J Clin Periodontol 1985;12:283-93. Likewise, studies in infrabony defects (Pradeep, Kanoriya, et al., 2017; Sharma & Pradeep, 2012a, 2012b; Sharma et al., 2017) showed a significantly higher reduction in IBD (ranging from 1.88 to 2.50 mm compared to 0.09 to 0.12 mm) and in %DDR (ranging from 40.4% to 46.1% compared to 1.86% to 2.5%) 6 months after applying local BPs instead of placebo together with NSPT. In addition, studies where participants presented with systemic diseases or that were taking medications were excluded. Hence, it is suggested that future larger (possibly multi‐centre) RCTs, with multi‐level analyses accounting for potential confounding factors (e.g. Further studies are needed to confirm the benefit of other host modulators. Isidor F, Karring T, Attstrom R. The effect of root planing as compared to that of surgical treatment. Hence, some level of caution in interpreting this finding needs to be considered. Although the mean estimate clearly suggested a benefit in adding statin gel compared to placebo to NSPT, the prediction interval for PPD reduction at 6 months (−0.08 to 3.74 mm) suggests that some level of caution needs to be adopted in terms of efficacy of this host modulator, while the prediction interval at 9 months (1.16–3.34 mm) indicates a more robust outcome. An experimental study in the dog. No clear clinical benefit was associated to the use of probiotics and no definitive conclusions could be drawn for the other included host modulators, although promising results emerged on the use of local BPs and metformin gels in infrabony defects, which need to be confirmed by future studies. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis. When looking at local host modulators, all studies applying 1.2% statin gel instead of placebo in infrabony defects showed a significant improvement in CAL gain, (Table 1) with a mean difference of 1.93 mm at 6 months and of 2.19 mm at 9 months (details of meta‐analyses are presented in Appendices S15–S18). Considering the limited sample size of the included papers, it was decided to perform meta‐analysis only when ≥5 articles within the same host modulator category and with similar study design were identified for each primary or secondary outcome (Faggion, Wu, Scheidgen, & Tu, 2015). VIII Issue 1 Jan–Mar 2016 1c 10.5368/aedj.2016.8.1.3.1 SUPPORTIVE PERIODONTAL THERAPY- A REVIEW 1 Ravi Chandu Katta 1 Post graduate student 2 Vijay Kumar Chava 2 Professor and Head The review was conducted according to the PRISMA criteria [].The research question was explored using the PICO method [22).The focused question addressed was: Does non-surgical periodontal therapy (I) have a different outcome in obese chronic periodontitis patients (P), than in non-obese chronic periodontitis patients (C), regarding periodontal … Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? Metformin provided by industry, More than 1 posterior tooth per patients and 1 site per tooth; UNC‐15 colour‐coded probe, 1 tooth per patient and 1 site per tooth; UNC‐15 probe, SRP completed in two sessions within 24 hr using periodontal curettes under local anaesthesia in accordance with the one‐stage, full‐mouth debridement protocol, Placebo (no details on preparation methods and composition), One tooth per patient and 1 site per tooth; UNC‐15 colour‐coded probe, SRP both supra‐ and subgingivally, under local anaesthesia if necessary (no details on instrumentation used), 1% metformin gel (metformin added to hydrated gell and gum powder and mannitol. Additional details on these and other secondary outcomes can be found in Appendix S28. Future and adequately powered multi‐centred trials are needed to clarify the role of local host modulators in furcation class II defects, and the role of micronutrients, dietary supplementation and omega‐3 PUFA. J Clin Periodontol 1976;3:233-50. Only one study investigated the effect of statins on furcation class II defects (Garg & Pradeep, 2017), which suggested a significant benefit in terms of PPD reduction. The procedure was repeated in the second and third weeks after re‐evaluation, Irrigation with essential oils for 5 min per site repeated for second and third week (0.064% thymol, 0.092% eucalyptol, 0.06% methyl salicylate, 0.042% menthol, and 21.6% ethanol)), Placebo irrigation (sorbitol solution 15%, ethanol 21%, sodium saccharin 0.05%, mint flavouring, green dye). An experimental study in the dog. For locally delivered modulators, most of the studies considered only one site per patient. Only one study investigated locally delivered statins in furcation class II defects and it showed that both rosuvastatin 1.2% and atorvastatin 1.2% gels led to an improved PPD reduction compared to placebo (3.3 ± 0.46 mm and 2.43 ± 0.62 mm vs. 1.63 ± 0.49 mm) (Garg & Pradeep, 2017) (Table 1). SDD (Periostat®) is currently the only FDA approved MMP inhibitor that can be used as adjunct to NSPT. Data The PICO strategy was used to include randomized clinical trials in human subjects with DH (P) after NSPT treated with DA (I) compared to those treated with placebo or control (C) to identify DH relief (O). A study done by Anita Badersten, Rolf Nilveus and Jan Egelberg in 1981 evaluated the effect of NSPT on moderately advanced periodontitis with hand instrument and ultrasonic instrumentation and showed no difference at the time of treatment but more reduction in pocket depth and more attachment gain for surfaces with 6–7.5 mm initial depth than for surfaces with 4–5.5 mm initial depth was seen, In 1984, they reported marked improvement of gingival conditions not only in periodontal pockets of moderate depth but also in pockets up to 12 mm deep bynon surgical therapy, In another study in 1984, they compared the effects of single versus repeated instrumentation and demonstrated no difference in results could and suggest that recurrence of disease due to subgingival recolonization by microorganisms during healing phase may not be a major problem, Continuing the study in 1985 showed that probing and attachment loss in sites with nonresponsive to initial periodontal therapy follows a gradual, linear course, or approximately a linear pattern for the vast majority of treated sites, In 1985, they suggested that the majority of sites with attachment loss were found amongst initially shallow or moderately deep a lesion which indicates that the attachment loss is due to trauma associated with therapy rather than loss as a result of a continuing inflammatory disease process. Data on GCF volume and composition were identified in studies employing NSAIDs, SDD, probiotics, and micronutrients, but only in the SDD group ≥3 studies (a total of eight) reported GCF outcomes. Regarding systemic host modulators, all studies comparing SDD to placebo showed a benefit in terms of CAL gain (up to 1.19 mm in moderate pockets and up to 1.96 mm in deep pockets at 6 months) when SDD was employed (Table 1). As only three studies met the inclusion criteria for assessing the effect of omega‐3 PUFAs combined with NSPT, meta‐analysis was not performed (Table 1). There was no limit to time for debridement during the 4 hr of available appointment time. While the inclusion of such studies in this review might have provided additional data to either corroborate or disprove our findings, we were, nevertheless, compelled to abide by the qualitative criteria set for the inclusion of studies in this systematic review. Moderate to severe chronic periodontitis (Armitage, Aloe vera gel 1% (filtered juice of aloe leaves was added to a gel containing cabopol 934 and 0.5% methylparaben), Metformin gel 1% (metformin added to hydrated gellan gum powder and mannitol. Clinical, microbiologic, and histologic responses to non‐surgical therapy are evaluated to provide guidelines for expected treatment results. Introduction. Moreover, owing to the long treatment regime of SDD (6–9 months), it is plausible to anticipate that patient's compliance might be an issue that clinicians should not underestimate. IV generation: Probiotics are incorporated in mouthwashes. Placebo twice a day for 3 months (identical capsules with the exception of omission of doxycycline), Academic/University. J Clin Dent 2007;18:34-8. de Almeida JM, Theodoro LH, Bosco AF, Nagata MJ, Oshiiwa M, Garcia VG. Presented By : Dr. Abhishek Gaur Guided By : Dr. Balaji Manohar Dr. Ravikiran N. Dr. Neema Dr. Aditi Mathur Dr. Barkha Makhijani 2. J Clin Periodontol 1982;9:115-28. This systematic review provided clarity on the role of host modulators as adjuncts to NSPT to reduce PPD and showed that evidence is available for local treatment (in the form of subgingivally delivered gels) of infrabony defects with statins and for systemic treatment with SDD in deep pockets (≥7 mm). The effect of the thermal diode laser (wavelength 808–980 nm) in non-surgical periodontal therapy: a systematic review and meta-analysis. Likewise, smoking was heterogeneously reported, with few studies excluding smokers, others including few of them and others considering only smoker patients (Table 1). In all studies, the gel was injected subgingivally, at the base of the pocket, with a blunt cannula syringe (Table 1). J Periodontol 1975;46:522-6. Other more subtle systemic and environmental issues ma… ABSTRACT. Information regarding periodontal regenerative therapy in patients with diabetes mellitus (DM) is limited. The mean PPD reduction was greater in the celecoxib group and this was particularly evident in the moderate (4–6 mm) and deep (≥7 mm) pockets at 12 months (Table 1). Conversely, all studies