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Evaluation of 4% Mangosteen (MG) Gel as a Local Drug Delivery in adjunct to Scaling and Root planing on Clinical Parameters and GCF MMP-9 levels in Chronic Periodontitis Patients - A Split Mouth Randomized Controlled Trial

Year 2023, , 130 - 138, 26.12.2023
https://doi.org/10.29228/erd.57

Abstract

Objective: The current study was conducted to assess the efficacy of 4% Mangosteen (MG) gel in adjunct to Scaling and root planing (SRP) on clinical parameters and Gingival Crevicular Fluid (GCF) matrix metalloproteinase 9 (MMP-9) levels in the management of patients with chronic periodontitis.

Methodology: This double blinded, randomized, placebo-controlled, split mouth, clinico-biochemical study was carried out on 13 patients (26 experimental sites) with Stage II and Grade B periodontitis. Following subgingival SRP, the 13 control sites were treated with LDD of placebo gel and the 13 test sites with 4% MG gel. Clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing depth (PD) and relative attachment level (RAL) were recorded and GCF was collected from all the experimental sites for MMP-9 analysis, using Enzyme Linked Immunosorbent Assay (ELISA); at baseline and 3 months post treatment.

Results: Both, control and test sites, demonstrated improvement in the clinical parameters and reduction in GCF MMP-9 levels during the study period. Test sites exhibited a statistically significant reduction (P <0.05) in PD and RAL (gain in clinical attachment level; CAL) and GCF MMP-9 levels than the control sites. All the clinical parameters showed a positive correlation with the GCF MMP-9 levels.

Conclusion: Within the limitations of this study, 4% MG gel proves to be an efficacious adjunctive agent to SRP, for management of chronic periodontitis.

