Clinical Outcomes of Adjunctive Use of Oxygen-Releasing Formula in Non-Surgical Treatment of Periodontal Abscess Associated with Type 2 Diabetes Mellitus

Authors

• Anil Kumar Kanakamedala, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow
• Laxmi Kavya Gangireddy, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow
• Gautami S Penmetsa, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow
• Sruthima Gottumukkala, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow
• Mohan Kumar Pasupuleti, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow
• Konathala Santhosh Venkata Ramesh, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, IndiaFollow

Abstract

Background: This study aimed to evaluate the effectiveness of oxygen-releasing formula (ORF) as an adjunct in the non-surgical management of periodontal abscess in patients with type 2 diabetes mellitus.

Methods: This split-mouth clinical trial was conducted on 14 patients with periodontal abscess with type 2 diabetes mellitus (T2DM), who were divided into a control group, nonsurgical periodontal therapy (NSPT) alone, and a test group (NSPT+ORF). Parameters such as Landry's healing index (HI) were evaluated at 1 week, 2 weeks, and 1 month. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing presence or absence (BOP) were evaluated at baseline and 1 month.

Results: There was statistical significance at one week in the test group in HI and BOP, but at 1 month, there was no statistical significance between the test and control groups. Mean PPD reduction and mean CAL gain were greater in the test group than in the control group at 1 month.

Conclusion: Adjunctive use of ORF with non-surgical periodontal therapy showed promising improvements in early periodontal healing and clinical parameters in patients with T2DM. However, given the limited follow-up duration and the absence of significant intergroup differences for most outcomes, further well-designed studies are required to establish its clinical benefit.

