Dental Loupe Versus Dental Operating Microscope for Non-Surgical Periodontal Treatment

To determine the amount of microorganisms, plaque samples taken from each patient will be stored in Eppendorf tubes at -80°C with sterile distilled water until microbial analysis is performed.

Plaque samples stored at -80°C in Eppendorf tubes will be transported to the laboratories where microbiological examination will be performed using personal vehicles in dry ice thermal storage bags.

DNA isolation from all suture samples will be performed using the High Pure PCR Template according to the manufacturer's instructions. The DNA will be stored at 80°C until the process is complete. The 16S rRNA gene will be detected by qPCR and the total bacterial count will be determined. Real-time PCR procedures will be performed on a LightCycler 480 II system using the Fast Start Essential DNA Green Master Mix Kit according to the manufacturer's instructions.

Probing pocket depth, or probing depth, is a numerical value obtained by measuring the distance between the gingival margin and the gingival sulcus/pocket floor using a standard periodontal probe with a tip approximately 0.4-0.5 mm in diameter, and rounding the measurement to the nearest millimeter.

This index was developed by Löe and Silness in 1963 and modified by various researchers in 1967. The system evaluates bleeding, the most fundamental sign of inflammation. The mesial, distal, vestibular, and lingual gingiva of the teeth are assessed. These values are then summed and divided by four to calculate the gingival index. Dividing the sum of these values by the number of teeth yields the individual score.

0 Healthy gingiva, no inflammation.

• Mild inflammation, discoloration, and slight swelling in the gingiva; no bleeding on probing.
• Moderate inflammation, redness, and swelling in the gingiva; bleeding on probing.
• Severe inflammation, redness, and swelling in the gingiva; spontaneous bleeding occurs.

Probing is used to evaluate bleeding in the gingival papillae. Probing is performed on all four half-jaws. However, to ensure the evaluation reflects inflammation of all papillae and to facilitate the procedure, evaluation is performed on the papillae on the oral surfaces of the upper right and lower left jaws, and on the facial surfaces of the teeth in the upper left and lower right jaws. The values obtained are then divided by the total number of papillae to find the average papillary bleeding index value. This index is quite important for patient motivation. Patients who see bleeding in their gums can easily identify the diseased area in their mouth and develop positive behaviors in applying the oral care procedures they have been taught.

Papillary Bleeding Index Values 0 No bleeding.

• Slight bleeding 20 seconds after probing.
• Linear bleeding in the papillary area after probing.
• Bleeding filling the interdental space after probing.
• Excessive bleeding overflowing from

The amount of plaque on facial and lingual surfaces is investigated using a plaque-staining agent. The total score is divided by the number of surfaces examined, and an index score is determined for the individual.

The plaque-staining agent (Tri Plaque ID Gel™, GC Dental, USA) is applied to all tooth surfaces using a fine-tipped brush.

Areas stained pink, purple, or blue on the tooth surfaces are scored from 0 to 5 (Score 0: no plaque, 1: independent plaque islands at the gingival margins, 2: thin bands of plaque at the gingival margins, 3: plaque covering no more than 1/3 of the tooth surface, 4: plaque covering no more than 2/3 of the tooth surface, 5: plaque covering more than 2/3 of the tooth surface). The entire mouth is divided into 6 different areas, and the average TQHPI values of the participants are calculated by taking the mathematical ratio of the values obtained from the mesial, distal, lingual, and vestibular surfaces of the specific teeth in each sextant.

This index assesses bleeding by gently probing within the gingival pocket. The presence or absence of bleeding in the gingiva is evaluated based on the probing results. A positive result is given if bleeding occurs within 10-15 seconds after probing the mesial, distal, vestibular, and lingual gingival areas of all teeth. The ratio of the bleeding area to the examined area is expressed as a percentage.

This value is obtained by measuring the distance between the pocket base and the enamel-cementum junction using a standard periodontal probe with a diameter of 0.4-0.5 mm and rounding the measurement to the nearest millimeter value.