Treatment of periodontal pocket with hydrogen peroxide and hyaluronic acid: Evaluation of oral microbiota

Background: Evaluation of the oral microbiota after treatment with hydrogen peroxide and hyaluronic acid, of periodontal pockets in order to alleviate the pain symptoms, reduce the pathogenic bacterial load, the probing depth and reduce bleeding in the survey. Methods: 25 adult patients of both sexes are randomly selected. The patients under examination are treated with two product applications at a distance of 5 minutes from each other, I mL of hydrogen peroxide undiluted and 1 mL of hyaluronic acid undiluted at application, performed by sterile syringe directly inside the periodontal pockets greater than 3.5 mm of multirooted and monoradicular elements. During the first visit (TO) and / or after a week from the latter (T1), the quantitative bleeding (FMBS) and semi-qualitative (IS) indices will be performed, considering six surfaces per tooth, the latter using four different codes: Code 0: absence of bleeding on probing; Code 1: presence of bleeding on probing, without redness and edema; Code 2: bleeding on probing with redness and edema; Code 3: spontaneous bleeding. Furthermore, the quantitative (FMPS) and semi-qualitative plaque indices of Silness J & Loe H (IP) will be calculated considering six surfaces per tooth; the latter attributing four different codes: Cod 0: absence of plaque; Cod.1: 1/3 of the dental surface covered with plaque; Cod.2: 2/3 of the dental surface covered with plaque; Cod.3: greater than 2/3 of the dental surface covered with plaque. Moreover, before washing the pocket (T0) and after 5 minutes from the last application of the solution (T1) a bacterial plaque pick-up will be performed, positioning a peri paper for 30 seconds inside one of the periodontal pockets with greater probing depth, processed in PCR-Real-Time. Painful symptomatology is evaluated by administering two different tests: Numerical Reating Scale - NRS (Downie, 1979; Grossi, 1983); Visual Analogical Scale - Vas (Scott Huskisson, 1976); Verbal Rating Scale - VRS (Keck, 1948; successive validations JPSM, 2002). Results: The formulation thus constituted seems to possess antibacterial and hemostatic action and alleviate painful symptoms. Conclusions: After treatment of periodontal pockets, it is therefore advisable to wash with hydrogen peroxide, hyaluronic acid and glycine to relieve painful symptoms, reduce the pathogenic bacterial load and bleeding on probing.