Impact of an oxygen-releasing agents and supportive hygienic aids on the periodontal pocket microbiota during the treatment of patients with stage III-IV periodontitis: clinico-microbiological study

Background. Taking into account that oxygen-releasing agents are relatively new in the periodontal practice it seems to be clinically relevant to validate how such may impact the results of classical periodontal treatment approaches, if latter are modified by the additional use of active oxygen-containing substances as local therapy modality. Moreover, effect of oxygen-releasing substances used in periodontology needs to be quantified not only through the changes of clinical criteria, but also through the changes of microbiological parameters registered with the precise laboratorial approach. Objective. To provide comparative quantitative assessment of periodontal pocket microbiota changes among patients with III-IV stages of periodontitis after modification of standard scaling and root planning approaches by application of oxygen-releasing gel with supportive hygienic aids and compare effect of such with chlorhexidine-containing agents. Material and Methods. Patients with III-IV stages of periodontitis were randomly allocated either to control (20 subjects) or study group (20 subjects). Independently of group allocation all patients underwent basic non-surgical periodontal treatment according to the EFP protocols (subgingival instrumentation). Patients within control group additionally to the basic non-surgical periodontal treatment received post-instrumentational application of chlorhexidine gel into the periodontal pockets immediately after cleaning. Patients within study group additionally to the basic non-surgical periodontal treatment received post-instrumentational application of an oxygen-releasing gel, which was applied immediately after subgingival instrumentation into the periodontal pockets. The microbiological assessment of the periodontal pocket biotope was performed using the PeriodontScreen Real-time PCR test. Samples for the study were collected at different time points: before treatment, two weeks after treatment, and two months after treatment. Results. Two months after treatment Aggregatibacter actinomycetemcomitans reappeared, although in smaller quantities, in 90% of patients in the control group, however, in the study group, among patients in whom Aggregatibacter actinomycetemcomitans was not detected after two weeks, it remained undetectable even after two months. Overall, Aggregatibacter actinomycetemcomitans was identified in only 20% of the patients in the second group after two months. No significant difference in the average quantitative levels of Porphyromonas gingivalis and Porphyromonas endodontalis between two groups were observed at different time points (p > 0.05). Conclusions. Considering limitations of present study, provided analysis of the obtained data revealed that oxygen-based preparations exhibit antibacterial properties no less effective than chlorhexidine-based preparations, which allows to recommend such as additional treatment modalities for local application and home hygiene aid during complex treatment of patients with periodontitis. Taking into account registered detection levels changes after provided treatment it may also be assumed that oxygen-releasing gel demonstrated the most pronounced antibacterial properties against such pathogens as Aggregatibacter actinomycetemcomitans and Treponema denticola, particularly in 2 months long monitoring. Conflict of Interest Authors do not have any potential conflict of interests that may influence the decision to publish this article. Funding No funding was received to assist in preparation and conduction of this research, as well as in composition of this article.