Stage III, Grade B periodontitis is a severe form of gum disease that damages the tissues and bone supporting the teeth. It can cause loose teeth, difficulty chewing, and reduced quality of life. Although periodontal (gum) treatment is known to improve gum health, less is known about how it affects chewing ability and how patients feel about their oral health after treatment.

This study looked at how comprehensive periodontal treatment affects gum health, chewing function, and oral health-related quality of life. Twenty patients with Stage III, Grade B periodontitis and twenty individuals with healthy gums participated. Patients with periodontitis received non-surgical treatment (deep cleaning and root surface debridement) followed, when needed, by surgical periodontal therapy.

Researchers measured gum health (including probing depth and bleeding), tooth mobility, chewing performance, and patient-reported quality of life. Chewing performance was tested using a standardized chewing test with silicone material. Quality of life was assessed using a validated questionnaire (OHIP-14), which measures how oral health affects daily life, comfort, and well-being.

Assessments were performed before treatment, after non-surgical therapy, and after surgical treatment.

At the start of the study, patients with periodontitis had worse gum health, poorer chewing ability, and lower oral health-related quality of life compared to healthy individuals. After treatment, gum inflammation and tooth mobility significantly improved. Chewing ability also improved after therapy, especially after surgical treatment. Patients reported better quality of life, with fewer symptoms and less discomfort.

The study also found that better chewing performance was strongly associated with better quality of life. This suggests that improving function is closely linked to how patients feel about their oral health.

Overall, comprehensive periodontal therapy not only improves clinical gum health but also enhances chewing efficiency and patient well-being. These findings highlight the functional and quality-of-life benefits of periodontal rehabilitation in patients with advanced gum disease.

Stage III, Grade B periodontitis is characterized by advanced periodontal attachment loss, deep periodontal pockets, tooth mobility, and radiographic bone loss. In addition to structural damage, this condition may impair masticatory efficiency and negatively affect oral health-related quality of life (OHRQoL). While conventional periodontal therapy effectively reduces inflammation and stabilizes periodontal tissues, its functional and patient-reported outcomes in advanced disease stages require further clarification.

This prospective controlled clinical study was designed to evaluate the impact of comprehensive periodontal therapy on clinical periodontal parameters, objective masticatory performance, and OHRQoL in patients with Stage III, Grade B periodontitis.

Study Population: The study included 20 systemically healthy patients diagnosed with Stage III, Grade B periodontitis and 20 periodontally healthy individuals serving as controls. Participants were recruited from a university dental clinic. Inclusion criteria for the periodontitis group were consistent with current periodontal classification guidelines. Exclusion criteria included systemic diseases affecting periodontal status, recent periodontal treatment, smoking, pregnancy, and use of medications known to influence periodontal tissues.

Study Design and Interventions: At baseline, all participants underwent comprehensive periodontal examination, including; Probing depth (PD), Bleeding on probing (BOP), Clinical attachment level (CAL), Tooth mobility measured using Periotest. Masticatory performance was assessed using a standardized silicone cube chewing test. Participants chewed the test material for a defined number of cycles. The comminuted material was sieved through multiple apertures to calculate objective performance indices. OHRQoL was evaluated using the validated Oral Health Impact Profile (OHIP-14) questionnaire.

Patients in the periodontitis group received: Non-surgical periodontal therapy (scaling and root planing) and surgical periodontal therapy when indicated, following re-evaluation. Clinical and functional assessments were repeated after completion of non-surgical therapy and again following surgical treatment. The healthy control group was evaluated once for baseline comparison.

Outcome Measures:

Primary outcomes included changes in:

Clinical periodontal parameters (PD, BOP, CAL) Tooth mobility (Periotest values) Masticatory performance indices OHIP-14 scores Secondary analyses examined correlations between masticatory performance and OHRQoL.

Statistical Analysis: Data distribution was assessed prior to analysis. Between-group comparisons were performed using ANOVA or Kruskal-Wallis tests, as appropriate. Within-group longitudinal changes were analyzed using repeated measures approaches. Spearman's rank correlation was used to evaluate associations between chewing efficiency and OHRQoL scores. Statistical significance was set at p < 0.05.

Scientific Rationale: This study addresses the multidimensional impact of periodontal rehabilitation beyond traditional clinical parameters. By integrating objective functional measurements and patient-reported outcomes, the research aims to clarify whether improvements in periodontal stability translate into meaningful gains in chewing efficiency and perceived well-being.

Understanding this relationship is important for patient-centered periodontal care and may contribute to more comprehensive treatment planning in advanced periodontitis.

Inclusion Criteria: Eligibility criteria included

• ≥ 20 natural teeth
• at least four functional chewing units (one molar pair = two units; one premolar pair = one unit).
• positive bleeding on probing in ≥ four chewing units
• probing depth ≥ 5 mm in ≥ four molar or premolar teeth
• age between 20 and 45 years.

Exclusion Criteria:

• Individuals with systemic diseases
• pregnancy
• smoking habits
• recent antibiotic or anti-inflammatory use

There is not a plan to make IPD available because of the participants consent.