeding Index (p<0.05). Conclusion: Minocycline HCl 2% was effectiveclinically and microbiologically in chronic periodontitis therapy.;Background: Minocycline is known as one of the antibiotics with greatbacteriostatic effect to eliminate periodontal pathogen. Healthier periodontalenvironment is usually shown with better clinical and microbiological response.Objective: To clinically and microbiologically (T. forsythia) analyze the effect ofMinocycline HCl 2% for treatment of chronic periodontitis within six months.Methods: Forty-two subjects applied with Minocyline HCl 2% for four times.Clinical and microbiological examinations were evaluated on baseline, month-2,month-3, and month-6. T. forsythia was examined with Real-Time PolymeraseChain Reaction (RT-PCR) techniques. Result: There were significant differencesbetween Probing Pocket Depth, Papilla Bleeding Index, Clinical AttachmentLevel, and amount of T. forsythia in baseline compare to six months period(p<0.05). There was an association between the amount of T. forsythia and PapillaBleeding Index (p<0.05). Conclusion: Minocycline HCl 2% was effectiveclinically and microbiologically in chronic periodontitis therapy., Background: Minocycline is known as one of the antibiotics with greatbacteriostatic effect to eliminate periodontal pathogen. Healthier periodontalenvironment is usually shown with better clinical and microbiological response.Objective: To clinically and microbiologically (T. forsythia) analyze the effect ofMinocycline HCl 2% for treatment of chronic periodontitis within six months.Methods: Forty-two subjects applied with Minocyline HCl 2% for four times.Clinical and microbiological examinations were evaluated on baseline, month-2,month-3, and month-6. T. forsythia was examined with Real-Time PolymeraseChain Reaction (RT-PCR) techniques. Result: There were significant differencesbetween Probing Pocket Depth, Papilla Bleeding Index, Clinical AttachmentLevel, and amount of T. forsythia in baseline compare to six months period(p<0.05). There was an association between the amount of T. forsythia and PapillaBleeding Index (p<0.05). Conclusion: Minocycline HCl 2% was effectiveclinically and microbiologically in chronic periodontitis therapy.]"

"Latar Belakang: Periodontitis kronis adalah penyakit multifaktorial yang dipengaruhi oleh plak bakteri dan respon inflamasi tubuh dengan matriks metalloproteinase sebagai salah satu molekul inflamasi yang ditemukan meningkat pada penyakit periodontal. Skeling dan penghalusan akar (SPA) telah umum digunakan sebagai pengobatan konvensional atau non-bedah dalam terapi periodontal. Tujuan: Untuk mengevaluasi ekspresi m-RNA matriks metalloproteinase-9 (MMP-9), jumlah Tannerella forsythia (T. forsythia), dan parameter klinis periodontal satu bulan setelah SPA. Metode: Lima puluh gigi dengan poket 4-6 mm dari enam pasien periodontitis kronis dan satu subjek periodontal sehat disertakan dalam penelitian ini. Data penelitian cairan sulkus gingiva diambil dari poket terdalam setiap gigi dengan poket periodontal 4-6 mm untuk mengukur tingkat ekspresi m-RNA MMP-9 dan T.forsythia menggunakan quantitative real time-PCR (qPCR). Kedalaman poket, indeks perdarahan gingiva, dan kehilangan perlekatan klinis diukur pada hari pertama sebagai baseline dan pada hari ke 30. SPA dilakukan pada hari ke-1. Data dianalisis menggunakan program perangkat lunak SPSS 22.0. Hasil: Dibandingkan dengan kontrol, parameter klinis periodontal dan T.forsythia secara signifikan berkurang sementara pengurangan ekspresi m-RNA ­MMP-9 ditemukan tidak signifikan pada hari ke-30 setelah SPA. Kesimpulan: Satu bulan setelah SPA pada periodontitis kronis dengan poket 4-6 mm didapatkan penurunan jumlah T.forsythia dan parameter klinis periodontal secara signifikan dengan ekspresi m-RNA MMP-9 menurun tidak signifikan. Penelitian lebih lanjut dengan periode pengamatan lebih lama diperlukan untuk mengkonfirmasi atau menolak temuan di atas.

