scholarly journals Effect of Adjuvant Use of NSAID in Reducing Probing Pocket Depth in the Context of Conventional Periodontal Therapy: A Systematic Review of Randomized Trials

2020 ◽  
Vol 10 (21) ◽  
pp. 7657
Author(s):  
Stefanie Gartenmann ◽  
Nicole Maier ◽  
Daniel B. Wiedemeier ◽  
Thomas Attin ◽  
Patrick Schmidlin
Keyword(s):  
Systematic Review ◽  
Root Surface ◽  
Periodontal Therapy ◽  
Cochrane Library ◽  
Pocket Depth ◽  
Nsaid Treatment ◽  
Probing Pocket Depth ◽  
Nsaid Group ◽  
Significant Difference ◽  
Inflammatory Drugs

This systematic review aimed to assess the literature on the benefit of adjuvant nonsteroidal anti-inflammatory drugs (NSAIDs) during conventional periodontal therapy in terms of probing pocket depth (PD). A literature search according to PRISMA guidelines in Medline (PubMed), Embase (Ovid), and Cochrane library identified seven studies to be included in this review. In terms of the main outcome, PD, three studies found a larger reduction after NSAID administration compared to non-NSAID control patients. In two studies, no difference in PD reduction between NSAID and placebo was found. Overall, the NSAID patients showed no significant difference with an estimated 0.11 mm larger reduction in PD than the control [95% CI: −0.22 mm, 0.44 mm]. The secondary outcomes, bleeding on probing (BOP) and clinical attachment gain, also showed comparable results in all studies between patients receiving NSAID and those that did not. The estimated additional PD reduction of 0.11 mm in the NSAID group is very small and not statistically significant. It is unlikely that PD can be improved by adjuvant NSAID treatment after root surface debridement, yet the evidence to date is limited and warrants further investigation.

scholarly journals Efficacy of silver nanoparticles in chronic periodontitis patients: a clinico-microbiological study

2020 ◽  
Vol 2 (3) ◽  
pp. 142-147
Author(s):  
Pooja Kadam ◽  
◽  
Swapna Mahale ◽  
Prasad Sonar ◽  
Dipali Chaudhari ◽  
...  
Keyword(s):  
Silver Nanoparticles ◽  
Chronic Periodontitis ◽  
Periodontal Diseases ◽  
Periodontal Therapy ◽  
Local Drug Delivery ◽  
Pocket Depth ◽  
High Antibacterial Activity ◽  
Probing Pocket Depth ◽  
Nonsurgical Periodontal Therapy ◽  
Significant Difference

Introduction: Recent advances in nanotechnology have introduced new therapeutic materials for periodontal therapy. Previous studies showed that nanoparticles of silver provide high antibacterial activity. Taking this in consideration, it can be used in nonsurgical periodontal therapy. The present study focuses on efficacy of subgingival local drug delivery of silver nanoparticles in comparison with tetracycline in chronic periodontitis. Methods: To understand the effect of silver nanoparticles and tetracycline gel in chronic periodontitis, patients which were divided in different: Group A: Scaling and root planning (SRP) with sub-gingival delivery of silver nanoparticles gel, Group B: SRP with sub-gingival delivery of tetracycline gel and Group C: SRP alone. The other data recorded was Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) at baseline (just before placement of gel), 1 month and 3 months of application of gel. Microbiological evaluation (Colony Forming Units, CFU) were recorded at baseline and after 3 months. Results: The results showed that the use of silver nanoparticles delivery after SRP was as efficacious as tetracycline subgingival delivery to treat chronic periodontitis patients. All the clinical as well as microbiological parameters showed statistically significant difference from baseline to 3 months in all the groups. Conclusions: As compared to other therapeutic modalities employed against infection, silver nanoparticles gel is non-toxic at given concentration, has no side effects and does not require complicated application method or any complex armamentarium. It is well tolerated and well accepted by the patients. Silver nanoparticles gel with SRP gives promising results and it can definitely aid in periodontal diseases.

scholarly journals Does flare trial design affect the effect size of non-steroidal anti-inflammatory drugs in symptomatic osteoarthritis? A systematic review and meta-analysis

2016 ◽  
Vol 75 (11) ◽  
pp. 1971-1978 ◽  
Author(s):  
Toby O Smith ◽  
Kun Zou ◽  
Natasya Abdullah ◽  
Xi Chen ◽  
Sarah R Kingsbury ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Joint Effusion ◽  
Cochrane Library ◽  
Short Term ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Randomised Controlled

