Periodontal Disease Case Study

DISCUSSION
Periodontal disease, which is characterized by gingival attachment loss and bone resorption, is a family of diseases affecting the dental supporting tissues. The currently recognized key Gram negative periodontopathogens in the periodontal pocket could damage periodontal tissues and good knowledge of these as well as an adequate treatment could be helpful in treatment of periodontal disease.6 Mechanical therapy is usually the first mode of therapy recommended and is considered the gold standard till date. However, the temporary effect of subgingival scaling and root planing and its inability to eradicate all periodontal pathogens is explained by the unfavourable anatomy or dimensions of periodontal pockets.5
Local delivery of antimicrobial

However, the improvements were highly statistically significant in group B as compared to group A. This marked reduction in the proportions of sites that bled on probing represents significant reduction in inflammation and possibly, bacterial load in these sites. This is in agreement to another study by Gonzales et al17 where in the mean percentage of bleeding sites decreased from 95% to 35% after 10 days and to 42% after 28 days of placement of CHX chip. Goodson et al.18 have shown that local delivery of antimicrobial drugs had a significant effect in reducing the red-complex bacteria in the periodontal pocket. The larger reduction in PBI observed in the present study is likely due to the anti-infective effect that the frequent applications of these chips had on the microbial flora with chlorhexidine and inflammatory response due to flurbiprofen. The CHX chips resulted in similar and even greater response compared to the FBP

These results exceed those by Machtei et al in a study21 after 8 weeks when using repeated local application of FBP and CHX chips. The greater CAL gain in the present study might be associated with the greater intensity of the application of the chips which in turn results in higher local concentration of the drug that might be responsible for the greater effect. It has been demonstrated that PGE2 and TXB2 levels decreased and remained relatively constant from day 29 to day 50 with flurbiprofen administration in a study by Abramson et al.22 Similar results were confirmed by various authors20,21,23,24,25,26 where there were significant improvements in the values of CAL after administration of FBP and CHX chips. When the comparison was made between the groups, no statistically significant differences were seen in the values of PD and CAL at 1, 3 and 6 months in between the groups. This is in agreement with the study done by Machtei et