on NSAIDs either did not provide information or were underpowered. A total of 3,873 unique records were identified and screened for title and abstract, which led to 171 articles eligible for full‐text screening and five additional studies identified through manual search (Figure 1). The authors do not have any conflict of interest in relation to this manuscript to declare. The primary endpoint (PE) considered was the delta difference between treated and placebo groups (PEx months = Δtreated(x months − basal) − Δplacebo(x months − basal)). Likewise, 1,000 mg of omega‐3 PUFA twice a day for 6 months resulted in a greater mean PPD reduction, especially in deep pockets compared to placebo oil capsules (Elgendy & Kazem, 2018). Nonsurgical therapy remains the cornerstone of periodontal treatment. Nonsurgical periodontal therapy (NSPT) is the cornerstone of periodontal therapy and the first recommended approach to the control of periodontal infections. Search strategy and review process An electronic search of SCOPUS, MEDLINE, PubMed, … As it is obvious that for certain types of host modulators not available in the market an input from the industry was necessary, the lack of clarity on the level of industry involvement in sponsoring the study poses at least some concerns on the outcomes reported, and future validation of these results by independent groups is hence warranted. Tanwar, et al. Ex‐or current smokers: 63 (58.9%) in SDD group, 59 (57.8%) in placebo group, Current smokers: 41 (38.3%) in SDD group and 26 (25.5%) in placebo group, Current smoker: 18 (% 33.3) in celecoxib group 17 (%36.2) in placebo group and Ex‐smoker: 13 (%24.1) in celecoxib group and 11 (%23.4) in placebo group, Subgingival SRP under local anaesthesia for sites with PD ≥ 4 mm, Only scaling for the sites with PD ≤ 3 mm. J Clin Periodontol 1985;12:525-39. Regular maintenance therapy (i.e. Ower P. Minimally invasive non periodontal therapy. The same approach was followed to perform meta‐analysis of secondary outcomes, whenever applicable. Industry provided simvastatin, Chronic periodontitis and at least one infrabony defect with PPD > 5 mm and radiographic evidence of vertical bone loss of 3 mm in at least 1 site, 1 tooth and 1 site/tooth per patient; no details on probe used, 1.2% simvastatin gel (simvastatin added to a 4% methylcellulose gel), Chronic periodontitis with PPD ≥ 5 mm and periodontal attachment loss ≥4 mm and vertical bone loss ≥3 mm on intra‐oral periapical radiographs, Multiple posterior teeth per pts and 1 site/tooth; UNC‐15 colour‐coded probe, No details on instruments used. Clinical advantages were demonstrated when using non‐steroidal anti‐inflammatory drugs (NSAID) and sub‐antimicrobial dose doxycycline (SDD) (for review see (Preshaw, 2018)), whereas controversial data, adverse effects or lack of proper clinical trials were available for other interventions at the time. per site. Statistical heterogeneity among the studies was assessed with the Cochran's test for heterogeneity, with a significance threshold of p < .1. Jyotsana Tanwar, Shital A Hungund, Kiran Dodani Furthermore, the same research group published all data on local statins (as well as on local BPs and metformin), so the generalizability of the results might not be as applicable without studies performed in other centres indicating similar findings. Moreover, before applying routinely these host modulators, properly powered studies performed by independent research groups are recommended. Among the limitations that we need to consider in this review is the definition of NSPT, which was not consistent between the studies (Table 1). Besides the benefit on PPD reduction, this review suggests that statins have a tangible benefit in terms of CAL gain, radiographic infrabony defect depth reduction, and reduction of gingival inflammation (mSBI) (Supplementary Material). Lasers Surg Med 1989;9:338-44. Use the link below to share a full-text version of this article with your friends and colleagues. It is also important to highlight that some of the available studies did not provide data on sample size calculation (Garg & Pradeep, 2017; Rath et al., 2012) and one was moderately underpowered (Pradeep et al., 2015) (Supplementary material). * Indicates studies considered at high risk of bias, Forest plot showing the mean difference (95% CI) in PPD reduction between systemic SDD therapy compared to placebo in moderate and deep pockets at 6 and 9 months after NSPT, Forest plot showing the mean difference (95% CI) in PPD reduction between probiotic therapy compared to placebo at 6 months after NSPT, Risk of bias of all included studies according to the domain, orcid.org/https://orcid.org/0000-0002-4117-9073, orcid.org/https://orcid.org/0000-0001-8781-1997, orcid.org/https://orcid.org/0000-0002-6742-3556, orcid.org/https://orcid.org/0000-0002-8164-0653, I