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Background: Chronic periodontitis is a multifactorial disease influenced by both bacterial plaque and host inflammatory response with matrix metalloproteinase as one of inflammatory molecules found elevated in periodontal disease. Scaling and root planning (SRP) has been commonly used as conventional or non-surgery treatment in periodontal therapy. Aim: To evaluate m-RNA expression of matrix metalloproteinase-9 (MMP-9), Tannerella forsythia (T. forsythia), and clinical periodontal parameter one month after SRP. Methods: Fifty tooth with pocket 4-6 mm from six CP patients and one periodontally healthy subject was recuited in this study. Gingival crevicular fluid (GCF) were collected from deepest pocket of every tooth with pocket 4-6 mm, the expression level of MMP-9 m-RNA and T.forsythia was measured using quantitative real time-PCR(qPCR). Pocket depth (PD), papilla bleeding index (PBI), and clinical attachment loss (CAL) were measured on day 1 as baseline and on the 30th day. SRP were performed on day 1. Data were analyzed using SPSS 22.0 software program. Results: By comparing to control, the periodontal clinical parameters and T.forsythia were significantly reduced after SRP while the reduction of MMP-9 m-RNA expression was found no significantly after 30th day. Conclusion: Our study show that SRP was clinically effective for CP with 4-6 mm pocket although the expression of MMP-9 m-RNA was not significantly reduced following SRP for one month period. Further studies with longer observation period are needed to confirm or reject the above finding."

"Latar belakang: Skeling dan penghalusan akar (SPA) dapat mengubah komposisi bakteri patogen. Tujuan: Mengetahui efek klinis dan mikrobiologis (P. gingivalis, T. forsythia) setelah SPA pada periodontitis kronis poket 4-6 mm. Metode: Empat puluh tiga subjek diperiksa kedalaman poket, indeks pendarahan gingiva, sampel plak subgingiva, serta dilakukan SPA pada kunjungan awal, bulan kedua, ketiga, keenam. Hasil: Kedalaman poket, pendarahan gingiva, populasi P. gingivalis, T. forsythia menurun (p<0,05). Penurunan kedalaman poket tidak berhubungan dengan penurunan populasi P.g (p>0,05). Kesimpulan: SPA meningkatkan kondisi klinis dan mikrobiologis poket 4-6 mm. Perbaikan kondisi klinis berhubungan dengan penurunan kedua bakteri kecuali kedalaman poket dengan populasi P.gingivalis.

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Background: Scaling and root planing (SRP) can change the composition of bacterial pathogens.

Objective: To know the clinical and microbiological effects (P.gingivalis and T. forsythia) of SRP at 4-6 mm pocket depth of chronic periodontitis.

Method: Forty-three subject were performed with SRP on the initial visit, two, three, six month. Pocket depth, gingival bleeding index (PBI) and subgingival plaque samples were examined.

Result: (There is a) decrease in pocket depth, gingival bleeding index, populations of P. gingivalis and T. forsythia (p <0.05). The decrease in pocket depth was not associated with a decrease in the population of P.g (p >0.05).

Conclusion: SRP can improve clinical and microbiological condition in the treatment of chronic periodontitis with 4-6 mm pocket depth. The improvement of clinical condition is associated with the decreasing of bacteria population, except pocket depth is not associated with the P. gingivalis population."