ObjectivesIt is thought that the clinical trial benefits of oral non-steroidal anti-inflammatory drugs (NSAIDs) may relate to flare designs. The aim of this study was to examine the difference in NSAID (including cyclooxygenase-2 (COX-2) inhibitors) response in osteoarthritis (OA) trials based on different designs.MethodsSystematic review was undertaken of the databases MEDLINE, EMBASE, AMED, CINAHL and the Cochrane library till February 2015. Randomised controlled trials assessing pain, function and/or stiffness following commencement of NSAIDs in flare and non-flare designs were eligible. Trials were assessed using the Cochrane Risk of Bias tool. Meta-analyses were conducted to assess the effect sizes (ES) of NSAIDs for OA with flare versus non-flare trial designs.ResultsFifty-seven studies including 33 263 participants assessing 26 NSAIDs were included. Twenty-two (39%) were flare design, 24 (42%) were non-flare designs, 11 (19%) were possible flare designs. On meta-analysis, there was no statistically significant difference in ES of NSAIDs versus placebo between flare and non-flare trial designs for absolute pain and function or stiffness at immediate-term (1 week), short-term (2–4 week) or longer-term (12–13 week) follow-up periods (p>0.05). However there was a lower ES for mean change in pain in flare and possible flare trials compared with non-flare trials at short-term follow-up (0.36 vs 0.69; p=0.05).ConclusionsContrary to previous understanding, flare trial designs do not result in an increased treatment effect for NSAIDs in people with OA compared with non-flare design. Whether flare design influences other outcomes such as joint effusion remains unknown.

scholarly journals EFFICACY OF CURCUMIN AS AN ADJUNCT TO SCALING AND ROOT PLANING IN PERIODONTITIS PATIENTS – A CLINICAL AND MICROBIOLOGICAL STUDY

2019 ◽  
Vol 8 (5) ◽  
Author(s):  
P. Karthickeyan ◽  
J. Bhaskar ◽  
K. Mahalakshmi ◽  
B. Krishna Prasanth ◽  
Bhagavad Gita ◽  
...  
Keyword(s):  
Pathogenic Bacteria ◽  
Root Surface ◽  
Periodontal Therapy ◽  
Periodontal Pocket ◽  
Control Group ◽  
Scaling And Root Planing ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Root Planing ◽  
Bacterial Plaque

Background: The goal of periodontal therapy is to eliminate bacterial plaque and the factors favoring its formation. Conventional therapy includes scaling, root planing and curettage along with appropriate maintenance of oral hygiene. However, complete elimination of sub gingival micro flora is difficult from areas inaccessible to periodontal instrumentation, which demands the use of antimicrobials as adjuncts in periodontal therapy. Periodontal pocket provides an ideal environment for the growth of anaerobic pathogenic bacteria. In the course of initiation and progression of the inflammatory process, the sub gingival bacteria increase in numbers and invade the pocket epithelial cells and subsequently, the underlying tissues. Aim: To evaluate the efficacy of the adjunctive use of curcumin with scaling and root planing as compared with scaling and root planing alone in the treatment of the  periodontitis. Materials and Methods: Twenty patients with two contralateral sites were identified for the study having probing pocket depths (PPDs) of >5mm. Full mouth scaling and root planing (SRP) was done followed by subgingival application of curcumin gel only on one side. Assessment of Plaque index (PI), Gingival index (GI), Probing Pocket Depth, Clinical attachment levels (CALs) were done at both baseline and at 4th week. Subgingival plaque samples was collected from the root surface and standard microbiologic assessment was done both from the control and the test sites before scaling and root planing. Result: There was a reduction in PI, GI, PPD, CAL and microbiologic parameters in test sites followed by SRP and curcumin gel application, when compared with SRP alone in control group. Conclusion: The subgingival application of curcumin gel in adjunct with scaling and root planing has shown good improvement in periodontal parameters and has a beneficial effect in periodontitis patients. Keywords: Curcumin, Periodontitis, Scaling and root planing.

scholarly journals Indocyanine green–mediated antimicrobial photodynamic therapy as an adjunct to periodontal therapy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Nasir Zeeshan Bashir ◽  
Har-Amrit Singh ◽  
Satnam Singh Virdee
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Indocyanine Green ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Additional Reduction