have read and accept the Wiley Online Library Terms and Conditions of Use, Development of a classification system for periodontal diseases and conditions, Adjunctive use of essential oils following scaling and root planing ‐a randomized clinical trial, Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis, Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: Post‐treatment effects, Clinical and microbiological effects of an essential‐oil‐containing mouth rinse applied in the “one‐stage full‐mouth disinfection” protocol – A randomized double‐blinded preliminary study, Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: A double‐blind RCT, Effects of Ginkgo biloba extract on periodontal pathogens and its clinical efficacy as adjuvant treatment, Sample size calculation in clinical research, Statins and IL‐1β, IL‐10, and MPO levels in gingival crevicular fluid: Preliminary results, Essential oils in one‐stage full‐mouth disinfection: Double‐blind, randomized clinical trial of long‐term clinical, microbial and salivary effects, Effect of Omega‐3 fatty acids on chronic periodontitis patients in postmenopausal women: A randomised controlled clinical study, Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega‐3 Fatty acids and low‐dose aspirin, The effect of adjunctive low‐dose doxycycline therapy on clinical parameters and gingival crevicular fluid matrix metalloproteinase‐8 levels in chronic periodontitis, The effect of adjunctive subantimicrobial dose doxycycline therapy on GCF EMMPRIN levels in chronic periodontitis, Adjunctive low‐dose doxycycline therapy effect on clinical parameters and gingival crevicular fluid tissue plasminogen activator levels in chronic periodontitis, Subantimicrobial‐dose doxycycline and cytokine‐chemokine levels in gingival crevicular fluid, Adjunctive effects of a sub‐antimicrobial dose of doxycycline on clinical parameters and potential biomarkers of periodontal tissue catabolism, Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects. A search of the literature on English publications was performed in Cochrane Central, Medline, ISI Web of Knowledge and EMBASE (until 06 February 2014). In class II furcation defects, subgingival delivery at the base of the pocket of aloe gel compared to placebo gel significantly improved PPD reduction (2.43 vs. 1.86 mm) at 12 months (Ipshita et al., 2018). However, an approved formulation with appropriate good manufacturing practice quality control (GMP) and patient's safety validation is currently not available. Since we pooled the outcomes of the different statin gels together and compared them to the placebo, it is not possible to draw definite conclusions on which statin is more efficient. Initial screening of electronic databases resulted in 283 articles. Non surgical periodontal therapy-a literature review. Ramfjord S, Knowles J, Nissle R, Shick R, Burgett F. Longitudinal study of periodontal therapy. Recent evidence suggests that statins may also attenuate periodontal inflammation by decreasing inter‐leukin IL‐1β and increasing IL‐10 levels in GCF of patients with periodontitis (Cicek Ari et al., 2016). Each study was judged as at low, moderate, high, or unclear risk of bias on the basis of five domains: (a) bias arising from the randomization process; (b) bias due to deviations from intended interventions; (c) bias due to missing outcome data; (d) bias in measurement of the outcome; (e) bias in selection of the reported result. This pilot study compared the regenerative outcomes of minimally invasive periodontal surgery using enamel matrix derivative (EMD) between DM and non-DM patients. If not available, baseline and follow‐up data of mean PPD and CAL were presented. J Clin Periodontol 1985;12:374-88. This case report documents a nonsurgical protocol to achieve reattachment of periodontal tissues that had been lost to periodontitis. Teeth were scaled supra and subgingivally and polished at baseline and at all recall appointments and OH was reinforced, Placebo twice a day for 9 months (no details on preparation methods and composition), All smokers (at least 10 cigarettes a day), Chronic periodontitis, at least 16 teeth, at least two teeth with PPD ≥ 6 mm and at least 30% bone loss in at least two quadrants, Teeth with PPD ≥ 5 mm at baseline (unclear number); UNC‐15 probe. Although NSPT is effective, it does have … OH instructions were given. >30% sites with ≥5 mm clinical attachment loss and having at least two sites with a PD ≥ 6 mm in each quadrant that bled on probing, Local anaesthesia employed and up to 1 hr per quadrant was allowed. Mean prediction intervals and their 95% lower and upper limits were also obtained. None of the studies used questionnaires to assess patient's quality of life or their perception of the treatment received. Effect of Adjuvant Use of NSAID in Reducing Probing Pocket Depth in the Context of Conventional Periodontal Therapy: A Systematic Review of Randomized Trials. T his literature review is concerned with the ability of personal oral hygiene and mechanical instrumentation to establish and maintain periodontal health. