Showing papers in "Journal of Indian Society of Periodontology in 2011"
TL;DR: Photodynamic therapy (PDT) involves the use of low power lasers with appropriate wavelength to kill micro organisms treated with a photosensitizer drug and could be a useful adjunct to mechanical as well as antibiotics in eliminating periopathogenic bacteria.
Abstract: Inflammatory periodontal disease caused by dental plaque is characterized by the clinical signs of inflammation and loss of periodontal tissue support The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy But the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access The possibility of development of resistance to antibiotics by the target organism has led to the development of a new antimicrobial concept with fewer complications Photodynamic therapy (PDT) involves the use of low power lasers with appropriate wavelength to kill micro organisms treated with a photosensitizer drug PDT could be a useful adjunct to mechanical as well as antibiotics in eliminating periopathogenic bacteria
186 citations
TL;DR: This essay provides a detailed insight into properties, mechanisms of etiopathogenesis, detection and removal of microbial biofilms in relation to caries and periodontal disease.
Abstract: Microbial biofilms are mainly implicated in etiopathogenesis of caries and periodontal disease Owing to its properties, these pose great challenges Continuous and regular disruption of these biofilms is imperative for prevention and management of oral diseases This essay provides a detailed insight into properties, mechanisms of etiopathogenesis, detection and removal of these microbial biofilms
138 citations
TL;DR: It is concluded that subgingival administration of Aloe vera gel results in improvement of periodontal condition and can be used as a local drug delivery system inperiodontal pockets.
Abstract: Background: Recent interest and advances in the field of alternative medicine has promoted the use of various herbal and natural products for multiple uses in the field of medicine. Aloe vera is one such product exhibiting multiple benefits and has gained considerable importance in clinical research. This clinical study focuses on Aloe vera and highlights its property when used as a medicament in the periodontal pocket. Materials and Methods: A total number of 15 subjects were evaluated for clinical parameters like plaque index, gingival index, probing pocket depth at baseline, followed by scaling and root planing (SRP). Test site comprised of SRP followed by intra-pocket placement of Aloe vera gel, which was compared with the control site in which only SRP was done, and clinical parameters were compared between the two sites at one month and three months from baseline. Results: Results exhibited encouraging findings in clinical parameters of the role of Aloe vera gel as a drug for local delivery. Conclusion: we conclude that subgingival administration of Aloe vera gel results in improvement of periodontal condition. Aloe vera gel can be used as a local drug delivery system in periodontal pockets.
92 citations
TL;DR: Herbal mouthrinse was found to be a potent plaque inhibitor, though less effective than Chlorhexidine Gluconate, however, it can serve as a good alternative for the patients with special needs as in case of diabetics, xerostomics, and so on.
Abstract: Background: The key to good oral health is hidden in nature. Natural herbs like neem, tulsi, pudina, clove oil, ajwain, triphala and many more has been used since ages either as a whole single herb or as a combination against various oral health problems like bleeding gums, halitosis, mouth ulcers and preventing tooth decay. The aim of the study was to compare the efficacy of a commercially available herbal mouthrinse (Herboral) with that of chlorhexidine gluconate which is considered to be a gold standard as an anti-plaque agent. Materials and Methods: A randomized, two-group, parallel study as a 'de novo' plaque accumulation model was carried out on 50 subjects (23 males and 27 females). At baseline, all participants received a professional prophylaxis and were randomly assigned to the test (Herbal mouthrinse) and control (Chlorhexidine Gluconate) group. On the following three days, all subjects rinsed with 10 ml of the allocated mouthrinse twice daily for 1 min. They were asked to refrain from use of any other oral hygiene measures during the study. At the end of the experimental period, plaque was assessed and a questionnaire was filled by all subjects. Results: Chlorhexidine (mean plaque score=1.65) inhibited plaque growth significantly more than the herbal mouthrinse (mean plaque score=1.43, P<0.001). The results of the questionnaire showed that Herboral was preferred by patients for its taste, its convenience of use and taste duration (aftertaste). However, Chlorhexidine was considered to be more effective in reducing plaque as compared to Herboral. Conclusion: Herbal mouthrinse was found to be a potent plaque inhibitor, though less effective than Chlorhexidine Gluconate. However, it can serve as a good alternative for the patients with special needs as in case of diabetics, xerostomics, and so on.