Abstract Objectives The aim of this systematic review and meta-analysis was to evaluate the efficacy of indocyanine green–mediated photodynamic therapy (ICG-PDT) as an adjunct to non-surgical periodontal therapy (NSPT), in the management of chronic periodontitis. Materials and methods Four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase via OVID, Web of Science) were searched for randomised controlled trials comparing NSPT with ICG-PDT to NSPT without laser therapy. Primary outcome measures were changes in probing pocket depth (PPD) and clinical attachment level (CAL). Clinical outcomes were extracted and pooled from 7 eligible trials and meta-analyses conducted using mean difference with standard deviations. Results For PPD, adjunctive ICG-PDT resulted in a mean additional reduction of 1.17 mm (95% CI: 0.67–1.66 mm) at 3 months and a mean additional reduction of 1.06 mm (95% CI: 0.54–1.57 mm) at 6 months. For CAL, adjunctive ICG-PDT resulted in a mean additional gain of 0.70 mm (95% CI: 0.17–1.23 mm) at 3 months and a mean additional gain of 1.03 mm (95% CI: 0.83–1.24 mm) at 6 months. No adverse events were reported in any studies. Conclusions The adjunctive use of ICG-PDT in NSPT results in improved treatment outcomes at 3 and 6 months post-therapy. Further investigation is needed to evaluate variables such as different photosensitiser concentrations and adjusting parameters associated with the light source. Clinical relevance Indocyanine green–based photosensitisers may be a novel, clinically efficacious agent for use in the management of periodontitis.

scholarly journals Influence of Femoral Version on the Outcomes of Hip Arthroscopic Surgery for Femoroacetabular Impingement or Labral Tears: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110091
Author(s):  
Chenghui Wang ◽  
Yaying Sun ◽  
Zheci Ding ◽  
Jinrong Lin ◽  
Zhiwen Luo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Femoroacetabular Impingement ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Femoral Version ◽  
Labral Tears ◽  
Significant Difference ◽  
Secondary Outcomes

Background: It remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears. Purpose: To review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV. Study Design: Systematic review; Level of evidence, 4. Methods: Embase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable. Results: Included in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), –3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, –0.70 [96% CI, –8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, –3.09 [95% CI, –7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, –1.92 [95% CI, –6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04). Conclusion: The results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

scholarly journals Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Maria Karolina Martins Ferreira ◽  
Iasmin Encaua Essashika Prazeres ◽  
Paula Beatriz de Oliveira Nunes ◽  
Marcela Baraúna Magno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Periodontal Diseases ◽  
Hormonal Contraceptive ◽  
Cochrane Library ◽  
Hormonal Contraceptives ◽  
Clinical Parameters ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

scholarly journals Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Yijuan Hu ◽  
Dongling Zhong ◽  
Qiwei Xiao ◽  
Qiang Chen ◽  
Juan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Balance Function ◽  
Balance Impairment ◽  
Kinesio Taping ◽  
Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

scholarly journals Digital models and orthodontic diagnosis: what degree of reliability?

2021 ◽  
Vol 8 ◽  
Author(s):  
ABDOUL Hafizou RABE ◽  
Fatima SALEK ◽  
Intissar El IDRISSI ◽  
Fatima ZAOUI ◽  
Hicham BENYAHIA
Keyword(s):  
Systematic Review ◽  
Numerical Models ◽  
Meta Analysis ◽  
Physical Models ◽  
Cochrane Library ◽  
Digital Models ◽  
Significant Difference ◽  
Clinically Significant ◽  
Conventional Models ◽  
Plaster Models

Abstract  Background: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis  Method: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies. Results: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means. Conclusion: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters.

scholarly journals Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 125-132
Author(s):  
Fahime Khorasani ◽  
Fariba Ghaderi ◽  
Parvin Sarbakhsh ◽  
Parisa Ahadi ◽  
Elahe Khorasani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Groups ◽  
Pelvic Floor Muscle Exercises ◽  
Significant Difference ◽  
Prevention And Treatment ◽  
Pfm Strength