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. The benefits of periodontal maintenance therapy (PMT) in maintaining the homeostasis of periodontal tissues obtained after active periodontal therapy (APT), which includes surgical and non-surgical procedures, has been extensively documented in numerous studies [1–6].A classic problem in PMT programs is difficulty in maintaining the patient’s compliance and in … Overall, local host modulators seemed to improve bleeding scores compared to placebo, while poor evidence exists for systemic host modulators. Then sucralose, citric acid, and methylparaben, propylparaben and sodium citrate were added), In SDD group 67 past smokers and 34 current smokers; in placebo group 69 past smokers and 40 current smokers, Adult periodontitis (CAL and PPD between 5 and 9 mm, with BOP]) in at least 2 tooth sites within each of 2 quadrants, All teeth of 2 quadrants (no number specified); UNC‐15 probe, SRP performed on the 2 qualifying quadrants until the crown and root surfaces were visually and/or tactilely free of all deposits, with a time allowance of up to 1 hr per quadrant. No details on instruments used, Omega‐3 PUFAs including 6.25 mg EPA and 19.19 mg DHA obtained from the Atlantic salmon Salmo salar twice a day for 6 months, Placebo tablet twice a day for 6 months (identical except for the fish oil and prepared by the pharmacy of the Gulhane Military Medical Academy), Advanced chronic periodontitis defined as the presence of ≥6 teeth with PPDs > 6 mm, CAL ≥ 4 mm, and radiographic evidence of bone loss more than one‐third of the root length, At least 18 teeth/patients, unclear number of sites/tooth; probe type not reported, Full‐mouth SRP, by hand and with ultrasonic instrumentation and OH instructions, 3g omega‐3 PUFA and 81 mg aspirin daily for 6 months, Placebo capsules for 6 months (no details on preparation methods and composition). Kalkwarf K, Kaldahl W, Patil K. Evaluation of furcation region response to periodontal therapy. In particular, the measurements provided included the reduction in infrabony/furcation defect depth (IBD), defined as the vertical distance from the crest of the alveolar bone/furcation fornix to the base of the defect, and the percentage of defect depth reduction (%DDR) or bone defect fill, calculated as the difference between the distance from the cemento‐enamel junction and the bottom of the defect before and after the treatment divided by the depth of the defect (difference between top and bottom of the defect at baseline). J Clin Periodontol 1992;19:348-56. Overall, it is suggested that in infrabony defects the use of different 1.2% statin gels improves periodontal clinical parameters in comparison with placebo gels, with a tangible clinical benefit at 6–9 months following NSPT. Five studies assessed the adjunctive effect of probiotics to NSPT (Table 1). Meta‐analysis for PPD reduction was performed on five studies that stratified periodontal pocket depth in deep (≥7 mm) and moderate (4–6 mm) (Figure 3). An improvement in CAL gain was also reported by studies applying 1% bisphosphonate gel (from 1.15 to 4.03 mm) or 1% metformin gel (from 1.17 to 4.06 mm) instead of placebo in infrabony defects (Table 1) (details of meta‐analyses are presented in Appendices S19 and S20). J Clin Periodontol 1987;14:213-20. Full mouth SRP under local anaesthesia, one quadrant per visit. Chronic periodontitis with radiographically detected horizontal bone loss (Armitage, All teeth (not specified number of teeth and number of sites/tooth); PCP‐UNC 15 probe, lozenges containing L. reuteri (Prodentis; BioGaia, Lund, Sweden) twice a day for 3 weeks. Pihlstrom B, Oritz-Campos C, McHugh R. Randomized four-year study of periodontal therapy. While biofilm formation on the tooth/root surface is required to initiate periodontal inflammation, it is not sufficient to induce a periodontal tissue damage itself. Effect of topical administration of propolis in chronic periodontitis. This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. Systemic BPs were only investigated in two studies (Table 1) and, therefore, they were not assessed further by meta‐analysis (Lane et al., 2005; Rocha, Malacara, Sánchez‐Marin, Vazquez de la Torre, & Fajardo, 2004). Periodontal … Out of the 58 included studies, 14 studies did not report information on sample size calculation and 44 reported a priori