References

  • Reference1 Aljuanid MA, Qaid HR, Lashari DM, Ridwan RD, Budi HS, Alkadasi BA, et al. Nano-emulsion of mangosteen rind extract in a mucoadhesive patch for periodontitis regenerative treatment: An in vivo study. J Taibah Univ Med Sci. 2022;17(5):910-20.
  • Reference2 Bildt MM, Bloemen M, Kuijpers-Jagtman AM, Von den Hoff JW. Collagenolytic fragments and active gelatinase complexes in periodontitis. J Periodontol. 2008;79(9):1704-11.
  • Reference3 Bural C, Güven MÇ, Kayacıoğlu B, Ak G, Bayraktar G, Bilhan H. Effect of Over-the-Counter Topical Agents on Denture-Induced Traumatic Lesions: A Clinical Study. Int J Prosthodont. 2018;31(5):481-4.
  • Reference4 Checchi V, Maravic T, Bellini P, Generali L, Consolo U, Breschi L, et al. The Role of Matrix Metalloproteinases in Periodontal Disease. Int J Environ Res Public Health. 2020;17(14):4923-36.
  • Reference5 Chen CM, Hsieh SC, Lin CL, Lin YS, Tsai JP, Hsieh YH. Alpha-Mangostin Suppresses the Metastasis of Human Renal Carcinoma Cells by Targeting MEK/ERK Expression and MMP-9 Transcription Activity. Cell Physiol Biochem. 2017;44(4):1460-70. Reference6 Drisko CH. Non-surgical pocket therapy: pharmacotherapeutics. Ann Periodontol. 1996;1(1):491-566.
  • Reference7 Franco C, Patricia HR, Timo S, Claudia B, Marcela H. Matrix Metalloproteinases as Regulators of Periodontal Inflammation. Int J Mol Sci. 2017;18(2):440-52.
  • Reference8 Gonçalves PF, Huang H, McAninley S, Alfant B, Harrison P, Aukhil I, et al. Periodontal treatment reduces matrix metalloproteinase levels in localized aggressive periodontitis. J Periodontol. 2013;84(12):1801-8.
  • Reference9 Goodson JM, Hogan PE, Dunham SL. Clinical responses following periodontal treatment by local drug delivery. J Periodontol. 1985;56(11 Suppl):81-7.
  • Reference10 Greenstein G. Nonsurgical periodontal therapy in 2000: a literature review. J Am Dent Assoc. 2000;131(11):1580-92.
  • Reference11 Han DH, Shin HS, Paek D, Kim HD. Gingival crevicular fluid levels of matrix metalloproteinases cross-sectionally related to periodontitis and metabolic syndrome in community Koreans. J Clin Periodontol. 2012;39(12):1125-31.
  • Reference12 Hendiani I, Hadidjah D, Susanto A. Inhibitory and bactericidal power of mangosteen rind extract towards Porphyromonas Gingivalis and Actinobacillus Actinomycetemcomitans (Laboratory test). Padj J Dent. 2016;28(2):75-80.
  • Reference13 Hendiani I, Hadidjah D, Susanto A, Pribadi IMS. The effectiveness of mangosteen rind extract as additional therapy on chronic periodontitis (Clinical trials). Padjajaran J Dent. 2017;29(1):64-70.
  • Reference14 H R, Dhamecha D, Jagwani S, Rao M, Jadhav K, Shaikh S, et al. Local drug delivery systems in the management of periodontitis: A scientific review. J Control Release. 2019;307:393-409.
  • Reference15 Kresnoadi U, Ariani MD, Djulaeha E, Hendrijantini N. The potential of mangosteen (Garcinia mangostana) peel extract, combined with demineralized freeze-dried bovine bone xenograft, to reduce ridge resorption and alveolar bone regeneration in preserving the tooth extraction socket. J Indian Prosthodont Soc. 2017;17(3):282-8.
  • Reference16 Lim YK, Yoo SY, Jang YY, Lee BC, Lee DS, Kook JK. Anti-inflammatory and in vitro bone formation effects of Garcinia mangostana L. and propolis extracts. Food Sci Biotechnol. 2019;29(4):539-48.
  • Reference17 Luchian I, Goriuc A, Sandu D, Covasa M. The Role of Matrix Metalloproteinases (MMP-8, MMP-9, MMP-13) in Periodontal and Peri-Implant Pathological Processes. Int J Mol Sci. 2022;23(3):1806-24.
  • Reference18 Mahendra J, Mahendra L, Svedha P, Cherukuri S, Romanos GE. Clinical and microbiological efficacy of 4% Garcinia mangostana L. pericarp gel as local drug delivery in the treatment of chronic periodontitis: A randomized, controlled clinical trial. J Investig Clin Dent. 2017;8(4):1-8.
  • Reference19 Manjunatha VA, Vemanaradhya GG, Gowda TM. Clinical and antioxidant efficacy of 4% mangosteen gel as a local drug delivery in the treatment of chronic periodontitis: A placebo-controlled, split-mouth trial. Dent Med Probl. 2022;59(1):111-9.
  • Reference20 Marcaccini AM, Meschiari CA, Zuardi LR, de Sousa TS, Taba M Jr, Teofilo JM, et al. Gingival crevicular fluid levels of MMP-8, MMP-9, TIMP-2, and MPO decrease after periodontal therapy. J Clin Periodontol. 2010;37(2):180-90.