Objectives: The present systematic review focused on the prevention or treatment of three main types of pelvic floor dysfunctions (PFDs) specifically pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) using physiotherapy and pelvic floor muscle exercises (PFMEs). With regard to the breadth of the problem, there is not much evidence grounded on the best management. The main purpose of this systematic review was to evaluate the effects of physiotherapy and PFMEs on the prevention and treatment of pregnancy-related PFDs; namely, POP, FI, and UI. Therefore, this review incorporated studies comparing the use of physiotherapy and PFMEs with every other existing interventions. Methods: This systematic review and meta-analysis was conducted on randomized-controlled-trial (RCT) articles and quasi-RCT designs through a search in the studies published with no time limits until December 2017 in the databases of PubMed (Medline), Web of Science, Scopus, Embase, Cochrane Library, and ProQuest. The meta-analysis was also applied for data synthesis. Moreover, heterogeneity was assessed using Cochran’s Q test and I2 index. Results: A total number of 26 RCTs were examined in this review in which the outcome variables were related to POP, UI, and FI prevalence; POP, UI, and FI severity, as well as pelvic floor muscle (PFM) strength and endurance. In most articles, UI prevalence or severity in intervention groups had significantly improved compared with those in controls. The number of studies examining POP and FI was also relatively low. In two studies, FI severity or prevalence in intervention groups had significantly enhanced in comparison with those in control groups; however, FI prevalence in two articles had been reported lower in intervention groups than that in control groups although no significant difference had been observed. There was also no significant improvement in intervention groups in two other studies in this respect. Besides, three articles had not reported traces of improvement in POP, as well as a significant difference between intervention and control groups. Nevertheless, two studies had found a significant improvement in POP in this regard. Based on meta-analysis results for the variable of PFM strength, Cochran’s Q test (P<0.001) and I2 index (90.02) indicated heterogeneity between studies; so, a random-effect meta-analysis was applied to estimate overall effect sizes. The overall mean differences following intervention between the study groups were also equal to 6.94, with a 95% CI (1.36 to 12.52). Conclusions: It was concluded that physiotherapy and PFMEs might have effects on pregnancy-related UI, but they had not consistently reduced FI severity or prevalence and failed to constantly improve POP.

scholarly journals A COMPARATIVE STUDY TO ASSES THE EFFICACY OF NANOBIO FUSION GEL AS AN ADJUNCT TO SCALING AND POLISHING IN CHRONIC PERIODONTITIS. - A CLINICAL STUDY

2020 ◽  
pp. 1-3
Author(s):  
Patil A. Veena ◽  
Ansari T. Sobia ◽  
Agarwal Priyanka ◽  
Ayesha Ayesha ◽  
Sultana Shahnaaz
Keyword(s):  
Periodontal Disease ◽  
Chronic Periodontitis ◽  
Antimicrobial Agents ◽  
Test Group ◽  
Controlled Clinical Trial ◽  
Pocket Depth ◽  
Antioxidant Power ◽  
Probing Pocket Depth ◽  
Significant Difference ◽  
And Control

Introduction: Various chemical agents such as nonsteroidal, anti-inflammatory drugs and antimicrobial agents has gained popularity in treatment of periodontal disease but simultaneously lead to condition such as drug resistance and drug allergy. Hence , the topical application of herbal agents such as propolis, aloevera, green tea extracts, Neem reduces the potency and effectiveness to prevent progression of periodontal disease. NanoBioFusion(NBF)gel contains the natural antioxidant power of propolis,vit C,vit E which allows the ultrafine antioxidant to surpase the moist intraoral environment to enter the cells and rejuvenate,revitalize,support,protect and optimize gum and soft oral tissue.Hence the present study is aimed to evaluate the clinical effect of locally delivered NBF gel as an adjunctive therapy to scaling and polishing in the treatment of Periodontitis. Materials and Methods: Chronic Periodontitis patients with 40 sites and probing pocket depth (PD) between 5 and 7 mm were selected in a randomized controlled clinical trial. SRP was performed in both control and test group followed by NBF gel application in 40 sites. The plaque index, gingival index and probing Pocket depth,were recorded at baseline, 6 weeks, and 3 months.The statistical analysis with paired t‑test was used to compare the test and control sites. Results: From baseline to a period of 3 months, a statistically significant difference was seen between both groups for Pocket probing depth and from baseline to 6 weeks the mean GI and PI score have a statistically significant result was obtained(P=0.01& 0.00). Conclusions: Locally delivered NBF gel exhibited a significant improvement compared with SRP alone in chronic periodontitis.

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