power analysis or sample size calculation, out of which three were underpowered (one of the BP group, one of the statin group and one of the NSAIDs group) (Gupta et al., 2018; Pradeep et al., 2015; Yen et al., 2008) (Appendix S36). Plessas A. Nonsurgical Periodontal Treatment: Review of the Evidence. Nonsurgical therapy remains the cornerstone of periodontal treatment. Any queries (other than missing content) should be directed to the corresponding author for the article. Effect of subantimicrobial dose doxycycline as an effective adjunct to scaling and root planing, The saliva metabolome in association to oral health status, Comparative evaluation of efficacy of subgingivally delivered 1.2% Atorvastatin and 1.2% Simvastatin in the treatment of intrabony defects in chronic periodontitis: A randomized controlled trial, Preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement, The microbiota associated with successful or failing implants, Microbiological and clinical effects of probiotics and antibiotics on nonsurgical treatment of chronic periodontitis: A randomized placebo‐ controlled trial with 9‐month follow‐up, The effect of statins on periodontal treatment‐a systematic review with meta‐analyses and meta‐regression, Effect of alendronate with beta – TCP bone substitute in surgical therapy of periodontal intra‐osseous defects: A Randomized Controlled Clinical Trial, A randomized‐controlled trial of low‐dose doxycycline for periodontitis in smokers, Adjunctive benefits of subantimicrobial dose doxycycline in the management of severe, generalized, chronic periodontitis, Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin‐1beta: A 6‐month randomized controlled clinical trial, Comparative evaluation of subgingivally delivered 1.2% rosuvastatin and 1% metformin gel in treatment of intrabony defects in chronic periodontitis: A randomized controlled clinical trial, Contribution of statins towards periodontal treatment: A review, 1.2% Rosuvastatin versus 1.2% atorvastatin gel local drug delivery and redelivery in treatment of intrabony defects in chronic periodontitis: A randomized placebo‐controlled clinical trial, Comparative evaluation of subgingivally delivered 1% alendronate versus 1.2% atorvastatin gel in treatment of chronic periodontitis: A randomized placebo‐controlled clinical trial, Efficacy of locally delivered 1.2% rosuvastatin gel to non‐surgical treatment of patients with chronic periodontitis: A randomized, placebo‐controlled clinical trial, Clinical efficacy of subgingivally delivered 1.2% atorvastatin in chronic periodontitis: A randomized controlled clinical trial, 1% alendronate gel as local drug delivery in the treatment of Class II furcation defects: A randomized controlled clinical trial, Efficacy of 1% metformin gel in patients with moderate and severe chronic periodontitis: A randomized controlled clinical trial, Efficacy of locally‐delivered 1% metformin gel in the treatment of intrabony defects in patients with chronic periodontitis: A randomized, controlled clinical trial, Clinical effect of subgingivally delivered simvastatin in the treatment of patients with chronic periodontitis: A randomized clinical trial, Host modulation therapy with anti‐inflammatory agents, Subantimicrobial dose doxycycline enhances the efficacy of scaling and root planing in chronic periodontitis: A multicenter trial, Clinical efficacy of subgingivally delivered 1.2 mg simvastatin in the treatment of patients with aggressive periodontitis: A randomized controlled clinical trial, Simvastatin local drug delivery in smokers with chronic periodontitis: A randomized controlled clinical trial, Locally delivered 1% metformin gel in the treatment of smokers with chronic periodontitis: A randomized controlled clinical trial, A clinical, radiological and IL‐6 evaluation of subgingivally delivered simvastatin in the treatment of chronic periodontitis, Clinical effect of locally delivered gel containing green tea extract as an adjunct to non‐surgical periodontal treatment, Effect of alendronate on periodontal disease in postmenopausal women: A randomized placebo‐controlled trial, The effects of non‐steroidal anti‐inflammatory drugs (selective and non‐selective) on the treatment of periodontal diseases, Host response modulation in the management of periodontal diseases, Clinical efficacy of 1% alendronate gel as a local drug delivery system in the treatment of chronic periodontitis: A randomized, controlled clinical trial, Clinical efficacy of 1% alendronate gel in adjunct to mechanotherapy in the treatment of aggressive periodontitis: A randomized controlled clinical trial, Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers, Periodontal disease in pregnancy.

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