"Latar Belakang: Tannerella forsythia merupakan salah satu agen etiologi utama pada penyakit periodontitis yang merupakan penyakit pada jaringan periodontal penyebab kerusakan tulang alveolar. Beberapa penelitian menunjukkan bahwa bakteri tersebut mampu menyebabkan kerusakan tulang alveolar, namun protokol eksperimennya bervariasi sehingga dibutuhkan evaluasi literatur secara sistematis untuk dapat menjelaskan mekanisme bakteri tersebut dalam menyebabkan kerusakan tulang. Tujuan: Tujuan dari tinjauan sistematis ini adalah untuk mengevaluasi secara sistematis dan terstruktur berbagai literatur ilmiah dalam bentuk artikel dengan topik relevan untuk menganalisis mekanisme kerusakan tulang alveolar oleh bakteri Tannerella forsythia pada penyakit periodontitis. Metode: Pencarian literatur secara online dilakukan dari bulan Juli sampai bulan November 2020. Penelitian dilakukan dengan berpedoman pada PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) sebagai panduan dalam penulisan tinjauan sistematis. Literatur yang memenuhi syarat dievaluasi pada empat kriteria inklusi: 1) artikel dipublikasikan dalam Bahasa Inggris, 2) artikel diterbitkan dalam kurun waktu 10 tahun terakhir, 3) artikel tersedia dalam fulltext, 4) literatur berupa research article. Hasil: Pencarian literatur mengidentifikasi sebanyak lima artikel yang telah memenuhi kriteria inklusi dan lolos pada tahap penilaian kelayakan. Artikel-artikel tersebut diterbitkan pada tahun 2011-2017. Di antara kelima artikel tersebut, terdapat tiga artikel yang membahas pengaruh faktor virulensi serta infeksi bakteri utuh Tannerella forsythia terhadap kerusakan tulang, sementara dua artikel lainnya membahas pengaruh bakteri hingga terjadinya inflamasi. Penelitian yang dilakukan menargetkan sel yang berbeda-beda, di antaranya monosit, makrofag, human gingival fibroblast (HGF), periodontal ligament cell (PDL), hingga bone marrow dendritic cell (BMDC). Berdasarkan hasil penelitian, diketahui Tannerella forsythia mampu menginduksi sekresi sitokin proinflamasi pada sel, di antaranya sitokin utama dalam osteoklastogenesis seperti interleukin-6 (IL-6), IL-1β, dan tumor necrosis factor a (TNF-a), dan melalui penelitian secara in vivo, Tannerella forsythia mampu menyebabkan kerusakan tulang pada hewan percobaan. Kesimpulan: Setelah dilakukan analisis pada lima literatur terpilih, ditemukan bahwa bakteri Tannerella forsythia dapat memicu kerusakan tulang alveolar melalui interaksi dengan sel residen dan sel imun pada jaringan periodonsium sehingga menyebabkan respons inflamasi. Mediator inflamasi yang diproduksi oleh sel-sel tersebut kemudian dapat mendorong terjadinya kerusakan tulang dengan menginduksi ekspresi faktor receptor of nuclear factor-kappa ligand (RANKL) yang terlibat dalam difrerensiasi osteoklas sebagai sel perombak tulang.

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Background: Tannerella forsythia is one of the main etiologic agents in periodontitis, the inflammation of the periodontal tissue disease that cause alveolar bone destruction. Several studies have shown that these bacteria are capable of causing alveolar bone destruction, but the experimental protocol varies so that a systematic literature evaluation is needed to explain the mechanism of these bacteria in causing bone damage. Objective: The aim of this systematic review is to systematically evaluate and analyze the scientific literature in the form of articles with topics related to the mechanism of alveolar bone destruction by Tannerella forsythia in periodontitis. Methods: Online literature search was conducted from July to November 2020. The study was carried out based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) as a guide in writing a systematic review. Eligible literature is evaluated on four inclusion criteria: 1) articles published in English, 2) articles published in the past 10 years, 3) articles available in full text, 4) literature in the form of research articles. Results: The literature search identified five articles that had met the inlcusion criteria and passed the eligibility assessment stage. These articles were published in 2011-2017. Among the five articles, there are three articles that discuss the effect of virulence factors and infection of whole bacteria on bone destruction, while two other articles discuss the influence of bacteria to inflammation. The research conducted targets different cells, including monocytes, macrophages, human gingival fibroblasts (HGF), periodontal ligament cells (PDL), and bone marrow dendritic cells (BMDC). Based on the research results, it is known that Tannerella forsythia is able to induce the secretion of pro-inflammatory cytokines in cells, including the main cytokines in osteoclastogenesis such as interleukin- 6 (IL-6), IL-1β, tumor necrosis factor a (TNF-a), and through in vivo research, Tannerella forsythia is capable of causing bone destruction in experimental animals. Conclusion: After analyzing the five selected articles, it was found that the Tannerella forsythia can trigger alveolar bone destruction through its interaction with resident cells and immune cells in the periodontium tissue, causing an inflammatory response. Inflammatory mediators produced by these cells can then trigger bone damage by inducing the expression of the receptor of nuclear factor-kappa ligand (RANKL),which is involved in differentiation of osteoclasts as bone resorption cells"