  • Reference21 Pan T, Wu D, Cai N, Chen R, Shi X, Li B, et al. Alpha-Mangostin protects rat articular chondrocytes against IL-1β-induced inflammation and slows the progression of osteoarthritis in a rat model. Int Immunopharmacol. 2017;52:34-43.
  • Reference22 Peniche-Palma DC, Carrillo-Avila BA, Sauri-Esquivel EA, Acosta-Viana K, Esparza-Villalpando V, Pozos-Guillen A, et al. Levels of Myeloperoxidase and Metalloproteinase-9 in Gingival Crevicular Fluid from Diabetic Subjects with and without Stage 2, Grade B Periodontitis. Biomed Res Int. 2019;2019:5613514-22.
  • Reference23 Phongpaichit S, Ongsakul M, Nilrat L, Tharavichitkul P, Bunchoo S, Chuaprapaisilp T. Antibacterial activities of extracts from Garcinia mangostana pericarps on methicillin-resistant Staphylococcus aureus and Enterococcus species. Songklanakarin J Sci Technol. 1994;16:399-405.
  • Reference24 Pradeep AR, Bajaj P, Agarwal E, Rao NS, Naik SB, Kalra N, et al. Local drug delivery of 0.5% azithromycin in the treatment of chronic periodontitis among smokers. Aust Dent J. 2013;58(1):34-40.
  • Reference25 Preshaw PM, Taylor JJ, Jaedicke KM, De Jager M, Bikker JW, Selten W, et al. Treatment of periodontitis reduces systemic inflammation in type 2 diabetes. J Clin Periodontol. 2020;47(6):737-46.
  • Reference26 Putri K, Darsono L, Mandalas H. Anti-inflammatory properties of mangosteen peel extract on the mice gingival inflammation healing process. Padjajaran J Dent. 2017;29:190-5.
  • Reference27 Qasim SSB, Al-Otaibi D, Al-Jasser R, Gul SS, Zafar MS. An Evidence-Based Update on the Molecular Mechanisms Underlying Periodontal Diseases. Int J Mol Sci. 2020;21(11):3829-50.
  • Reference28 Rai B, Kaur J, Jain R, Anand SC. Levels of gingival crevicular metalloproteinases-8 and -9 in periodontitis. Saudi Dent J. 2010;22(3):129-31.
  • Reference29 Rassameemasmaung S, Sirikulsathean A, Amornchat C, Maungmingsook P, Rojanapanthu P, Gritsanaphan W. Topical application of Garcinia mangostana L. pericarp gel as an adjunct to periodontal treatment. Complement Ther Med. 2008;16(5):262-7.
  • Reference30 Ridwan RD, Kusumaningsih T, Saputra D. Inhibitory Effect of Mucoadhesive Gingival Patch of Mangosteen Peel Extract Against Periodonto Pathogen Bacteria. J Int Dent Med Res. 2020;13(3):843-48.
  • Reference31 Ridwan RD, Yuliati Y, Sidarningsih S, Sholihah FM, Aljunaid M, Lashari DM. A study of the mucoadhesive patches loaded with mangosteen peel extract in periodontitis. J Taibah Univ Med Sci. 2021;16(6):864-9.
  • Reference32 Singh A, Sridhar R, Shrihatti R, Mandloy A. Evaluation of Turmeric Chip Compared with Chlorhexidine Chip as a Local Drug Delivery Agent in the Treatment of Chronic Periodontitis: A Split Mouth Randomized Controlled Clinical Trial. J Altern Complement Med. 2018;24(1):76-84.
  • Reference33 Tangsuksan P, Srichana T, Kettratad M, Nittayananta W. Antimicrobial and Anti-inflammatory Effects of α-Mangostin Soluble Film. J Int Soc Prev Community Dent. 2022;12(2):189-98.
  • Reference34 Wei Y, Deng Y, Ma S, Ran M, Jia Y, Meng J, et al. Local drug delivery systems as therapeutic strategies against periodontitis: A systematic review. J Control Release. 2021;333:269-82.
  • Reference35 Widjaja J, Wahjuningrum DA, Cahyani F. Antibacterial Effect of Xanthone from Mangosteen Pericarp Extract (Garcinia mangostana Linn.) against Porphyromonas gingivalis. J Int Dent Medical Res. 2019;12(1):19-21.
  • Reference36 Widyarman AS, Lay SH, Wendhita IP, Tjakra EE, Murdono FI, Binartha CTO. Indonesian Mangosteen Fruit (Garcinia mangostana L.) Peel Extract Inhibits Streptococcus mutans and Porphyromonas gingivalis in Biofilms In vitro. Contemp Clin Dent. 2019;10(1):123-8.
  • Reference37 Xu XH, Liu QY, Li T, Liu JL, Chen X, Huang L, et al. Garcinone E induces apoptosis and inhibits migration and invasion in ovarian cancer cells. Sci Rep. 2017;7(1):10718-31.
  • Reference38 Yabluchanskiy A, Ma Y, Iyer RP, Hall ME, Lindsey ML. Matrix metalloproteinase-9: Many shades of function in cardiovascular disease. Physiology (Bethesda). 2013;28(6):391-403.
  • Reference39 Yakob M, Meurman JH, Sorsa T, Söder B. Treponema denticola associates with increased levels of MMP-8 and MMP-9 in gingival crevicular fluid. Oral Dis. 2013;19(7):694-701.