87 citations
TL;DR: There is a very urgent need for standardized population-based studies with a robust design to identify the true prevalence of periodontitis, which in turn will help in planning oral health policies and creating the necessary infrastructure.
Abstract: Background: Periodontitis is one of the major reasons for tooth loss in adults India, with a population of over 1 billion, is bound to become a developed nation soon This transition will require a population that is healthy, including in terms of periodontal health Early studies done in India gave an indication that the population is highly susceptible to periodontitis Aim: This paper reviews the prevalence of periodontitis in the Indian population Settings and Design: Review of periodontitis prevalence studies on the Indian population Materials and Methods: After identifying articles from PubMed and hand searching, the epidemiology of periodontitis is reviewed together with the case definition, study settings, type of population, age and other factors as all these are bound to affect the prevalence rates determined in various studies Statistical Analysis: None Results: This review identifies very limited number of studies that provide prevalence data and faces difficulty in comparing various studies due to nonstandardization of case definition and use of nonrepresentative samples There is a high prevalence of periodontitis among the adults and the economically weak population Conclusions: There is a very urgent need for standardized population-based studies with a robust design to identify the true prevalence of periodontitis, which in turn will help in planning oral health policies and creating the necessary infrastructure
87 citations
TL;DR: A. indica-based mouth rinse is equally efficacious with fewer side effects as compared to chlorhexidine and may be used as an adjunct therapy in treating plaque induced gingivitis.
Abstract: Background: Azadirachta indica (neem), a Meliaceae family tree, has been used in India for several decades for the treatment of several diseases in medicine and dentistry. Neem has been considered to have antiseptic activity, but still its use for the treatment of gingivitis and periodontitis is not very clear. Hence, the purpose of the present study was to assess the efficacy of neem based mouth rinse regarding its antigingivitis effect. Materials and Methods: Forty five subjects with plaque induced gingivitis were selected for the study. They were equally divided into three groups. Group I patients were asked to rinse with 15 ml of neem mouthwash twice daily, group II with 15 ml of chlorhexidine mouthwash twice daily, and group III with 15 ml of saline twice daily. The three groups were asked to perform the routine oral hygiene procedures thought out the study period. Bleeding on probing and gingivitis were evaluated by Muhlemann and Son's Sulcus bleeding index (1971) and Loe and Sillness gingival index (1963), respectively, at base line, after every week till one month. Results: Our result showed that an A. indica mouthrinse is equally effective in reducing periodontal indices as Chlorhexidine. The results demonstrated a significant reduction of gingival, bleeding, and plaque indices in both groups over a period of 21 days as compared to placebo. Conclusion: A. indica-based mouth rinse is equally efficacious with fewer side effects as compared to chlorhexidine and may be used as an adjunct therapy in treating plaque induced gingivitis.
71 citations
TL;DR: Propolis might be used as a natural mouthwash, an alternative to chemical mouthwashes, e.g., chlorhexidine, which is found to be better than propolis and saline in inhibiting plaque formation.
Abstract: Background: This study was carried out to investigate the effectiveness of a propolis-containing mouthrinse in inhibition of plaque formation and improvement of gingival health. Materials and Methods: Thirty subjects were selected and randomly assigned into three groups of ten subjects each, which received a propolis-containing mouthrinse, or a negative control (Saline) or a positive control (Chlorhexidine 0.2%). Plaque index and gingival index were assessed at baseline and at a five-day interval. Results: Chlorhexidine mouthwash was found to be better than propolis and saline in inhibiting plaque formation. Propolis was found to be only marginally better than chlorhexidine in improving gingival scores. Conclusion : The present study suggests that propolis might be used as a natural mouthwash, an alternative to chemical mouthwashes, e.g., chlorhexidine. Further, long term trials are required for more accurate data and any conclusive evidence.
63 citations
TL;DR: The experimental local drug-delivery system containing 2% whole turmeric gel can be effectively used as an adjunct to scaling and root planing and is more effective than scaling andRoot planing alone in the treatment of periodontal pockets.
