{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:47:56Z","timestamp":1790912876862,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T00:00:00Z","timestamp":1581638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Effectiveness of scaling and root planing (SRP) with\/without adjunct probiotic (<jats:italic>Lactobacillus reuteri<\/jats:italic>) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in <jats:italic>shamma<\/jats:italic> users and non\u2010users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among <jats:italic>shamma<\/jats:italic> users and controls (individuals not using tobacco in any form).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted in accordance with the Consolidated Standards of Reporting Trials\u00a0guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma\u2010chewers that underwent SRP + PT; 3) group 3: Non\u2010chewers that underwent SRP alone; and 4) group 4: Non\u2010chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3\u2010 and 6\u2010month follow\u2010ups. Level of significance was set at <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among <jats:italic>shamma<\/jats:italic> users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with\/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05), BOP (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05) and PD (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05) at 3\u2010month follow\u2010up. There was no significant difference in periodontal parameters at 3\u2010 and 6\u2010month follow\u2010ups in patients that underwent SRP with and without adjunct PT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Habitual <jats:italic>shamma<\/jats:italic> use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.19-0464","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:39:08Z","timestamp":1580085548000},"page":"1177-1185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among <i>shamma<\/i> users and non\u2010users: A randomized controlled trial"],"prefix":"10.1002","volume":"91","author":[{"given":"Fahim","family":"Vohra","sequence":"first","affiliation":[{"name":"Department of Prosthetic Dental Science College of Dentistry King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishfaq 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