Kronik Periodontitis Hastalarında Klinik Parametreler ve GCF MMP-9 seviyeleri üzerinde Ölçeklendirme ve Kök planlamasına ek olarak Yerel İlaç Dağıtımı olarak %4 Mangosten (MG) Jelinin Değerlendirilmesi - Bölünmüş Ağızlı Randomize Kontrollü Bir Çalışma

Year 2023, , 130 - 138, 26.12.2023
https://doi.org/10.29228/erd.57

Abstract

Amaç: Bu çalışma, diş taşı temizliği ve kök düzleştirme (SRP) işlemine ek olarak %4 Mangosten (MG) jelinin klinik parametreler ve diş eti oluğu sıvısı (GCF) matriks metaloproteinaz 9 (MMP-9) düzeyleri üzerindeki etkinliğini değerlendirmek amacıyla gerçekleştirilmiştir. Kronik periodontitli hastaların tedavisi.

Metodoloji: Bu çift kör, randomize, plasebo kontrollü, bölünmüş ağızlı, kliniko-biyokimyasal çalışma, Evre II ve Derece B periodontitli 13 hasta (26 deney bölgesi) üzerinde gerçekleştirildi. Subgingival SRP'nin ardından 13 kontrol bölgesi LDD plasebo jeli ile ve 13 test bölgesi ise %4 MG jeli ile tedavi edildi. Plak indeksi (PI), diş eti kanama indeksi (GBI), sondalama derinliği (PD) ve göreceli ataşman seviyesi (RAL) dahil olmak üzere klinik parametreler kaydedildi ve Enzim Bağlantılı İmmünosorbent Testi kullanılarak MMP-9 analizi için tüm deney alanlarından GCF toplandı. (ELISA); başlangıçta ve tedaviden 3 ay sonra.

Sonuçlar: Hem kontrol hem de test sahalarında, çalışma süresi boyunca klinik parametrelerde iyileşme ve GCF MMP-9 seviyelerinde azalma görüldü. Test bölgeleri, PD ve RAL (klinik bağlanma seviyesinde kazanç; CAL) ve GCF MMP-9 düzeylerinde kontrol bölgelerine göre istatistiksel olarak anlamlı bir azalma (P <0.05) sergiledi. Tüm klinik parametreler GCF MMP-9 düzeyleri ile pozitif korelasyon gösterdi.

Sonuç: Bu çalışmanın sınırlamaları dahilinde, %4 MG jelinin kronik periodontit tedavisinde SRP'ye etkili bir yardımcı ajan olduğu kanıtlanmıştır.