Abstract: Aim: To compare the effect of experimental local-drug delivery system containing 2% whole turmeric (gel form) as an adjunct to scaling and root planing (SRP) with the effect achieved using SRP alone by assessing their respective effects on plaque, gingival inflammation, bleeding on probing pocket depth, relative attachment levels and trypsin-like enzyme activity of red complex microorganisms, namely, Bacteroides forsythus, Porphvromonas gingivalis and Treponema denticola. Material and Methods: Thirty subjects with chronic localized or generalized periodontitis with pocket depth of 5 to 7 mm were selected in a split-mouth study design. Control sites received SRP alone, while experimental sites received SRP plus experimental material (2% whole turmeric gel). Plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), probing pocket depth (PPD), relative attachment loss (RAL), microbiological study of collected plaque sample for trypsin-like activity of red complex by BAPNA assay were the parameters recorded on day 0, 30 days and 45 days. Results: Both groups demonstrated statistically significant reduction in PI, GI, SBI, PPD; and gain in RAL. Significant reduction in the trypsin-like enzyme activity of red complex (BAPNA values) was observed for both the groups when compared to the baseline activity. Greater reduction was seen in all the parameters in the experimental group in comparison to the control group. Conclusion: The experimental local drug-delivery system containing 2% whole turmeric gel can be effectively used as an adjunct to scaling and root planing and is more effective than scaling and root planing alone in the treatment of periodontal pockets.
59 citations
TL;DR: It was found that cigarette smoking was associated with lesser gingival bleeding and deeper pockets as compared to non-smokers, and positive association was observed between periodontal disease and cigarette smoking.
Abstract: Context: Survey. Aims: The objective of the study was to evaluate the periodontal health status among cigarette smokers and non cigarette smokers, and oral hygiene measures. Settings and Design: Cross sectional study. Materials and Methods: The study included 400 male (200 cigarette smokers and 200 non smokers) aged 18-65 years. The subjects were randomly selected from the patients attending dental out-patient department of civil hospital and Himachal Dental College, Sundernagar. Community Periodontal Index (CPI) score was recorded for each patient and a questionnaire was completed by each patient. Statistical Analysis Used: Chi square and t-test. Results: Periodontal condition as assessed by CPI score showed that there was statistically significant difference in the findings between cigarette smokers and non-smokers. Conclusions: Within the limits of this study, positive association was observed between periodontal disease and cigarette smoking. It was found that cigarette smoking was associated with lesser gingival bleeding and deeper pockets as compared to non-smokers.
57 citations
TL;DR: Green tea catechin local delivery along with scaling and root planing is more effective than scaling andRoot planing alone in the management of chronic periodontitis.
Abstract: Background: Evaluate the adjunctive use of locally delivered green tea catechin with scaling and root planing, as compared to scaling and root planing alone in the management of chronic periodontitis. Materials and Methods: Fourteen patients with two sites in the contralateral quadrants with probing pocket depth of 5−8mm were selected. Each of the sites was assessed for the plaque index, gingival index, and probing pocket depth at baseline and 21 days and for microbiological analysis at baseline, 1 week and 21 days. Test sites received scaling and root planing along with green tea catechin strips and control sites received scaling and root planning alone. Results: The result showed intercomparison of the plaque index and gingival index for test and control groups at 21 days was not significant with P>0.05, whereas the probing depth at 21 days was significant with P<0.001. Intercomparison between microbial results demonstrated a considerable reduction of occurrence of Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Fusobacterium species and Capnocytophaga in test. Conclusion: Green tea catechin local delivery along with scaling and root planing is more effective than scaling and root planing alone.
53 citations
TL;DR: This case series presents a split mouth de-epithelization procedure using popular surgical techniques such as scalpel, bur abrasion or electrosurgery to treat gingival hyperpigmentation and reiterates that the scalpel technique still serves as a gold standard for depigmentation.
