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"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."

"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."

"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."

"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 "

"Latar Belakang: Periodontitis kronis mempunyai prevalensi yang sangat tinggi. Baru-baru ini, ada tipe baru fototerapi non bedah untuk mengeliminasi bakteri dinamakan terapi fotodinamik. Tujuan: Menganalisis efek terapi fotodinamik setelah SPA pada periodontitis kronis. Metode: Desain split-mouth menerima SPA dengan atau tanpa terapi fotodinamik. BOP, kedalaman poket, dan kehilangan perlekatan diperiksa pada awal dan 1 bulan. Hasil: Terjadi penurunan kedalaman poket dan peningkatan perlekatan, yang lebih besar dibandingkan sisi kontrol (p<0,05). Pada BOP terjadi penurunan hampir sama dengan sisi kontrol. Kesimpulan: Tindakan SPA + terapi fotodinamik dibandingkan SPA saja terbukti menyebabkan perubahan efek klinis yang lebih baik pada penurunan kedalaman poket periodontal dan meningkatkan perlekatan gingiva.

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Background: Chronic periodontitis has a very high prevalency. Recently, there is a new type of non-surgical phototherapy to eliminate bacteria called photodynamic therapy.

Aim: Analyzing the effects of photodynamic therapy after SPA in chronic periodontitis.

Methods: split-mouth design receives SPA with or without photodynamic therapy. BOP, pocket depth, and attachment loss examined at baseline and 1 month.

Results: There was a decrease in pocket depth and increasing clinical attachment, which is greater than the controls (p <0.05). In BOP decreased nearly equal to the control side.

Conclusions: Measures SPA + photodynamic therapy have better clinical effect on periodontal reduction pocket depth and increased gingival attachment."

"In deep periodontal lesions, scaling and root planning (SRP) failed to complete elimination of periodontal bacteria, so chemical antimicrobial agents are used topically to destroy microorganism. Povidon-iodin 10% is one of antimicrobial agents that can be applied topically anddirectly in the pocket. The aim of the research were evaluated the efficacy of povidon-iodin l0% as chemical antimicrobial agents locally applied into periodontal pocket. The data are obtained from patients with chronic adult periodontitis baseline periodontal pocket depth (PPD) are 5-7 mm. The teeth are scaled and root planed after clinical examinations ( plaque index, papilla bleeding index and periodontal pocket depth ) and test sites or control sites are assisned randomly. Topically application of povidon-iodin 10% at test sites and aquabides at control sites is applied at day 1st and day 7th. The clinical parameters are assessed at day 14th. The results of the research showed that application of povidon-iodin l0% afer SRP provide statistically significant more favorable papilla bleeding index reduction than SRP + aquabides after 14 days. The pocket depth reduction at testsites are greater than control sites ( baseline PPD=6 and 7 mm). The conclusions of the research showed that application subgingival povidon-iodin 10% as adjunctive to SRP significantly reducePBI and PPD ( 6 & 7 mm ) than without application povidon-iodin 10%."

"Osteopontin merupakan salah satu sitokin yang banyak dihubungkan dengan proses resorpsi tulang, namun perannya di dalam proses penyembuhan periodontal masih didapatkan hasil yang berbeda-beda sedangkan Tumor Necrosis Factor-α (TNF-α)merupakan sitokin pro-inflamasi yang berperandalam inflamasi kronis dan proses resorpsi tulang. Penelitian ini bertujuan menganalisis perbedaan tingkat ekspresi Osteopontin dan TNF-αpada pasien periodontitis sebelum terapi dengan setelah terapi skeling dan penghalusan akar (diukur setelah 7 hari, 14 hari, dan 28 hari). Tingkat ekspresi Osteopontin dan TNF-αdalam cairan krevikuler gingiva (CKG)dari 28 subjek penderita periodontitis berusia ≥ 30 tahun dan dari 8 subjek sehat diukur dengan menggunakan qPCR. Dilakukan juga uji korelasi Spearmanantara tingkat ekspresi Osteopontin dan TNF-αdalam CKG dengan pemeriksaan klinis berupa modified gingival index (MGI).Uji Wilcoxontingkat ekspresi Osteopontin dan TNF-αdalam CKG pada pasien periodontitis sebelum dan setelah 28 hari terapi skeling dan penghalusan akar menunjukkan perbedaan bermakna (p < 0,05). Uji korelasi Spearmanmenunjukkan korelasi positif lemah antara tingkat ekspresi OPNdengan skor MGI(r=0,213;p<0,05) dan antara tingkatekspresi TNF-αdengan skor MGI(r=0,256;p<0,05). Penelitian ini menyimpulkan bahwa terdapat perbedaan tingkat ekspresi Osteopontin dan TNF-αpada subjekperiodontitis antara sebelum terapi dengan 28 hari setelahterapi skeling dan penghalusan akar gigi. Adakorelasi positif antara tingkat ekspresi OPNdengan MGIdan tingkat ekspresi TNF-αdengan MGI.

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Osteopontin is one of many cytokines that is often associated with bone resorption process, but the role in the periodontal healing is still not clear accordingto some studies presenting different results, while Tumor Necrosis Factor-α (TNF-α) is a well-known pro-inflammatory cytokine which stimulates bone resorption. The objective of this study was to analyze different Osteopontin and TNF-α expression level on patients with periodontitis before (baseline) and 7 days, 14 days, 28 days following scaling and root planing. Osteopontin and TNF-α level on gingival crevicular fluid (GCF) from 28 subjects with periodontitis aged ≥ 30years old and 8 healthy patients (control subjects)were measured by qPCR. Spearman correlation test between GCF Osteopontin and TNF-α level and modified gingival index (MGI) was also done. Wilcoxon test between Osteopontin and TNF-α level before scaling and root planing and 28 days after scaling and root planing showed a significant difference (p < 0.05). Spearman correlation test between TNF-α level on GCF and MGI showed a positive correlation (r=0.256; p<0.05). Conclusions of this study was a significant difference of OPN and TNF-αexpression level between baseline and 28 days after scaling and root planing in periodontitis subjects and a positive correlation between GCF OPN level and MGI and also between TNF-α expression level and MGI."