References

  • Reference1 Aljuanid MA, Qaid HR, Lashari DM, Ridwan RD, Budi HS, Alkadasi BA, et al. Nano-emulsion of mangosteen rind extract in a mucoadhesive patch for periodontitis regenerative treatment: An in vivo study. J Taibah Univ Med Sci. 2022;17(5):910-20.
  • Reference2 Bildt MM, Bloemen M, Kuijpers-Jagtman AM, Von den Hoff JW. Collagenolytic fragments and active gelatinase complexes in periodontitis. J Periodontol. 2008;79(9):1704-11.
  • Reference3 Bural C, Güven MÇ, Kayacıoğlu B, Ak G, Bayraktar G, Bilhan H. Effect of Over-the-Counter Topical Agents on Denture-Induced Traumatic Lesions: A Clinical Study. Int J Prosthodont. 2018;31(5):481-4.
  • Reference4 Checchi V, Maravic T, Bellini P, Generali L, Consolo U, Breschi L, et al. The Role of Matrix Metalloproteinases in Periodontal Disease. Int J Environ Res Public Health. 2020;17(14):4923-36.
  • Reference5 Chen CM, Hsieh SC, Lin CL, Lin YS, Tsai JP, Hsieh YH. Alpha-Mangostin Suppresses the Metastasis of Human Renal Carcinoma Cells by Targeting MEK/ERK Expression and MMP-9 Transcription Activity. Cell Physiol Biochem. 2017;44(4):1460-70. Reference6 Drisko CH. Non-surgical pocket therapy: pharmacotherapeutics. Ann Periodontol. 1996;1(1):491-566.
  • Reference7 Franco C, Patricia HR, Timo S, Claudia B, Marcela H. Matrix Metalloproteinases as Regulators of Periodontal Inflammation. Int J Mol Sci. 2017;18(2):440-52.
  • Reference8 Gonçalves PF, Huang H, McAninley S, Alfant B, Harrison P, Aukhil I, et al. Periodontal treatment reduces matrix metalloproteinase levels in localized aggressive periodontitis. J Periodontol. 2013;84(12):1801-8.
  • Reference9 Goodson JM, Hogan PE, Dunham SL. Clinical responses following periodontal treatment by local drug delivery. J Periodontol. 1985;56(11 Suppl):81-7.
  • Reference10 Greenstein G. Nonsurgical periodontal therapy in 2000: a literature review. J Am Dent Assoc. 2000;131(11):1580-92.
  • Reference11 Han DH, Shin HS, Paek D, Kim HD. Gingival crevicular fluid levels of matrix metalloproteinases cross-sectionally related to periodontitis and metabolic syndrome in community Koreans. J Clin Periodontol. 2012;39(12):1125-31.
  • Reference12 Hendiani I, Hadidjah D, Susanto A. Inhibitory and bactericidal power of mangosteen rind extract towards Porphyromonas Gingivalis and Actinobacillus Actinomycetemcomitans (Laboratory test). Padj J Dent. 2016;28(2):75-80.
  • Reference13 Hendiani I, Hadidjah D, Susanto A, Pribadi IMS. The effectiveness of mangosteen rind extract as additional therapy on chronic periodontitis (Clinical trials). Padjajaran J Dent. 2017;29(1):64-70.
  • Reference14 H R, Dhamecha D, Jagwani S, Rao M, Jadhav K, Shaikh S, et al. Local drug delivery systems in the management of periodontitis: A scientific review. J Control Release. 2019;307:393-409.
  • Reference15 Kresnoadi U, Ariani MD, Djulaeha E, Hendrijantini N. The potential of mangosteen (Garcinia mangostana) peel extract, combined with demineralized freeze-dried bovine bone xenograft, to reduce ridge resorption and alveolar bone regeneration in preserving the tooth extraction socket. J Indian Prosthodont Soc. 2017;17(3):282-8.
  • Reference16 Lim YK, Yoo SY, Jang YY, Lee BC, Lee DS, Kook JK. Anti-inflammatory and in vitro bone formation effects of Garcinia mangostana L. and propolis extracts. Food Sci Biotechnol. 2019;29(4):539-48.
  • Reference17 Luchian I, Goriuc A, Sandu D, Covasa M. The Role of Matrix Metalloproteinases (MMP-8, MMP-9, MMP-13) in Periodontal and Peri-Implant Pathological Processes. Int J Mol Sci. 2022;23(3):1806-24.
  • Reference18 Mahendra J, Mahendra L, Svedha P, Cherukuri S, Romanos GE. Clinical and microbiological efficacy of 4% Garcinia mangostana L. pericarp gel as local drug delivery in the treatment of chronic periodontitis: A randomized, controlled clinical trial. J Investig Clin Dent. 2017;8(4):1-8.
  • Reference19 Manjunatha VA, Vemanaradhya GG, Gowda TM. Clinical and antioxidant efficacy of 4% mangosteen gel as a local drug delivery in the treatment of chronic periodontitis: A placebo-controlled, split-mouth trial. Dent Med Probl. 2022;59(1):111-9.
  • Reference20 Marcaccini AM, Meschiari CA, Zuardi LR, de Sousa TS, Taba M Jr, Teofilo JM, et al. Gingival crevicular fluid levels of MMP-8, MMP-9, TIMP-2, and MPO decrease after periodontal therapy. J Clin Periodontol. 2010;37(2):180-90.
  • Reference21 Pan T, Wu D, Cai N, Chen R, Shi X, Li B, et al. Alpha-Mangostin protects rat articular chondrocytes against IL-1β-induced inflammation and slows the progression of osteoarthritis in a rat model. Int Immunopharmacol. 2017;52:34-43.