Abstract: Gingival melanin pigmentation occurs in all races of mankind. Although clinical melanin pigmentation does neither present itself as a medical problem nor a disease entity, it is a major esthetic concern for many people, especially Asians. Esthetic gingival depigmentation procedures can be performed in such patients with excellent results. This case series presents a split mouth de-epithelization procedure using popular surgical techniques such as scalpel, bur abrasion or electrosurgery. These techniques were successfully used to treat gingival hyperpigmentation. Although we found that electrosurgery increased the efficacy of our work, giving a cleaner and neater work field, it required a lot of precision. In contrast, scalpel de-epithelization was easy and technique-friendly, giving excellent results and patient satisfaction. However, the cases are being followed-up to study the factors affecting the rate and length of time required for repigmentation and to study the repigmentation patterns. This case series also reviews the advantages and disadvantages of various techniques available for depigmentation, and reiterates that the scalpel technique still serves as a gold standard for depigmentation.
TL;DR: Cone-beam computed tomography provides 3D images that facilitate the transition of dental imaging from initial diagnosis to image guidance throughout the treatment phase and offers increased precision, lower doses, and lower costs when compared with medical fan-beam CT.
Abstract: In the field of periodontology and implantology, assessment of the condition of teeth and surrounding alveolar bone depends largely on two-dimensional imaging modalities such as conventional and digital radiography. Though these modalities are very useful and have less radiation exposure, they still cannot determine a three-dimensional (3D) architecture of osseous defects. Hence, an imaging modality which would give an undistorted 3D vision of a tooth and surrounding structures is essential to improve the diagnostic potential. Cone-beam computed tomography (CBCT) provides 3D images that facilitate the transition of dental imaging from initial diagnosis to image guidance throughout the treatment phase. This technology offers increased precision, lower doses, and lower costs when compared with medical fan-beam CT. This review discusses all the finer details of CBCT which not only reveals 3D architecture of the periodontium but also helps to reconstruct it.
TL;DR: This review highlights the various potentials of saliva as a diagnostic biomarker for periodontal diseases and suggests that saliva, as a mirror of oral and systemic health, is a valuable source for clinically relevant information.
Abstract: Early detection of disease plays a crucial role in successful therapy. Early diagnosis and management reduces the severity and possible complications of the disease process. To overcome this challenge, medical researchers are devoted to finding molecular disease biomarkers that reveal a hidden lethal threat before the disease becomes complicated. Saliva, an important physiologic fluid, containing a highly complex mixture of substances, is rapidly gaining popularity as a diagnostic tool. Periodontal disease is a chronic disease of the oral cavity comprising a group of inflammatory conditions affecting the supporting structures of the dentition. In the field of periodontology, traditional clinical criteria are often insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Saliva, as a mirror of oral and systemic health, is a valuable source for clinically relevant information because it contains biomarkers specific for the unique physiologic aspects of periodontal diseases. This review highlights the various potentials of saliva as a diagnostic biomarker for periodontal diseases.
TL;DR: The findings of the present study show that there is an association between periodontal disease and COPD and it is suggested that periodontitis is one of the risk factors for COPD.
Abstract: Context: Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases. An association between periodontal disease and chronic obstructive pulmonary disease (COPD) has been observed . Aims: The aim of the present study was to evaluate the potential association between periodontal health and COPD and to assess the potential health status of patients with and without COPD. Settings and Design: In this observational study, the association between periodontal disease and COPD has been assessed. Materials and Methods: Hundred patients were chosen for the study: group A comprising 50 COPD patients and group B consisting of 50 patients without COPD. Gingival Index (GI) and Papilla Bleeding Index (PBI) were used to assess the gingival status. Periodontal indices included Russell's Periodontal Index (PI) and Periodontal Index for Risk of Infectiousness (PIRI), which were assessed in all 100 patients. Analysis of covariance (ANCOVA) was the statistical analysis used. Results: After eliminating age affects using ANCOVA, the mean indices of all variables between groups were found to be highly significant (P<0.001). The scores were highly significant in COPD group than in non-COPD group. Conclusions: The findings of the present study show that there is an association between periodontal disease and COPD. It is suggested that periodontitis is one of the risk factors for COPD.
