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This may be due to other confounding variables apart from genetics that influence the development of this condition.[27,28] Chronic periodontitis induced by bacterial plaque is associated with a variable microbial pattern, but it is initiated by Gram-negative tooth-associated bio-film that elicits host response resulting in the destruction of the periodontal tissues.[29] These anaerobic bacteria microbial films include porphyromonas gingivalis, bacteroides forsythus, treponema denticola, prevotella intermedia, fusobacterium nucleatum, and eubacterium specie.[30] In response to endotoxins derived from these periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and other supporting connective tissue structures selleck inhibitor like periodontal ligament.[29,31] The major drivers of this aggressive periodontal tissue destruction are matrix metalloproteinases, cathepsins, and other osteoclast-derived enzymes.[1,3,31] The extent of the disease progression is influenced adversely by the presence of risk factors and the duration of disease before patient presents for treatment. These factors directly determine the degree of teeth mobility and depth of the periodontal pockets formed. As reported earlier, the scaling and root planing carried out in the two groups of patients as treatment modality to remove supragingival plaque/calculus and subgingival debridement including oral Selleckchem Decitabine hygiene instructions and use of warm saline mouth wash after treatment enhanced healing and bacterial plaque control by reducing clinical inflammation, periodontal pocket depth, microbial shift to a less pathogenic subgingival flora, gain in the clinical attachment level of the periodontal tissues and less disease progression.[1,6,7,8] However, the periodontal pocketing/bleeding persisted in 33.3% of Group A patients and none was recorded in the experimental group. BOP is a very important clinical measurement to assess clinical response since its absence can be used as a criterion for periodontal tissue stability.[32] Furthermore, Tryptophan synthase from the existing literature, the use of antibiotics in the management of chronic periodontitis is controversial. However, adjunctive systemic antibiotics uses have been shown to offer some advantages to the treatment outcome in severe and refractory periodontitis.[1,13] Consequently, these groups of patients benefitted from the two treatment approaches used in this study. However, the beneficial effect was more in the experimental (95.1%) than the control (39.5%) group (P