  • Reference22 Peniche-Palma DC, Carrillo-Avila BA, Sauri-Esquivel EA, Acosta-Viana K, Esparza-Villalpando V, Pozos-Guillen A, et al. Levels of Myeloperoxidase and Metalloproteinase-9 in Gingival Crevicular Fluid from Diabetic Subjects with and without Stage 2, Grade B Periodontitis. Biomed Res Int. 2019;2019:5613514-22.
  • Reference23 Phongpaichit S, Ongsakul M, Nilrat L, Tharavichitkul P, Bunchoo S, Chuaprapaisilp T. Antibacterial activities of extracts from Garcinia mangostana pericarps on methicillin-resistant Staphylococcus aureus and Enterococcus species. Songklanakarin J Sci Technol. 1994;16:399-405.
  • Reference24 Pradeep AR, Bajaj P, Agarwal E, Rao NS, Naik SB, Kalra N, et al. Local drug delivery of 0.5% azithromycin in the treatment of chronic periodontitis among smokers. Aust Dent J. 2013;58(1):34-40.
  • Reference25 Preshaw PM, Taylor JJ, Jaedicke KM, De Jager M, Bikker JW, Selten W, et al. Treatment of periodontitis reduces systemic inflammation in type 2 diabetes. J Clin Periodontol. 2020;47(6):737-46.
  • Reference26 Putri K, Darsono L, Mandalas H. Anti-inflammatory properties of mangosteen peel extract on the mice gingival inflammation healing process. Padjajaran J Dent. 2017;29:190-5.
  • Reference27 Qasim SSB, Al-Otaibi D, Al-Jasser R, Gul SS, Zafar MS. An Evidence-Based Update on the Molecular Mechanisms Underlying Periodontal Diseases. Int J Mol Sci. 2020;21(11):3829-50.
  • Reference28 Rai B, Kaur J, Jain R, Anand SC. Levels of gingival crevicular metalloproteinases-8 and -9 in periodontitis. Saudi Dent J. 2010;22(3):129-31.
  • Reference29 Rassameemasmaung S, Sirikulsathean A, Amornchat C, Maungmingsook P, Rojanapanthu P, Gritsanaphan W. Topical application of Garcinia mangostana L. pericarp gel as an adjunct to periodontal treatment. Complement Ther Med. 2008;16(5):262-7.
  • Reference30 Ridwan RD, Kusumaningsih T, Saputra D. Inhibitory Effect of Mucoadhesive Gingival Patch of Mangosteen Peel Extract Against Periodonto Pathogen Bacteria. J Int Dent Med Res. 2020;13(3):843-48.
  • Reference31 Ridwan RD, Yuliati Y, Sidarningsih S, Sholihah FM, Aljunaid M, Lashari DM. A study of the mucoadhesive patches loaded with mangosteen peel extract in periodontitis. J Taibah Univ Med Sci. 2021;16(6):864-9.
  • Reference32 Singh A, Sridhar R, Shrihatti R, Mandloy A. Evaluation of Turmeric Chip Compared with Chlorhexidine Chip as a Local Drug Delivery Agent in the Treatment of Chronic Periodontitis: A Split Mouth Randomized Controlled Clinical Trial. J Altern Complement Med. 2018;24(1):76-84.
  • Reference33 Tangsuksan P, Srichana T, Kettratad M, Nittayananta W. Antimicrobial and Anti-inflammatory Effects of α-Mangostin Soluble Film. J Int Soc Prev Community Dent. 2022;12(2):189-98.
  • Reference34 Wei Y, Deng Y, Ma S, Ran M, Jia Y, Meng J, et al. Local drug delivery systems as therapeutic strategies against periodontitis: A systematic review. J Control Release. 2021;333:269-82.
  • Reference35 Widjaja J, Wahjuningrum DA, Cahyani F. Antibacterial Effect of Xanthone from Mangosteen Pericarp Extract (Garcinia mangostana Linn.) against Porphyromonas gingivalis. J Int Dent Medical Res. 2019;12(1):19-21.
  • Reference36 Widyarman AS, Lay SH, Wendhita IP, Tjakra EE, Murdono FI, Binartha CTO. Indonesian Mangosteen Fruit (Garcinia mangostana L.) Peel Extract Inhibits Streptococcus mutans and Porphyromonas gingivalis in Biofilms In vitro. Contemp Clin Dent. 2019;10(1):123-8.
  • Reference37 Xu XH, Liu QY, Li T, Liu JL, Chen X, Huang L, et al. Garcinone E induces apoptosis and inhibits migration and invasion in ovarian cancer cells. Sci Rep. 2017;7(1):10718-31.
  • Reference38 Yabluchanskiy A, Ma Y, Iyer RP, Hall ME, Lindsey ML. Matrix metalloproteinase-9: Many shades of function in cardiovascular disease. Physiology (Bethesda). 2013;28(6):391-403.
  • Reference39 Yakob M, Meurman JH, Sorsa T, Söder B. Treponema denticola associates with increased levels of MMP-8 and MMP-9 in gingival crevicular fluid. Oral Dis. 2013;19(7):694-701.
There are 38 citations in total.

Details

Primary Language English
Subjects Periodontics
Journal Section Original Articles
Authors

Manjiri Kulkarni 0009-0002-0303-1542

Gayathri Gunjiganur Vemanaradhya This is me 0000-0002-7791-4113

Triveni Mg This is me 0000-0003-3207-0137

Early Pub Date December 25, 2023
Publication Date December 26, 2023
Published in Issue Year 2023

Cite

APA Kulkarni, M., Gunjiganur Vemanaradhya, G., & Mg, T. (2023). Evaluation of 4% Mangosteen (MG) Gel as a Local Drug Delivery in adjunct to Scaling and Root planing on Clinical Parameters and GCF MMP-9 levels in Chronic Periodontitis Patients - A Split Mouth Randomized Controlled Trial. European Journal of Research in Dentistry, 7(3), 130-138. https://doi.org/10.29228/erd.57