TL;DR: A meta-analysis completed on four studies including SRP and local sustained-release agents compared with SRP alone indicated significant adjunctive probing depth (PD) reduction for 10% Doxycycline hycylate (ATRIDOX) and minocycline hydrochloride (ARESTIN) and chlorhexidine gluconate (PERIOCHIP).
Abstract: Periodontal diseases are multi-factorial in etiology, and bacteria are one among these etiologic agents. Thus, an essential component of therapy is to eliminate or control these pathogens. This has been traditionally accomplished through mechanical means (scaling and root planing (SRP)), which is time-consuming, difficult, and, sometimes, ineffective. From about the past 30 years, locally delivered, anti-infective pharmacological agents, most recently employing sustained-release vehicles, have been introduced to achieve this goal. This systematic review is an effort to determine the efficacy of the currently available anti-infective agents, with and without concurrent SRP, in controlling chronic periodontitis. Four studies were included, which were all randomized controlled trials, incorporating a total patient population of 80, with 97 control sites and 111 test sites. A meta-analysis completed on these four studies including SRP and local sustained-release agents compared with SRP alone indicated significant adjunctive probing depth (PD) reduction for 10% Doxycycline hycylate (ATRIDOX), minocycline hydrochloride (ARESTIN), tetracycline hydrochloride (PERIODONTAL PLUS AB), and chlorhexidine gluconate (PERIOCHIP). Essentially, all studies reported substantial reductions in gingival inflammation, plaque scores, and bleeding indices, which were similar in both the control and the experimental groups. Use of antimicrobial sustained-release systems as an adjunct to SRP does not result in significant patient-centered adverse events. Local drug delivery combined with SRP appears to provide additional benefits in PD reduction compared with SRP alone.
TL;DR: A 24-year-old male with tongue-tie who complained of difficulty in speech following which he underwent frenectomy procedure under local anesthesia without any complications and was given speech therapy sessions.
Abstract: Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. In this article, we have reported a 24-year-old male with tongue-tie who complained of difficulty in speech following which he underwent frenectomy procedure under local anesthesia without any complications. Finally, he was given speech therapy sessions.
TL;DR: A mere change in diet by including probiotic foods may halt, retard, or even significantly delay the pathogenesis of periodontal diseases, promoting a healthy lifestyle to fightperiodontal infections.
Abstract: Macfarlane Burnett stated in 1962 that "By the late twentieth century, we can anticipate the virtual elimination of infectious diseases as a significant factor in social life". Probiotics have become of interest to researchers in recent times. Time has come to shift the paradigm of treatment from specific bacteria elimination to altering bacterial ecology by probiotics. The development of resistance to a range of antibiotics by some important pathogens has raised the possibility of a return to the pre-antibiotic dark ages. Here, probiotics provide an effective alternative way, which is economical and natural to combat periodontal disease. Thus, a mere change in diet by including probiotic foods may halt, retard, or even significantly delay the pathogenesis of periodontal diseases, promoting a healthy lifestyle to fight periodontal infections.
TL;DR: It can be concluded that poorer the glycemic control, and longer the duration of diabetes, the greater will be the prevalence and severity of periodontal disease.
Abstract: The relationship between diabetes mellitus and periodontal disease is not clear, even though studied intensively. From the available data, it seemed reasonable to believe that diabetics were more susceptible to periodontal disease than non-diabetics. Aim: The present study was to clinically evaluate the relationship of diabetes mellitus with periodontal disease along with various parameters. Materials and Methods: Fifteen hundred patients with diabetes mellitus were examined. A thorough oral examination was carried out and relevant history was recorded for all the patients. Results: Results indicated that the prevalence of periodontal disease in diabetic patients was 86.8%. Conclusion: It can be concluded that poorer the glycemic control, and longer the duration of diabetes, the greater will be the prevalence and severity of periodontal disease.
TL;DR: The present review concentrates on the effects of green tea in periodontal and general health.