"Halitosis merupakan bau mulut yang sebagian besar sumbernya berasal dari rongga mulut. Volatile Sulfur Compound(VSC) merupakan penyebab halitosis dan produksinya berhubungan dengan aktifitas periodontobacteria termasuk Tannerella forsythia. Periodontitis dan diabetes memiliki hubungan dua arah. Diabetes adalah faktor predisposisi periodontitis. Tujuan pemelitian ini adalah menetapkan hubungan antara kadar metil merkaptan (CH3SH) dan hidrogen sulfida (H2S) dengan proporsi T. forsythia pada pasien periodontitis dengan halitosis tanpa dan dengan diabetes mellitus.Metode yang digunakan adalah subjek periodontitis (n=20) dikelompokkan berdasarkan kadar glukosa darah : periodontitis dan normoglikemik, n = 8; periodontitis dan DM, n = 8, kontrol sehat, n = 4. Diagnosis periodontitis didasarkan pada parameter klinik. Pengambilan sampel mikrobiologis dari cairan krevikular gingiva dan tongue coating. Kadar CH3SH dan H2S ditetapkan dengan menggunakan Oral Chroma™. Proporsi T. forsythia dianalisis menggunakanmetoda quantitative real time-PCR (qPCR). Data dianalisis dengan uji Mann Whitney dan Spearman. Hasilnya terdapat perbedaan bermakna kadar H2S pada pasien periodontitis dengan halitosis tanpa dan dengan diabetes melitus, namun tidak terdapat perbedaan kadar CH3SH dan T. forsythia pada pasien periodontitis disertai halitosis dengan dan tanpa diabetes melitus. Terdapat korelasi positif kadar H2S dengan proporsi T. forsythia pada permukaan tongue coating pada pasien periodontitis dengan halitosis tanpa diabetes melitus, tetapi tidak terdapat korelasi kadar CH3SH pada permukaan tongue coating pada pasien periodontitis dengan halitosis tanpa dan dengan diabetes melitus. Pada cairan krevikular gingiva, tidak terdapat korelasi antara CH3SH dan H2S dengan proporsi T.forsythia pada pasien periodontitis dengan halitosis tanpa dan dengan diabetes melitus. Kesimpulan yang didapat pada pasien periodontitis dengan halitosis tanpa diabetes melitus terdapat korelasi positif sangat kuat antara kadar H2S dengan proporsi T. forsythia pada permukaan tongue coating dan pada pasien periodontitis dengan halitosis dan diabetes melitus tidak terdapat korelasi kadar CH3SH dan H2S dengan proporsi T. forsythia pada permukaan tongue coating. Pada cairan krevikular gingiva, tidak terdapat korelasi antara CH3SH dan H2S dengan proporsi T.forsythia pada pasien periodontitis dengan halitosis tanpa dan dengan diabetes melitus.

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Halitosis is bad breath which is mostly sourced from the oral cavity. Volatile Sulfur Compound (VSC) is a cause of halitosis and its production is related to the activity of periodontobacteria including Tannerella forsythia. Periodontitis and diabetes have a two-way relationship. Diabetes is a predisposing factor for periodontitis. The aim of this study was to determine the relationship between methyl mercaptan (CH3SH) and hydrogen sulfide (H2S) with the proportion of T. forsythia in periodontitis patients with halitosis without and with diabetes mellitus. The methods used Periodontitis subjects (n = 20) were grouped based on blood levels: periodontitis and normoglycemic, n = 8; periodontitis and DM, n = 8, healthy controls, n = 4. The diagnosis of periodontitis is based on clinical parameters. Microbiological sampling of gingival crevicular fluid and tongue coating. CH3SH and H2S levels are determined using Oral Chroma ™. The proportion of T. forsythia was analyzed using quantitative real time-PCR (qPCR) methods. Data were analyzed by Mann Whitney and Spearman test. There were differences of H2S in periodontitis patients with halitosis without and with diabetes mellitus, but there were no differences in the levels of CH3SH and T. forsythia in periodontitis halitosis patients with and without diabetes mellitus. Positive correlation of H2S by comparison of T. forsythia on the tongue coating in periodontitis patients with diabetes mellitus, but it is not related to CH3SH on the tongue coating in periodontitis patients with halitosis without and with diabetes mellitus. In gingival crevicular fluid, showed no correlation between CH3SH and H2S with the proportion of T.forsythia in periodontitis patients with halitosis without and with diabetes mellitus. The conclusion of this study is in periodontitis patients with halitosis without diabetes mellitus showed a very strong positive correlation between H2S with the proportion of T. forsythia on the tongue coating. There was no correlation between CH3SH and H2S with proportion of T. forsythia on the tongue coating in periodontitis patients with halitosis and diabetes mellitus. In gingival crevicular fluid, there was no correlation between CH3SH and H2S with the proportion of T.forsythiain periodontitis patients with halitosis without and with diabetes mellitus."

