Objectives The aim of this study was to evaluate the effects of Lactobacilli reuteri (Prodentis) alone and in combination with scaling and root planing (SRP) in a double blind, randomized, placebo-controlled clinical trial of volunteers with chronic periodontitis.Methods Thirty, otherwise systemically healthy, chronic periodontitis patients (19 males and 11 females, aged between 34 and 50 years) were included. The study period was 42 days. ‘Split-mouth’ design was used for the SRP, which was performed on day 0; two quadrants (either right or left) were treated with SRP whereas the remaining two quadrants were left untreated. The participants received a toothbrush, toothpaste, and brushing instructions. L. reuteri Prodentis lozenges (1×108 CFU DSM17938+1×108 CFU ATCC PTA 5289) or the corresponding placebo lozenges were taken twice daily from day 21 to day 42. Statistical analysis was done for comparisons of clinical parameters (Plaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), probing pocket depth (PPD), clinical attachment level (CAL)) and microbiological levels of the pathogens Aggregibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi). All p-values less than 0.05 were considered significant. Assessments were made on day 0 before SRP treatment, on day 21 before administration of the lozenges, and on day 42.Results At day 42, the PI, GI, and GBI were significantly reduced by all treatment modalities. When ranked, the amount of PI, GI and GBI reduction by the different treatments was SRP + Prodentis Prodentis SRP + placebo placebo; all differences were statistically significant. For PPD and CAL, the best result was obtained with the SRP+Prodentis treatment. PPD was reduced from 5.08±0.75 to 3.78±0.61 mm (p<0.001) and CAL from 3.93±0.93 to 2.85±0.74 mm (p<0.001). Prodentis, either alone or following SRP, reduced Aa, Pi, and Pg by 1 log10 unit (p<0.01). The SRP+placebo combination did not significantly affect the levels of the pathogens.Conclusion The present randomized controlled trial confirms the plaque inhibition, anti-inflammatory, and antimicrobial effects of L. reuteri Prodentis. L. reuteri Prodentis probiotic can be recommended during non-surgical therapy and the maintenance phase of periodontal treatment. Considering the beneficial effects of probiotics, this therapy could serve as a useful adjunct or alternative to periodontal treatment when SRP might be contraindicated. Further studies are required in this direction.

In the present study, it was concluded that gingival thickness varies according to age, gender and dental arch.

Indices are important tools to measure, quantify and treat periodontitis both in epidemiological and clinical situations and are based on the prevailing understanding of the pathogenesis of periodontal disease. However, there is dearth of literature on collective information of periodontal indices formulated to date. This article collectively describes the evolution and the present concept of formulation of periodontal indices based on the multi-factorial nature of periodontal disease and also provides some direction for future periodontal indices. Periodontal indices have evolved from the simple Russell's index to the current usage of measurement of clinical attachment level in the recording of indices. The use of dichotomous measurements and the Genetic Susceptibility Index are the new additions to the periodontal indices. Nevertheless, an ideal would be an index that will keep pace with the ever changing concept of the pathogenesis of periodontal disease.

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Background:We face various problems while measuring the Clinical attachment level (CAL) from Cemento-enamel junction (CEJ). This study aims to record and compare the CEJ location measurements using a xed reference point (FRP) [Custom made stent] before and after ap elevation.Materials and Methods:A custom made stent and UNC-15 probe were used. Recording of CEJ location was made using a UNC-15 (Hu-Friedy) probe, before (close CEJ) and after (Open CEJ) the reflection of the flap from the lower edge of the stent in those subjects who were indicated for flap surgery, at baseline.Results:We used statistical analysis involving intra-group comparison done by Paired-‘t’ test. The close and the open CEJ measurements demonstrated a, statistically, non-significant difference. The equi-measurements of close and open CEJ numerical data were remarkably lower than the under and overestimation of measurements. Thus, despite certain disadvantages of stent, the FRP provides a simple solution for CAL measurement.Conclusion:The results of this study confirms the objective of the study and strongly suggests that CAL measurements done without FRP is subjected to great variation and the diagnostic and prognostic interpretation of CAL should be viewed seriously in periodontics.