Abstract: Tea, the commonly consumed beverage, is gaining increased attention in promoting overall health. In specific, green tea is considered a healthful beverage due to the biological activity of its polyphenols namely catechins. Among the polyphenols Epigallo catechin 3 gallate and Epicatechin 3 Gallate are the most predominant catechins. The antioxidant, antimicrobial, anticollagenase, antimutagenic, and c hemopreventive properties of these catechins proved to be helpful in the treatment of chronic diseases like periodontal disease. Studies have demonstrated that the type of processing mainly effects the concentration of catechins. Several epidemiological studies have proved that green tea also has some general health benefitting properties like antihypertensive, reduction of cardiovascular risk, antibacterial, antiviral, and antifungal activity. The present review concentrates on the effects of green tea in periodontal and general health.
TL;DR: It could be concluded that smokers have less vascular density and reduced lumen area and increased epithelial thickness than non smokers, however, these changes were not statistically significant.
Abstract: Background: Smoking has been reported as a major risk factor for periodontal disease. Studies have demonstrated decreased bleeding on probing and reduced inflammatory response among smokers, which has been attributed to the alterations in gingival microvasculature, gingival epithelium. In previous investigations, vascular and epithelial changes have been studied in the gingival tissues of smokers suffering from periodontitis and compared with healthy periodontium of non smokers. Inflammation is known to cause vascular and epithelial changes in the gingiva on its own in the absence of smoking. Hence, in the present investigation, an attempt is made to study and to compare the vascular and epithelial changes in the gingiva of smokers and non smokers suffering from chronic periodontitis. Aim of Study: The purpose of this study was to evaluate the vascular and epithelial changes in gingiva of smokers and non smokers with chronic periodontitis. Study Design: Cross sectional study . Materials and Methods: Gingival biopsies were obtained from 33 male patients (18 smokers and 15 non smokers) who were undergoing periodontal therapy or extraction. The sections were stained with eosin and hematoxylin. Vascular density, area of the lumen, and epithelial thickness were assessed using histomorphometric image analysis. Statistical Method: Data was analyzed using student unpaired 't' test, Karl Pearsons correlation, and Chi-square test. Results: The mean blood vessel density for smokers was 12.388±6.472 and for non smokers was 14.800±4.91. The mean lumen area of the vessels among smokers and non smokers was 19.290±8.775 mm 2 and 20.044±7.896 mm 2 , respectively. The mean epithelial thickness among smokers was 150.551±32.994 m and 134.941±30.63 m for non smokers. Conclusion: Based on the present histomorphometric study, it could be concluded that smokers have less vascular density and reduced lumen area and increased epithelial thickness than non smokers. However, these changes were not statistically significant.
TL;DR: The prevalence of periodontal disease is higher among obese subjects, and obesity could be a potential risk factor for periodontAL disease in all age groups.
Abstract: Background: The aim of the study was to evaluate the relationship between obesity and periodontitis. Materials and Methods: A total of 300 subjects aged 20 years and above suffering from generalized periodontitis were recruited from Department of Periodontics, Pacific Dental College and Hospital, Udaipur. Periodontal status of the subjects was recorded. Body mass index and waist circumference were used as measure to assess obesity. Other variables like age, gender, oral hygiene index were also recorded. Results: When evaluation was done for prevalence of periodontal disease according to BMI in obese and non-obese, the prevalence of periodontal disease was significantly (P=0.03) more in obese (88%) than in non-obese (74.4%) individuals. [OR=−20.4 and 95% confidence interval (CI) 1.3-1.3]. Conclusion: The prevalence of periodontal disease is higher among obese subjects. Obesity could be a potential risk factor for periodontal disease in all age groups.
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TL;DR: When reading the PDF, the author is very reliable in using the words to create sentences and the ways how the author creates the diction to influence many people will be seen.
Abstract: When reading the PDF, you can see how the author is very reliable in using the words to create sentences. It will be also the ways how the author creates the diction to influence many people. But, it's not nonsense, it is something. Something that will lead you is thought to be better. Something that will make your feel so better. And something that will give you new things. This is it, the miles to go.
TL;DR: Recent advances in the use of biomarker-based disease diagnostics that focus on the identification of active periodontal disease from plaque biofilms, GCF, and saliva are highlighted.
