Antimicrobial Peptide Periodontal Gel As An Adjunct To Basic Treatment Of Periodontitis Clinical Efficacy Study

Objective: To observe the clinical effects of subgingival scraping and root planing(SRP)with the aid of antimicrobial peptide periodontal gel(Jetting Clean)in the basic treatment of stage II-III periodontitis and the effect on the concentration of Tumor Necrosis Factor-alpha(TNF-alpha)in the Gingival Crevicular Fluid(GCF).which will providea theoretical basis for the clinical application of Jetting Clean in periodontitis.Methods: Forty-two patients with systemic healthy periodontitis,aged between 18 and60 years,from the outpatient clinic of the Affiliated Hospital of Youjiang Medical College of Medicine,who attended the clinic between April 2021 and January 2022,were selected for this study,and a medical history as well as whole-mouth ultrasonic supragingival scaling was taken and followed up after 1 week.The experimental teeth were rigorously screened for SRP according to the inclusion criteria.After the operation,the same patient was divided into two areas,left and right,with similar condition of the same jaw with the same name for the control design,and the two areas were randomly divided into experimental and control groups.The experimental group was SRP+Jetting Clean,The control group was SRP alone,with saline rinsing of the periodontal pockets of the subject teeth after the SRP surgery.Applied once a week for 2 weeks by the same medical practitioner.The BI,PD,PAL and GCF volume indices of the two experimental teeth were observed at four stages: baseline,2 weeks,6 weeks and 12 weeks after SRP,respectively;Aenzyme-linked immunosorbent assay(ELISA)was performed to detect the change of TNF-α concentration before and after treatment and the incidence of adverse reactions of Jetting Clean.The experimental data were processed and analysed using SPSS 26.0 statistical software,and the data were expressed in the form of median and interquartile spacing M(Q25～Q75),The Friedman test was used for comparison of different observation nodes longitudinally within each group,and the Wilcoxon rank test for two paired samples was used for comparison of different observation nodes between groups,P <0.05 was considered a statistically significant difference,and the test level was two-sided α =0.05.Results:(1)At baseline,there was no statistical difference between the experimental and control groups for each observed index(PD,PAL,BI,GCF volume,and TNF-α concentration)between the groups,and they were comparable(P>0.05).(2)Compared to baseline,PD,PAL,BI,GCF volume and TNF-α concentrations were statistically significantly lower in both groups at 2,6 and 12 weeks post-treatment(P<0.001).(3)PD,PAL and TNF-α concentrations were not statistically different between the experimental and control groups at different time periods(P>0.05).BI and GCF volumes were statistically different between the 2,6 and 12 week groups(P<0.05).More significant reduction in BI and GCF volume numbers in the experimental group.(4)No adverse events were observed throughout the observation period.Conclusion:(1)In patients with stage II-III periodontitis,both the SRP group and the SRP+Jetting Clean group can effectively improve the periodontal clinical index,and Jetting Clean is more effective in reducing inflammation;it can be used as an adjunct to rapidly reduce gingival bleeding in the short term,and is safe and worth promoting.(2)During the3-month observation period,TNF-α concentrations coincided with the trend in periodontal clinical index parameters,but the use of Jetting Clean did not significantly reduce TNF-αconcentrations.(3)The overall indexes showed a decreasing trend during the observation period,but gradually slowed down,which indicates that the efficacy of SRP and Jetting Clean gradually decreases or disappears over time,and the improvement of periodontal clinical effect is limited,and the treatment of periodontitis still needs long-term maintenance and regular treatment.