Defensins in periodontal health.

Defensins are abundant and widely distributed peptides in human and animal tissues that are involved in host defence. Defensins not only have the ability to strengthen the innate immune system but can also enhance the adaptive immune system by chemotaxis of monocytes, T-lymphocytes, dendritic cells and mast cells to the infection site. Defensins also improves the capacity of macrophage phagocytosis. A greater understanding of how these peptides act in the healthy, gingivitis and periodontitis conditions would definitely open new opportunities for identifica¬tion, prevention and treatment of periodontal diseases. This discussion focuses on recent studies about biological function of defensins in human diseases and animal models.

Effects of tetracycline-containing gel and a mixture of tetracycline and citric acid-containing gel on non-surgical periodontal therapy.

Aims and Objectives: The purpose of this study was to assess the clinical and microbiological effects of a newly developed root-conditioning gel system containing tetracycline and a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Materials and Methods: Four anterior teeth from four quadrants with a probing depth of 4-6 mm, in each of the 20 subjects with chronic periodontitis, were subjected to four different modalities of treatment. A total of 80 teeths were divided into four groups of 20 teeth each taken from separate quadrants, on the basis of one of the following four treatments: (1) Root planning alone in first quadrant (RP group); (2) tetracycline-containing gel in the second quadrant (TCG group); (3) root planning plus tetracycline-containing gel in third quadrant (RP + TCG group); (4) root planning plus a mixture of tetracycline and citric acid-containing gel in fourth quadrant (RP + TC-CAG group). Plaque index (PI), sulcular bleeding index, probing pocket depth, and clinical attachment level were measured for 0 day, 8 th week, and 12 th week, respectively. Subgingival plaque samples from each site were collected at the same visits and examined with dark field microscope for proportions of motile rods and spirochetes. Results: From 0 day to 12 th week, PI, sulcular bleeding index, probing pocket depth, and clinical attachment levels decreased significantly in all the groups. From 0 day to 12 th week, RP + TC-CAG group showed a significantly higher change in the PI score. From 0 day to 12 th week, RP group showed a significantly higher change in sulcular bleeding index score. A significant decrease in probing pocket depth and gain in clinical attachment level was noted at 12 th week in RP + TC-CAG group compared to the other groups. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group. There was a decrease in the proportion of spirochetes in all the groups. Conclusion: The results indicated that the use of a mixture of tetracycline and citric acid-containing gel was effective in improving gingival health and in changing subgingival microflora.

Subepithelial connective tissue grafts for the coverage of denuded root surfaces: a clinical report.

AIMS AND OBJECTIVES: The aim of this study is to determine the effectiveness of subepithelial connective tissue grafts (SCTG) in the coverage of denuded roots. MATERIALS AND METHODS: A total of 16 sites with > or =2 mm of recession height were included in the study for treatment with SCTG. The clinical parameters, such as recession height, recession width, width of keratinized gingiva, probing pocket depth, and clinical attachment level were measured at the baseline, third month, and at the end of the study [sixth month]. The defects were treated with a coronally positioned pedicle graft combined with connective tissue graft. RESULTS: Out of 16 sites treated with SCTG, 11 sites showed complete (100%) root coverage; the mean root coverage obtained was 87.5%. There was a statistically significant reduction in recession height, recession width, and probing pocket depth. There was also a statistically significant increase in the width of keratinized gingiva and also a gain in clinical attachment level. The postoperative results were both clinically and statistically significant ( P 0.05). CONCLUSION: From this study, it may be concluded that SCTG is a safe and effective method for the coverage of denuded roots.

Effect of three commercial mouth rinses on cultured human gingival fibroblast: an in vitro study.

AIM: To examine the effect of three commercial mouth rinses (Hexidine 0.2%, Listerine Cool Mint, Betadine 1%) upon cultured human gingival fibroblast proliferation. MATERIALS AND METHODS: Human gingival fibroblasts were cultured and incubated in Dulbecco's Minimum Eagle's Medium containing Chlorhexidine, Listerine, Povidone-Iodine at varying concentrations (1%, 2%, 5%, 10%, 20% and 100% of the given solution) at 37 degrees C for 1, 5 and 15 min. Control cells received an equal volume of Dulbecco's Minimum Eagle's Medium without adding mouth rinses, for similar duration of exposure at 37 degrees C. Following incubation the media were removed, cells were washed twice with medium, supplemented with 10% Fetal Bovine Serum, and fibroblasts in the test and control group were allowed to recover in the same media for 24 h. RESULTS: In all the three groups, the proliferation inhibition was dependent on the concentration of solublized mouth rinses in the cell culture but independent of the duration of exposure to all three mouth rinses. The results showed that all three solutions were toxic to cultured human gingival fibroblasts, Chlorhexidine being the most cytotoxic. It was seen that at dilute concentrations (1% and 2% of given solutions) Listerine was more cytotoxic than Chlorhexidine and Povidone-Iodine. CONCLUSION: These results suggest that Chlorhexidine, Listerine and Povidone-Iodine are capable of inducing a dose-dependent reduction in cellular proliferation of fibroblasts. The results presented are interesting, but to know the clinical significance, further studies are needed.

Hospital periodontal surgery.

Phenytoin-induced gingival overgrowth is a recognized side effect in many cerebral palsy patients using diphenyl hydantoin for the control of seizures. Severe gingival overgrowth in these patients can affect normal masticatory function, lead to poor occlusal development, and compromise esthetics. This report addresses the complex nature of treating phenytoin-induced gingival overgrowth in a mentally retarded 20-year-old female patient. For this patient, full-mouth gingivectomy procedure was performed under general anesthesia in a single session. Post operative follow-up was uneventful. This article discusses major indications, contraindications, and protocols to be followed for periodontal surgical procedures done under general anesthesia.