Abstract: Periodontal disease is a chronic microbial infection that triggers inflammation-mediated loss of the periodontal ligament and alveolar bone that supports the teeth. Because of the increasing prevalence and associated comorbidities, there is a need for the development of new diagnostic tests that can detect the presence of active disease, predict future disease progression, and evaluate the response to periodontal therapy, thereby improving the clinical management of periodontal patients. The diagnosis of active phases of periodontal disease and the identification of patients at risk for active disease represent challenges for clinical investigators and practitioners. Advances in diagnostic research are moving toward methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. Advances in the use of oral fluids as possible biological samples for objective measures of the current disease state, treatment monitoring, and prognostic indicators have boosted saliva- and other oral-based fluids to the forefront of technology. Gingival crevicular fluid (GCF) is an inflammatory exudate that can be collected at the gingival margin or within the gingival crevice. This article highlights recent advances in the use of biomarker-based disease diagnostics that focus on the identification of active periodontal disease from plaque biofilms, GCF, and saliva.
TL;DR: The case of a patient who visited the authors' department with the complaint of darkened patches on the gums and his concern was purely aesthetic, which confirmed the diagnosis as ‘Oral Malignant Melanoma’, who succumbed to death within a few months after diagnosis as the lesion was highly invasive.
Abstract: Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Though these lesions are biologically aggressive, they often go unnoticed since they are clinically asymptomatic in the early stages and usually present merely as a hyperpigmented patch on the gingival surface. These lesions if diagnosed at an early in situ stage are potentially curable and definitely have a better prognosis, but unfortunately as they are clinically asymptomatic, it results in delayed diagnosis thus making the prognosis extremely poor. This paper presents the case of a patient who visited our department with the complaint of darkened patches on the gums and his concern was purely aesthetic. There were no symptoms associated with the hyperpigmented lesions and hence the patient did not approach us earlier. When the lesions grew larger and were unsightly, the patient has seeked dental advice. Histopathologic investigation confirmed the diagnosis as 'Oral Malignant Melanoma'. Though aggressive therapy was instilled immediately, unfortunately, the patient succumbed to death within a few months after diagnosis as the lesion was highly invasive. Due to the biologically aggressive but clinically silent nature of progression of the lesion, the importance of maintaining a high index of suspicion and early detection and diagnosis for any pigmented gingival lesions cannot be overemphasised. Diagnosis must be based on thorough detailed history and valid histologic evidence.
TL;DR: The results of electrosurgery and scalpel technique are compared, i.e., partial thickness flap for depigmentation of gingival pigmentation of the gingiva.
Abstract: A beautiful smile definitely enhances the personality of an individual and reveals self-confidence. The harmony of the smile is determined not only by the shape, position, and color of the teeth but also by the gingival tissues. Gingival pigmentation results from melanin granules which are produced by melanoblasts. Although melanin pigmentation of the gingiva is a completely benign condition and does not pose any medical problem, complaints of "black gums" are common particularly in patients having a very high smile line. The different treatment modalities that have been reported for depigmentation are bur abrasion, partial thickness flap, cryotherapy, electrosurgery, and lasers. In this paper we have compared the results of electrosurgery and scalpel technique, i.e., partial thickness flap.
TL;DR: A case of oral lesions associated with LCH in a young woman is presented and it is shown that oral soft tissue lesions without bone involvement are rare.
Abstract: Langerhans cell histiocytosis (LCH) is a group of rare disorders histologically characterized by the proliferation of Langerhans cells. Multiple organs and systems may be involved by the disease. Typically, there is bone involvement and, less frequently, lesions may be found in the lungs, liver, lymph nodes, skin, and mucosa. Oral soft tissue lesions without bone involvement are rare. We present a case of oral lesions associated with LCH in a young woman.
TL;DR: Although the potential efficacy of MIPS in the treatment of deep intrabony defects has been proved, larger studies are required to confirm and extend the reported positive preliminary outcomes, according to preliminary data from case cohorts and from many studies.
