In vitro adhesion of oral candida dubliniensis isolates to acrylic denture surfaces following brief exposure to sub-cidal concentrations of polyenes, azoles and chlorhexidine

We aimed to investigate the effect of brief exposure to sub-cidal concentrations of nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate on the adhesion of oral Candida dubliniensis isolates to the surface of acrylic dentures. After determining the minimum inhibitory concentration of each drug, 20 oral isolates of C. dubliniensis were exposed to sub-cidal concentrations of the drugs for 1 h. The drugs were then removed by dilution, and the adhesion of the isolates to denture acrylic strips was assessed by an in vitro adhesion assay. Compared to the controls, exposure to nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate suppressed the ability of C. dubliniensis isolates to adhere to acrylic denture surfaces with a reduction of 74.68, 74.27, 57.31, 44.57 and 56.53% [p <0.001 for all drugs], respectively. Brief exposure to sub-cidal concentrations of anti-mycotics suppressed the adhesion of C. dubliniensis oral isolates to acrylic denture surfaces

effect of locally delivered doxycycline as an adjunctive therapy to scaling and root planning in smokers

Locally delivered doxycycline is found to be effective in managing periodontitis as an adjunct to scaling and root planing. To evaluate the effect of locally delivered doxycycline [10%] with scaling and root planing in the periodontal treatment of smokers and to compare it with scaling and root planing alone. Twelve smokers with chronic periodontitis and a pocket depth [>/= 5 mm] on posterior teeth that bleed on probing were selected. Patients were randomly assigned to scaling and root planing [SRP] or scaling and root planing followed by local application of doxycycline [SRP-D]. Plaque, bleeding on probing, gingival recession, clinical attachment level [CAL], and probing depth [PD] were recorded at the baseline, 6 and 12 weeks. Both groups showed a significant reduction in Plaque, Bleeding on Probing and pocket depth at 6th and 12th week from the baseline. A statistically significant gain of attachment was observed in both groups after treatment. Even though the doxycycline group showed slightly higher attachment gain it was not statistically significant compared to the control group. The observations of the study reveal that the additional benefit of topical application of doxycycline as an adjunct to scaling and root planing in smokers is not convincing. However, further clinical studies may be necessary to substantiate the present observations

Multidisciplinary treatment in a patient with nifedipine induced gingival enlargement

Adult patients have preexisting condition that are not seen in the adolescent population including tooth loss, severe skeletal dysplasias, periodontal disease and various forms of temporomandibular dysfunction[TMD]. Frequently, the preexisting conditions that are present in the adult patient interfere with the achievement of orthodontisc's general idealized goals. Problem-oriented synthesis of the dental needs of each case helps determine specific treatment objectives that one must establish before determining the treatment plan. A 51 years old patient approached the dental clinic to improve her smile esthetics. She was a skeletal class III high angled case with an increased lower facial height and a dentally class I with supraerupted upper right central incisor, mild spacing 4 mm of overall tooth material excess in the lower arch. Ginigival overgrowth associated with nifedipine intake was also recorded. As a more realistic treatment plan with an interdisciplinary approach was considered to be appropriate in terms of treatment efficacy and duration, a team comprising of a periodontist, an orthodontist and a restorative dentist was formed to manage the case. The importance of multidisciplinary approach in managing the case was explained. After gingivectomy, the patient was kept in a maintenance program, including oral hygiene instructions and professional tooth cleaning during the complete orthodontic treatment. Follow-up of the case for a year did not reveal any recurrence of the drug induced gingival enlargement. This case not only emphasizes the role of meticulous oral hygiene maintenance in preventing the recurrence of gingival enragement but also the ease with which adult cases would be managed efficiently with minimal endeavors by a team approach

Gingival crevicular fluid immunoglobulins in smokers with chronic periodontitis

Tobacco smoking is regarded as one of the most significant risk factors in the development and pregression of periodontal disease. Studies have shown an altered host antibody response to antigenic challenge in smokers with periodontitis. The study was undertaken to estimate the gingival crevicular fluid [GCF] immunoglobulin G,A,M [IgA, IgG, and IgM] levls in smokers and non smoker with periodontitis. Patients with a periodontal probing depth > 4mm and clinical attachment loss >2mm in at least 30% of the teeth were diagnosed as chronic periodontitis group. Subject who smoked minimum of 10 cigarettes per day for not less than two years were included in smoker periodontitis group. GCF samples were obtained from the patient using filter paper and the immunoglobulin levels were estimated by the radial immunodiffusion assay. Gingival crevicular fluid immunoglobulins were found to be relatively lower in smokers compared to non- smokers. The IgA levels showed significant reduction in smokers. Current observations indicate that cigarette smoking may be associated with the suppression of B-cell function and immunoglobulin production. The alteration of antibody levels further explains the potential mechanism by which smoking exacerbates periodontal disease. Further studies at molecular level may highlight the specific mechanism by which tobacco can interact with cells of the immune system and its impact on periodontal disease process

Current concepts in alveolar bone augmentation: a critical appraisal

Augmentation of the alveolar bone is widely used in implant treatment to create predictable function and esthetics in areas with inadequate bone volume. This can be achieved by various techniques including hard tissue onlays, bone grafts, membrane techniques, bone distraction and bone expansion. The objective of this article is to discuss recent observations of the various bone grafts and bone substitutes, guided bone regeneration, combination techniques, as well as ridge preservation techniques. Despite the increase in the number of procedures that require bone grafts, there has not been a single ideal bone graft substitute. An attempt is made to review the existing bone grafts, and the developments in tissue engineering that may bring biologic alternatives to enhance the functional capabilities of the bone graft substitutes

Burning mouth syndrome: diagnostic appraisal and management strategies

Burning mouth syndrome [BMS] is a disorder that is characterized by a burning sensation of the oral cavity in the absence of visible local or systemic abnormalities. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. The exact cause of burning mouth syndrome often is difficulttopinpoint. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, type 2 diabetes and change sinsalivary function. Studies have pointed todys function of the cranial nerves associated with taste sensation as a possible cause of burning mouth syndrome. Since burning mouth symptoms may arise as the result of a number of etiologic factors, diagnosis and management of the patient with BMS should involve consideration of all possible causative factors. Hormone replacement therapy, benzodiazepines/ anti-convulsants, anti-depressants, analgesics, capsaicin, alpha-lipoic acid and cognitive behavioral therapy etc. have all been used in the management of BMS. The present review outlines various aspects of BMS, updates current knowledge on the disease, and provides guidelines for successful patient management

impact of periodontal infections on systemic diseases. An update for medical practitioners

Oral health status is an integral component of a general health and well-being of an individual. Knowledge about the link between periodontal disease and systemic diseases are growing rapidly. Increasing evidence is available from many investigators to indicate periodontitis as a risk factor for cardiovascular diseases, diabetes mellitus, low birth weight infants and pulmonary diseases. Both epidemiologists and researchers in oral microbiology have contributed significantly to the new paradigm of periodontal disease. Although additional studies are needed to determine the mechanisms by which such associations exist; available research clearly demonstrates that oral diseases and conditions are not only markers for underlying health problems, but also important determinants influencing the development and management of adverse chronic health conditions. Physicians and dentists should be aware of this link and provide treatment that will greatly benefit the patients. A review of the relationship between periodontal infections and its possible impact on systemic diseases is discussed