## 4 Discussion  
This preliminary study aimed to evaluate the clinical effects of treatment with SRP and Alflutop(r), compared with the clinical effects of SRP alone. All the participants from group I tolerated the Alflutop(r) therapy well, and no side effects were noticed as other studies mentioned before [21, 22]. The clinical effects of the Alflutop(r) solution used in  
Figure 4: Evolution of tooth mobility in both groups after therapy. Figure 3: Evolution of Papilla Bleeding Index in cases compared to controls. the test study group in conjunction with SRP resulted in a reduction in GI and PBI scores. Additional therapy with Alflutop(r) can also contribute to a reduction in inflammation not only in gingival tissues but also at the level of the periodontal ligament fibers, suggested by the decrease in pathologic tooth mobility, supporting the hypothesis of anti-inflammatory action in both gingival tissues and periodontal ligament fibers. This reduction in pathologic tooth mobility after Alflutop(r) therapy was noticed more often in sites with severe inflammation than in sites with advanced bone loss. Periodonal disease could have some characteristics similar to osteoarticular diseases, being characterized by the loss of tooth-supporting tissues (alveolar bone and periodontal ligaments) induced by an immune response activated by periodontal pathogens. This is the reason why we used Alflutop(r) infiltrations as an adjuvant for periodontal treatment. The elimination of pathogen microbiota from periodontal pockets is crucial, but the need for arresting bone loss mechanisms led to the use of different healing methods and the use of different compounds, such as marine-derived biomaterials, to provide healing [23; 24; 25]. The stimulation of the chondrocyte proliferation could be considered a therapeutic solution for periodontal disease as it was revealed in osteoarticular diseases [22]. Periodontal tissues are supporting structures of both alveolar bone and periodontal ligaments, which can be considered a relatively inflexible joint. This was the main aspect that led us to choose marine fish extract (Alflutop(r)) for periodontal anti-inflammatory and regeneration therapy. Periodontal disease involves both alveolar bone and periodontal ligament resorption, as well as endodontic periapical lesions. Histological investigations have shown the osteo-regenerative abilities of Alflutop(r) can possess a significant clinical efficiency for temporary placement into root canals in the treatment of periapical bone defects and for stimulating the regeneration of the damaged periapical tissues [18; 26]. For periodontal therapy, the active substance should be administrated via infiltration, in the mobile mucosa, in front of the periodonotally compromised teeth. If the periodontal destruction is generalized, the product will be injected into the mobile mucosa in front of canine-premolar teeth [1]. Therapeutic efficacy at the periodontal level could be improved by delivering drugs directly to the oral mobile mucosa [27] or by using other marine-derived drug-delivery biomaterials, such as chitosan [28]. Several studies [18; 29; 30] have shown that, in the case of periapical endodontic lesions, Alflutop(r) solution, applied intracanally, had regenerative properties observed one month after treatment. Because both periodontal disease and rheumatoid arthritis have similar pathways [25; 29], natural compounds with anti-inflammatory effects and regenerative properties are needed in order to arrest inflammation and to stimulate an organism to regenerate lost tissues. If the regenerative effects proven by studies [21; 24] can be expanded on periodontal lesions, we expect Alflutop(r) therapy to have a long-term stimulation effect on the alveolar bone's regeneration, but this will be a subject of future research. It has been shown that biomaterials for the periodontal ligament and bone regeneration provide good results in terms of maintaining bone volume, also offering a high percentage of vitality, safety, and lack of complications [24; 26; 31].