Abstract: Minimally invasive dentistry is a concept that preserves dentition and supporting structures However, minimally invasive procedures in periodontal treatment are supposed to be limited within periodontal surgery, the aim of which is to represent alternative approaches developed to allow less extensive manipulation of surrounding tissues than conventional procedures, while accomplishing the same objectives In this review, the concept of minimally invasive periodontal surgery (MIPS) is firstly explained An electronic search for all studies regarding efficacy and effectiveness of MIPS between 2001 and 2009 was conducted For this purpose, suitable key words from Medical Subject Headings on PubMed were used to extract the required studies All studies are demonstrated and important results are concluded Preliminary data from case cohorts and from many studies reveal that the microsurgical access flap, in terms of MIPS, has a high potential to seal the healing wound from the contaminated oral environment by achieving and maintaining primary closure Soft tissues are mostly preserved and minimal gingival recession is observed, an important feature to meet the demands of the patient and the clinician in the esthetic zone However, although the potential efficacy of MIPS in the treatment of deep intrabony defects has been proved, larger studies are required to confirm and extend the reported positive preliminary outcomes
TL;DR: Application of tetracycline in modified collagen matrix following scaling and root planing might be beneficial in treatment of chronic periodontitis and improving periodontal parameters for 3-month duration.
Abstract: Background: Chronic periodontitis is an inflammatory disorder caused by dental plaque having mixed microbial flora. The different treatment modalities available to treat this disease are aimed at removal of micro-organisms from both hard and soft tissues. Systemic as well as local anti-microbial agents are helpful adjuncts in reducing microbes especially in inaccessible areas along with mechanical debridement therapy. Materials and Methods: The study was conducted in a split mouth design. Thirty-five patients having at least two non-adjacent sites in different quadrants with periodontal pockets ≥5 mm and with bleeding on probing at initial visit were selected. The selected sites were treated with both scaling and root planing plus tetracycline fibers or with scaling and root planing alone. Baseline and follow-up measurements included plaque index, gingival index, probing pocket depth, and clinical attachment level. Result: Both treatment modalities were affective in improving clinical parameters over three months' observation period. The combined antimicrobial and mechanical debridement therapy has shown better results as compared with scaling and root planing alone. Conclusion: Application of tetracycline in modified collagen matrix following scaling and root planing might be beneficial in treatment of chronic periodontitis and improving periodontal parameters for 3-month duration.
TL;DR: A 42-year-old female, with an enlargement in the maxillary anterior region, treated by excisional biopsy and immunohistochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma.
Abstract: Plasma cell granuloma is a rare benign lesion characterized by the infiltration of plasma cells; primarily occurring in the lungs. It is also seen to occur in the brain, kidney stomach, heart, and so on. In the intraoral region it is seen to involve the tongue, oral mucosa, and gingiva. This case presents a 42-year-old female, with an enlargement in the maxillary anterior region, treated by excisional biopsy. Histological evaluation revealed plasma cell infiltrates in the connective tissue. The immunohistochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma.
TL;DR: Along with the other parameters related to dental esthetics, these clinical parameters may serve as esthetic guidelines and may enable us to obtain a more predictable outcome.
Abstract: Background: The purpose of this study was to quantify some clinical parameters useful as esthetic guidelines when gingival contour is modified and to compare the left and right sides of six maxillary anterior teeth. Materials and Methods: Maxillary casts mounted on an articulator according to the axis orbital plane were photographed from 35 young adults. The angle formed between the gingival line and maxillary midline (GLA) and the distance between the gingival zenith of the lateral incisor and the gingival line were measured (LID) using a flexible protractor and digital vernier caliper, respectively. The asymmetry was evaluated using a paired t test for the left vs right measurements of GLA and LID. The descriptive statistics for GLA and LID were calculated. Results: The GLA measurements of the left side (86.74.2) were significantly greater than those of the right side (84.65.4), and the mean absolute symmetry for GLA was 1.74.4. The mean LID measurement was 0.920.11. Conclusions: The gingival zenith of the canine is apical to the gingival zenith of the incisors (GLA <90) and the gingival zenith of the lateral incisor is below or on (17%) the gingival line when head is oriented on the axis orbital plane. A directional asymmetry was shown with the right side higher than the left side. Along with the other parameters related to dental esthetics, these clinical parameters may serve as esthetic guidelines and may enable us to obtain a more predictable outcome.