"[Latar Belakang: Merokokmempengaruhi peran host danbakteridalam patogenesis periodontitis kronis. Tujuan: Menganalisis efek merokok terhadap kebersihan mulut, perdarahan gingiva, dan jumlah bakteri P. gingivalis. Materi dan metode: Tiga puluh satu subjek laki-laki diperiksa indeks plak (PI), kalkulus (KI), kebersihan mulut (OHI-S), dan perdarahan papilla (PBI) kemudian diambil plak subgingiva untuk dihitung jumlah bakteri P. gingivalis. Hasil: Skor PI, KI, OHI-S, PBI, dan prevalensi bakteri P.gingivalis perokok lebih tinggi namun peningkatannya tidak bermakna. Kesimpulan: Merokok tidak mempengaruhi kebersihan mulut, perdarahan gingiva, dan jumlah bakteri P.gingivalis pada periodontitis kronis., Introduction: Smoking affects host and bacteria roles in chronic periodontitis. Objectives: Analyzing smoking effects towards oral hygiene, gingival bleeding, and P. gingivalis prevalence. Material and methods: Thirty one male subjects were examined with plaque(PI), calculus (CI), oral hygiene (OHI-S), and papilla bleeding index (PBI). Sub-gingival plaque was taken to quantify P. gingivalis. Results: Smokers had higher PI, CI, OHI-S, PBI score, and P. gingivalis was more prevalent, though the differences were not significant. Conclusion: Smoking does not affect oral hygiene, gingival bleeding, and P. gingivalis prevalence in chronic periodontitis. ]"

"Latar Belakang: Informasi radiografis mengenai kehilangan tulang berperan penting dalam penentuan diagnosis, rencana perawatan, dan prognosis periodontitis. Pengklasifikasian diagnosis periodontitis berdasarkan AAP 2017 mencakup komponen kehilangan perkelatan klinis dan persentase kehilangan tulang radiografis yang menghasilkan diagnosis periodontitis berdasarkan tingkat keparahan. Tujuan: Melihat tingkat kesesuaian diagnosis radiografis berdasarkan persentase kehilangan tulang dengan diagnosis klinis berdasarkan kehilangan perlekatan. Metode: Menggunakan studi potong lintang menggunakan 70 sampel komponen data kehilangan perlekatan klinis rekam medis dan radiograf intraoral sisi proksimal sampel gigi dengan diagnosis dan kerusakan terparah dari pasien periodontitis kronis di RSKGM FKG UI. Perhitungan kerusakan menggunakan persentase kehilangan tulang dengan mengukur jarak CEJ ke defek tulang terparah dan jarak CEJ ke ujung apeks gigi. Hasil: Uji komparatif Wilcoxon menunjukkan terdapat perbedaan bermakna secara statistik antara diagnosis klinis dan radiografis berdasarkan klasifikasi AAP 2017 mengenai periodontitis dengan nilai p=0,003. Sebanyak 64,3% sampel memiliki kesesuaian diagnosis klinis dan radiografis, 27,1% sampel memiliki diagnosis radiografis < klinis, dan 8,6% sampel memiliki diagnosis radiografis > klinis. Kesimpulan: Diperlukan dua alat diagnostik untuk menentukan tingkat keparahan periodontitis, yaitu secara klinis dan diikuti dengan pemeriksaan radiografis untuk menutupi limitasi dari masing-masing jenis pemeriksaan. Berdasarkan kesesuaian diagnosis yang signifikan, radiograf periapikal dapat digunakan untuk membantu diagnosis periodontitis.

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Background: Radiographic information regarding bone loss plays an important role in determining periodontitis diagnosis. The AAP 2017 classification of periodontitis diagnosis uses CAL and the RBL that would result in a periodontitis diagnosis based on the severity and disease progression. Objectives: The study was aimed to compare the diagnosis based on a percentage of RBL and clinical diagnosis based on CAL. Methods: The cross-sectional study was conducted on 70 samples using CAL and percentage of RBL in proximal sites. Radiographic assessment was done by calculating the distance from CEJ to proximal bone defects and from CEJ to root tip. Result: The result of the Wilcoxon comparative test showed a statistically significant difference between clinical and radiographic diagnosis based on the AAP 2017 classification with p-value=0.003. The result showed that 64,3% had clinical diagnosis = radiographic diagnosis, 27,1% had a radiographic diagnosis < clinical diagnosis, and 8,6% had a radiographic diagnosis > clinical diagnosis. Conclusion: Two diagnostic tools are needed to determine the severity of periodontitis, clinically and followed by a radiographic examination to cover the limitations of each examination. Based on the significant accuracy of the diagnosis, the periapical radiograph can be used to assist in the periodontitis diagnosis."

