# Adjunctive Use of PerioCream Following Scaling and Root Planing: Preliminary Findings From an Observational Clinical Study

## TL;DR

This study explores using PerioCream after a standard dental procedure to improve healing and reduce discomfort, showing early positive results.

## Contribution

The study introduces the use of PerioCream with AI-based image analysis to assess periodontal healing in a real-world setting.

## Key findings

- Bleeding on Probing and Gingival Index significantly decreased after using PerioCream.
- AI analysis showed reduced inflammation in 13 out of 15 patients.
- Patients reported less discomfort, though the result was not statistically significant.

## Abstract

Background

Scaling and root planing (SRP) remains the standard of care for non-surgical periodontal therapy, but its long-term effectiveness is often limited by microbial recolonization and persistent inflammation. These challenges have led to growing interest in adjunctive topical agents that can enhance healing, reduce discomfort, and improve patient adherence. PerioCream, a mucoadhesive formulation based on NitrAdine®, has shown broad-spectrum antimicrobial activity, anti-inflammatory effects, and modulation of the oral microbiota in both laboratory and early clinical studies.

Objective

This study aimed to evaluate the adjunctive use of PerioCream after SRP in a real-world clinical setting, focusing on clinical outcomes, patient-reported experiences, and artificial intelligence (AI)-based assessment of tissue healing.

Methods

Fifteen adult patients (8 females, 7 males; aged 35-64 years) with moderate-to-severe periodontitis (Stage II/III, Grade B/C) underwent SRP followed by adjunctive topical application of PerioCream. Clinical parameters, including Bleeding on Probing (BOP) and Gingival Index (GI), were assessed at baseline (T0) and after 72 hours (T3). Patient-reported outcomes were recorded using a Visual Analog Scale (VAS) for discomfort and a Health-Related Quality of Life (HRQOL) questionnaire. Standardized intraoral images were analyzed using a convolutional neural network (CNN)-based AI model to evaluate visible signs of inflammation.

Results

All 15 patients completed follow-up without adverse effects. Clinical indices improved significantly: BOP decreased from 72% (70.5-74.0) to 12% (11.0-13.5) and GI from 1.6 (1.55-1.7) to 0.5 (0.4-0.5) (Wilcoxon W = 0, Z = −3.41, p < 0.001 for both). The VAS pain showed a numerical reduction from 3.53 to 2.27 (Wilcoxon W = 21.0, Z = 1.42, p = 0.157). AI-assisted image analysis indicated decreased inflammation in 13/15 patients, consistent with clinical findings.

Conclusion

The adjunctive use of PerioCream after SRP may be associated with early improvements in clinical outcomes and patient comfort; however, these findings are preliminary and require confirmation in larger controlled trials. The combination of traditional measures with AI-assisted image analysis offers a multidimensional perspective on healing and may support more personalized periodontal care. These findings provide a rationale for larger, controlled trials.