"Dinamika periostin, protein matriks ekstraseluler jaringan ikat yang berperan sebagai regulator homeostasis struktural dan fungsional, ditemukan dalam cairan krevikuler gingiva (CKG) saat kondisi inflamasi maupun sehat. Pada kasus borderline, pemeriksaan secara biomolekuler dapat membantu meminimalisasi keparahan penyakit, risiko dan kerugian pasien dalam perawatan. Penelitian ini bertujuan mendapatkan perbedaan tingkat periostin sebelum dan sesudah terapi skeling dan penghalusan akar gigi (SPA) pada pasien periodontitis stage II grade A, serta hubungan antara tingkat periostin dengan kedalaman poket periodontal - PPD dan perdarahan saat probing - BOP. Sampel CKG dari enam subjek sehat [BOP (-)] dan 25 pasien periodontitis stage II grade A [PPD 4 - 5 mm, BOP (+)] usia 26 - 55 tahun di RSKGM FKG UI, Jakarta, diambil saat baseline (D0), dan dilanjutkan untuk kelompok periodontitis saat satu minggu (D1), dua minggu (D2), dan empat minggu (D3) pascaterapi SPA menggunakan paper point. Dilakukan juga pengukuran PPD dan BOP saat D0 dan D3. Tingkat periostin diamati menggunakan metode RT-PCR kuantitatif dalam 45 siklus. Nilai p<0,05 dinyatakan signifikan. Saat inflamasi, tingkat periostin ditemukan menurun, namun setelah terapi SPA, periostin meningkat dalam satu minggu (p<0,05), dua minggu (p<0,05), hingga empat minggu (p<0,05), sejalan dengan temuan klinis perbaikan PPD dan BOP. Perubahan tingkat periostin mengkonfirmasi penyembuhan jaringan pascaterapi SPA pada kasus periodontitis stage II grade A.

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The dynamics of periostin, a connective tissue extracellular matrix protein that acts as a regulator of structural and functional homeostasis, is detected in gingival crevicular fluid (GCF) during both inflammatory and healthy conditions. In borderline cases, biomolecular examinations can help minimize the severity of the disease, the risk, and the loss of patients in treatment. The aim of this study was to obtain differences in the levels of periostin before and after treatment of scaling and root planing (SRP) in patients with stage II grade A periodontitis, as well as its relationship with the depth of the periodontal pocket - PPD and bleeding on probing - BOP. Samples from GCF of six healthy subjects [BOP (-)] and 25 stage II grade A periodontitis patients [PPD 4-5 mm, BOP (+)] aged 26 - 55 years at RSKGM FKG UI, Jakarta, were taken at baseline (D0), and continued for the periodontitis group at one week (D1), two weeks (D2), and four weeks (D3) after SRP treatment by using paper points. PPD and BOP measurements were also taken at D0 and D3. Periostin levels were observed using qRT-PCR methods in 45 cycles. A value of p <0.05 was stated as significant. During inflammation, the level of periostin was found to decrease, but after SRP therapy, periostin increased in one week (p <0.05), two weeks (p <0.05), up to four weeks (p <0.05), in line with the clinical finding improvement of PPD and BOP. Periostin level changes confirmed healing of periodontal tissue after SRP therapy in stage II grade A periodontitis cases."

"Latar Belakang: Minosiklin merupakan antibiotik dengan sifat bakteriostatik yang potensial mengeliminasi bakteri patogen periodontal. Kesembuhan perawatan periodontitis kronis umumnya ditunjukkan secara klinis dan mikrobiologis. Tujuan: Menganalisis parameter klinis (penurunan kedalaman poket dan indeks perdarahan gingiva, peningkatan perlekatan klinis) dan jumlah T. forsythia sebelum dan sesudah aplikasi gel Minosiklin HCl 2%. Metode: Empat puluh dua subjek menerima aplikasi gel Minosiklin HCl 2% sebanyak empat kali, kemudian dievaluasi parameter klinis dan T. forsythia dengan Real-Time Polymerase Chain Reaction (RT-PCR). Hasil: Terdapat perbedaan bermakna dari parameter klinis dan T. forsythia antara pemeriksaan awal dan kontrol bulan ke-6 (p<0,05). Terdapat perbedaan bermakna antara hubungan penurunan indeks perdarahan gingiva dengan jumlah T. forsythia (p<0,05). Kesimpulan: Aplikasi gel Minosiklin HCl 2% secara klinis dan mikrobiologis efektif dalam perawatan periodontitis kronis.

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Background: Minocycline is known as one of the antibiotics with great bacteriostatic effect to eliminate periodontal pathogen. Healthier periodontal environment is usually shown with better clinical and microbiological response.

Objective: To clinically and microbiologically (T. forsythia) analyze the effect of Minocycline 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 Polymerase Chain Reaction (RT-PCR) techniques.

Result: There were significant differences between Probing Pocket Depth, Papilla Bleeding Index, Clinical Attachment Level, 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 Papilla Bleeding Index (p<0.05).

Conclusion: Minocycline HCl 2% was effective clinically and microbiologically in chronic periodontitis therapy."