The aim of this study was to evaluate the effects of host modulation therapy on periodontal and biochemical parameters. Sixteen rheumatoid arthritis patients newly scheduled for anti-tumour necrosis factor (TNF) therapy were screened for 30 days. Periodontal parameters (clinical attachment level, probing pocket depth, bleeding on probing, plaque index and gingival index) as well as salivary and gingival crevicular fluid (GCF), interleukin (IL)-1β, IL-8 and monocyte chemoattractant protein-1 (MCP-1) levels of the patients were evaluated at baseline and on the 30th day of therapy. GCF volume, IL-1β and IL-8 levels (p = 0.007, p = 0.017 and p = 0.009, respectively) of the periodontitis patients significantly decreased. Although there was a decrease in all these parameters in healthy patients, it was below statistical significance. Salivary IL-8 and MCP-1 levels significantly decreased in periodontitis patients (p = 0.028 and p = 0.013, respectively), but IL-1β levels remained unchanged. These results suggest that TNF blockers may significantly modify host response in terms of biochemical parameters of the periodontium and may mask significant associations such as those reported between periodontitis and rheumatoid arthritis.

Within the limitations of this study, the use of diode lasers as an adjunct to SRP produced significant improvements in clinical parameters as well as gingival crevicular fluid (GCF) IL-1β levels in the 6 month study period.

The purpose of this split-mouth, single-blind, controlled clinical study was to evaluate the impact of low-level laser therapy (LLLT) as an adjunct to non-surgical treatment of chronic periodontitis. Twenty-five systemically healthy and non-smoking adults with chronic periodontitis who had at least two bilateral premolar teeth with probing pocket depth (PPD) of 7 ≥ x ≥ 5 mm were included in the study. In the periodontal examination of these patients, PPD, gingival index (GI), plaque index (PI), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at the baseline, first, third, and sixth months after treatment. Gingival crevicular fluid (GCF) samples were taken at the baseline, first week, and first month after treatment. The collected GCF samples were analyzed using the MAGPIX™ system with a Bio-Plex Pro™ Human Cytokine 27-plex kit. After non-surgical periodontal treatment, LLLT with an energy density of 7.64 J/cm was performed four times: immediately after scaling and root planning (SRP) and on the first, third, and seventh day after treatment. In the first month, PPD levels were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. At the third and sixth months, CAL, PPD, and GI were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. Differences in GCF cytokines levels among the group were not statistically significant. Within the limitations of this study, it is indicated that LLLT as an adjunct to non-surgical periodontal treatment has a positive impact on clinical parameters.

Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the gingiva in the context of an impaired host response. This form of gingivitis is relatively rare. NUG is an infection characterized by gingival necrosis presenting as "punched-out" papillae, spontaneous bleeding, pain, oral malodor, and pseudomembrane formation. The primary predisposing factors are bacterial plaque and an inadequate diet, but smoking and psychological stress may also affect the disease severity. NUG is associated with a characteristic bacterial flora, which includes fusiform bacteria, spirochetes, and Prevotella intermedia. Conventional treatment includes control of both the bacterial plaque and the secondary factors, as well as topical or systemic treatment biostimulative effect on wound healing, pain control, and inflammatory processes. Patients with NUG were treated using adjunct use of a diode laser (980 nm) for the control of pain and to accelerate the wound healing at day 2. 3. 5. 9, energy density was 9 J/cm 2 . After treatment, the patients' quality of life improved faster than with conventional treatment. These results suggest that low-level laser therapy (LLLT) is an effective treatment for the reduction of pain levels and healing times. As a result, our case report shows that LLTT has a positive effect in relieving the symptoms of NUG.

The contribution of CP on systemic oxidative levels in patients with PS and PsA or systemically healthy individuals seems limited. PS and PsA did not show any additional detrimental effect on clinical parameters in patients with CP.