"Aplikasi Subgingiva antimikroba setelah Skeling dan Penghalusan Akar SPA mampu membunuh bakteri anaerob yang tersisa Penelitian ini bertujuan menganalisis efek klinis aplikasi subgingiva H2O2 3 setelah SPA pada periodontitis kronis poket le 6 mm 45 subjek periodontitis kronis poket le 6 mm diskor plak skor perdarahan kedalaman poket kehilangan perlekatan Satu sisi rahang diaplikasi subgingiva H2O2 3 dan kontrol pada kontralateral dievaluasi 4 minggu setelahnya Aplikasi subgingiva H2O2 3 secara statistik terbukti menurunkan skor perdarahan kedalaman poket kehilangan perlekatan pre dan post perawatan serta antar kedua kelompok periodontitis kronis poket le 6 mm Kata kunci Skor Perdarahan Poket Periodontal Kehilangan Perlekatan SPA Aplikasi subgingiva

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Subgingival application with 3 H2O2 after scaling and root planing SRP is assumed to be kill the bacteria left behind after mechanical debridement The aim of this study was to analyze the clinical effects of subgingival application 3 H2O2 after SRP in the treatment of chronic periodontitis pocket depth le 6 mm Forty five patients chronic periodontitis pocket depth le 6 mm were scaled and root planed prior to baseline measurement BOP PPD CAL and evaluated on weeks 4 Subgingival application with 3 H2O2 produced a significant reduction in BOP PPD and CAL compared to the control Key words Gingival bleeding on probing probing pocket depth clinical attachment loss scaling and root planing subgingival application 3 H2O2 "

"Chronic adult periodontitis (CAP) is the most common type of periodontal disease. Treatment of moderate CAP has primarily been directed at the physical removal of bacterial plaque, calculus and contaminated cementum by scaling and root planing (SRP) with or without surgical access. Irrigation solutions reach the apical portion of the pocket has flushing action properties and easy to apply. Tetracyline HCI (TTC HCI) solutions demonstrated its antimicrobial activity against subgingival microflora, shown to be substantive to dentin surface and subsequently released in active form, also has anti-collagenase properties. This study evaluates the clinical outcomes of treatment with locally TTC HCI 10% irrigation as an adjunct to SRP in subset of moderate CAP patients. The data examined were obtained from 24 patients. All patient were scaled and root planed prior to baseline measurement. The patients were monitored by parameters : bleeding on probing (BOP), probing pocket depth (PPD), and attachment loss (LA). 56 contralateral surface exhibiting residual pocket depths 4-6 mm were randomly assigned as test or control sites. After baseline measurement, each subgingival root surface was irrigated with approximately 10ml for 1 minute either with TTC HCI 10% solution (test), or Aquabides solution (control). The clinical parameters were assessed at baseline and weeks 3. The two sites resulted in significant statistical and clinical improvement in all parameters. BOP was not significantly reduced in test site compared to control site. PPD and I.A was significantly reduced at test site compared to control site. The result indicate that subgingival irrigation with TTC HCI 10% solution 10 ml for 1 minute may have a role in the management of moderate CAP. This treatment reduces surgical needs."

"Metronidazole gel 25% as an adjunct to scaling and root planing showed clinical effect better than scaling and root-planing alone. In Indonesia metronidazole gel is not popular, since probably it is expensive and not easy to obtain, so there is an idea to make metronidazole gel 25% mixture with relatively cheaper. The purpose of the study was to evaluate clinical effect of metronidazole gel 25%. Thirty Chronic Adult Periodontitis patients possessing at least 3 teeth >6mm pocket dept, >4 mm attachment loss, and bleeding on probing were selected and grouped into metronidazole 25%, PVP-I 10%, and as controle respective. After SRP of all quadrant, 3 teeth were randomly selected as respectively metronidazole gel 25% and PVP-I 10% were applied on day 0 and day 7, BOP, PPD, and clinical attachment gain were recorded at baseline and 1 month post therapy. Bleeding on probing was analyzed using Kruskal-Wallis test, pocket depth and attachment gain were analyzed using Anova test. The result showed a significant difference in each group before and after the application. However, metronidazol group was the best compared to the other two groups."