References

1. Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National health and nutrition examination survey 2009–2014. J Am Dent Ass. 2018;149(7):576–88.e6.
2. Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Clin Periodontol. 2018;45(S20):S171–89.
3. Kudiyirickal MG, Pappachan JM. Diabetes mellitus and oral health. Endocrine. 2015;49:27–34.
4. Preshaw PM, Bissett SM. Periodontitis: oral complication of diabetes. Endocrinol Metab Clin North Am. 2013;42(4):849–67.
5. Yousefi Y, Meldrum J, Jan AH. Periodontal Abscess [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
6. Pant VA, Maurya DK, Nigam M. Non-surgical periodontal therapy in severe chronic periodontitis patients associated with type II diabetes mellitus: A case report. IP Int J Periodontol Implantol. 2022;7(1):23–6.
7. Sy K, Flamme J, Maquet H, Chai F, Neut C, Siepmann F, et al. Antimicrobial effect and physical properties of an injectable \"active oxygen\" gel for the treatment of periodontitis. Am J Dent. 2021;33(6):305–9.
8. Basudan AM, Abas I, Shaheen MY, Alghamdi HS. Effectiveness of topical oxygen therapy in gingivitis and periodontitis: clinical case reports and review of the literature. J Clin Med. 2024;13(5):1451.
9. Buranasin P, Kominato H, Mizutani K, Mikami R, Saito N, Takeda K, et al. Influence of reactive oxygen species on wound healing and tissue regeneration in periodontal and peri-implant tissues in diabetic patients. Antioxidants. 2023;12(9):1787.
10. Kollmar T, Schepers M, Nogueira AVB, Deschner J, Müller-Heupt LK. Oxygen-based adjunct therapies in periodontitis: a systematic review and meta-analysis within the framework of hypoxia and inflammation. Biomedicines. 2026;14(1):9.
11. Szulc M, Zakrzewska A, Zborowski J. Miejscowe dokieszonkowe podawanie leków w zapaleniu przyzębia–przegląd współczesnego piśmiennictwa [Local drug delivery in periodontitis treatment: A review of contemporary literature]. Dent Med Probl. 2018;55(3):333–42.
12. Agarwal R, Kamble PS, Mangalekar SB, Nayak Y, Sawant P, Chatterjee A. A comparative evaluation of efficacy of oxygen releasing formula gel, chlorhexidine gel and scaling and root planing alone in the management of chronic periodontitis–A clinico-microbiological study. Eur Chem Bull. 2023;12(Si6):4520–36.
13. Sharma A, Kochar D, Sachdeva S, Krishna S, Lhamu K, John M, et al. Active oxygen gel and diode laser application as an adjunct to scaling and root planing in periodontitis patients–a clinical comparative split-mouth study. J Pharm Bioallied Sci. 2025;17(Suppl 3):S2590–2.
14. Tan OL, Safii SH, Razali M. Commercial local pharmacotherapeutics and adjunctive agents for nonsurgical treatment of periodontitis: a contemporary review of clinical efficacies and challenges. Antibiotics. 2020;9(1):11.
15. Kareem A, Ghafory B, Al-Mizraqchi AS. Efficacy of intra periodontal pocket application with combined chlorhexidine and hydrogen peroxide on the bleeding on probing and anaerobic bacterial viable count. J Res Med Dent Sci. 2020;8(1):125–31.
16. Alayadi H, Talakey A, Aldulaijan H, Shaheen MY. The impact of a topical oxygen-releasing gel (Blue®m) on deep periodontal pockets: a case report. Medicina. 2024;60(9):1527.
17. Müller-Heupt LK, Eckelt A, Eckelt J, Groß J, Opatz T, Kommerein N. An in vitro study of local oxygen therapy as adjunctive antimicrobial therapeutic option for patients with periodontitis. Antibiotics. 2023;12(6):990.
18. Garcia VG, Miessi DMJ, da Rocha TE, Gomes NA, Rodrigues JVS, Ervolino E, et al. Shedding light on the therapeutic efficiency of oxygen-releasing gel and photodynamic therapy as adjuvants in the treatment of experimental periodontitis. Photobiomodul Photomed Laser Surg. 2025;43(4).
19. Garg J, Tiwari S, Sinha S, et al. Comparative assessment of efficacy of "BLUEM" active oxygen gel and COE-PAK dressing on postoperative healing after surgical depigmentation: a split-mouth study. J Pharm Bioallied Sci. 2025;17:S3307–9.
20. Koul A, Kabra R, Chopra R, Sharma N, Sekhar V. Comparative evaluation of oxygen-releasing formula (Blue-M Gel®) and chlorhexidine gel as an adjunct with scaling and root planing in the management of patients with chronic periodontitis. A clinico-microbiological study. J Dent Spec. 2019;7(2):111–7.
21. Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions—Introduction and key changes from the 1999 classification. J Periodontol. 2018;89(S1):S1–8.
22. Păunică I, Giurgiu M, Dumitriu AS, Păunică S, Pantea Stoian AM, Martu M-A, et al. The bidirectional relationship between periodontal disease and diabetes mellitus—a review. Diagnostics. 2023;13(4):681.
23. Pradeep AR, Garg V, Raju A, Singh P. Adjunctive local delivery of Aloe vera gel in patients with type 2 diabetes and chronic periodontitis: a randomized, controlled clinical trial. J Periodontol. 2016;87(3):268–74.
24. Juliana H, Tarek S. Comparative study of the effect of BlueM active oxygen gel and Coe-Pack dressing on postoperative surgical depigmentation healing. Saudi Dent J. 2022;34(4):328–34.
25. Rocha M, Nava LE, de la Torre CV, Sánchez‐Marín F, Garay‐Sevilla ME, Malacara JM. Clinical and radiological improvement of periodontal disease in patients with type 2 diabetes mellitus treated with alendronate: A randomized, placebo‐controlled trial. J Periodontol. 2001;72(2): 204–9.
26. Eguchi T, Koshy G, Umeda M, Iwanami T, Suga J, Nomura Y, et al. Microbial changes in patients with acute periodontal abscess after treatment detected by PadoTest. Oral Dis. 2008;14(2):180–4.
27. Stabholz A, Nicholas AA, Zimmerman GJ, Wikesjö UM. Clinical and antimicrobial effects of a single episode of subgingival irrigation with tetracycline HCl or chlorhexidine in deep periodontal pockets. J Clin Periodontol. 2005;25(10):794–800.
28. Jung D, Cha J-K, Kim Y-T, Kim C-S. Comparing the clinical effects of local administration of minocycline ointment and doxycycline solution in the treatment of acute periodontal abscess: a retrospective clinical study. J Periodontal Implant Sci. 2023;53(3):149–60.
29. Paquette D, Oringer R, Lessem J, Offenbacher S, Genco R, Persson GR, et al. Locally delivered minocycline microspheres for the treatment of periodontitis in smokers. J Clin Periodontol. 2003;30(9):787–94.
30. Goodson JM, Gunsolley JC, Grossi SG, Bland PS, Otomo‐Corgel J, Doherty F, et al. Minocycline HCl microspheres reduce red‐complex bacteria in periodontal disease therapy. J Periodontol. 2007;78(8):1568–79.
31. Drisko CL, Cobb CM, Killoy WJ, Michalowicz BS, Pihlstrom BL, Lowenguth RA, et al. Evaluation of periodontal treatments using controlled-release tetracycline fibers: clinical response. J Periodontol. 1995;66(8):692–9.
32. Han S-J, Jeong S-Y, Nam Y-J, Yang K-H, Lim H-S, Chung J. Xylitol inhibits inflammatory cytokine expression induced by lipopolysaccharide from Porphyromonas gingivalis. Clin Diagn Lab Immunol. 2005;12(11):1285–91.

Recommended Citation

Kanakamedala, A., Gangireddy, L., Penmetsa, G., Gottumukkala, S., Pasupuleti, M., & Ramesh, K. S. Clinical Outcomes of Adjunctive Use of Oxygen-Releasing Formula in Non-Surgical Treatment of Periodontal Abscess Associated with Type 2 Diabetes Mellitus. J Dent Indones. 2026;33(2): 87-93