Comparative evaluation of the efficacy of probiotic, Aloe vera, povidine-iodine, and chlorhexidine mouthwashes in the treatment of gingival inflammation: A randomized controlled trial.

BACKGROUND: Chemical plaque control with mouthwashes as an adjunct to mechanical plaque control with a toothbrush and dental floss has been considered an effective method for controlling gingivitis. The anti-inflammatory effects of chemical plaque control benefit the oral tissues by reducing inflammation and bleeding. OBJECTIVES: The aim of the present study was to evaluate and compare the clinical efficacy of probiotic, Aloe vera, povidine-iodine, and chlorhexidine (CHX) mouthwashes in treating gingivitis patients by assessing changes in their clinical parameters. MATERIAL AND METHODS: This prospective study was conducted on 40 patients from our outpatient department, divided into 4 groups of 10 patients each: probiotic mouthwash group (group 1); herbal (Aloe vera) mouthwash group (group 2); povidone-iodine mouthwash group (group 3); and CHX mouthwash group (group 4). All participants were provided with the same type of manual toothbrush, the Pepsodent® toothpaste and a respective mouthwash for twice-daily use until the end of a 28-day observation period. Clinical parameters, such as the marginal plaque index (MPI) and bleeding on interdental brushing (BOIB), were recorded at baseline, and on the 14th and 28th day of the study period. RESULTS: All groups showed a significant decrease in the MPI and BOIB scores. The results were similar in patients who used a probiotic mouthwash and those who used a CHX mouthwash. A comparable change in the mean scores was observed among the herbal and povidone-iodine groups from baseline to day 28. CONCLUSIONS: In the treatment of chronic gingivitis patients,a probiotic mouthwash was nearly as effective as CHX in reducing the plaque and bleeding scores. It showed better results in all clinical parameters than herbal and povidone-iodine mouthwashes. Using a mouthwash along with routine tooth brushing can help in treating gingivitis and slow the progression of the periodontal disease.

Evaluation of soft tissue and crestal bone changes around non-submerged implants with and without a platelet-rich fibrin membrane: A randomized controlled clinical trial.

BACKGROUND: Platelet-rich fibrin (PRF) membranes are known to enhance wound healing after periodontal surgeries and dental implant procedures. OBJECTIVES: The aim of the present study was to examine the effect of PRF on soft tissue healing and the crestal bone level (CBL) around non-submerged dental implants. MATERIAL AND METHODS: A total of 40 patients, aged 20-60 years, with partially edentulous posterior mandibular sites were divided into 2 groups of 20 patients each: group I received non-submerged implants with a PRF membrane; and group II was treated with non-submerged implants alone. The examined parameters included the modified plaque index (mPI), the gingival index (GI), the width of keratinized tissue (WKT), the thickness of keratinized tissue (TKT), and CBL, assessed using digital intraoral periapical radiography (IOPA). All parameters were measured at baseline (immediately post-op), and at 3-month and 6-month follow-ups. RESULTS: In comparison with baseline, statistically significant increases in WKT and TKT were observed in both groups at 3 and 6 months post-op (p < 0.05). Also, significant gains were noted in group I vs. group II (p < 0.05). The CBL increased significantly in both groups at 3 and 6 months post-op (p < 0.05), with no remarkable differences from 3 to 6 months. A decreased CBL was observed in group I vs. group II at the 3- and 6-month intervals (p < 0.05). CONCLUSIONS: The PRF membrane enhances peri-implant tissue wound healing, with gains in soft tissue width and thickness around non-submerged implants.

Estimation of Serum 1,25-Dihydroxycholecalciferol and Tumor Necrosis Factor-α Levels in Chronic Periodontitis.

BACKGROUND: Major trials in the field of periodontics include a thorough understanding of its pathophysiology and the interplay between host response and periodontal factors. Certain factors such as vitamin D play a crucial role in immune regulation and their depletion is known to contribute to the onset of periodontitis. Research efforts continue to unravel the impact of elevated pro-inflammatory cytokines like TNF-α on osteoclastogenesis in periodontitis. MATERIALS AND METHODS: The study comprised a total of 64 participants, with 33 men and 31 women, including 32 individuals with chronic periodontitis and 32 people without the condition. ELISA was employed to determine the concentrations of TNF-α and 1,25-dihydroxycholecalciferol (1,25(OH)2D) in the participants. Clinical attachment levels, probing pocket depth, gingival bleeding index, and plaque index were meticulously measured. Subsequent to data collection, appropriate statistical tests were conducted. RESULTS: The mean serum levels of 1,25(OH)2D in test and control groups are 173.59 ± 52.60 and 401.47 ± 99.81, respectively. The mean serum levels of TNF-α in the test and control groups are 1078.09 ± 231.51 and 204.75 ± 68.31, respectively. The TNF-α levels exhibited a statistically significant difference between test and control groups (p = 0.0001) at a 5% level of significance. CONCLUSION: Decreased levels of 1,25(OH)2D led to increased values of periodontal parameters. There was also a significant increase in serum levels of pro-inflammatory cytokines such as TNF-α.

Accuracy of digital intraoral periapical radiography and cone-beam computed tomography in the measurement of intrabony defects: A comparative study.

BACKGROUND: Periodontal disease is an inflammatory process resulting in clinical attachment loss (CAL), pocket depth (PD), and resulting in the loss of alveolar bone. Diagnostic imaging provides an adjunctive guidelines to assess the alveolar bone height in addition to clinical parameters such as PD and CAL. AIMS AND OBJECTIVES: The objectives of the study are to determine whether the digital intraoral periapical (IOPA) radiographs can be reliably used as an alternative to cone-beam computed tomography (CBCT) in the diagnosis of intrabony defects. MATERIALS AND METHODS: A total of 25 patients with the presence of intrabony defects were included in the study. All the radiographic parameters were recorded using digital IOPA and CBCT. Various intrabony defect morphological characteristics such as height, depth, width, and angle were measured and compared between digital IOPA and CBCT. STATISTICS: The data was subjected to statistical analysis. Mann-Whitney U-test was performed for interexaminer comparison and independent t-test for intergroup comparison. RESULTS: The mean intergroup comparison values between digital IOPA and CBCT in relation to defect width were 3.22 ± 1.10 and 3.20 ± 1.16, respectively (P = 0.970), in relation to defect depth were 7.71 ± 2.3 and 7.91 ± 2.4, respectively (P = 0.769), in relation to defect height were 3.80 ± 1.20 and 3.90 ± 1.2, respectively (P = 0.794), and in relation to defect angle were 34.82 ± 8.4 and 35.28 ± 0.8.6, respectively (P = 0.851). CONCLUSION: With the drawbacks of such as high radiation exposure, unavailability, and high financial cost, digital IOPA with digital software can be used as an alternative to CBCT for measuring intrabony defect morphological characteristics in periodontitis patients.

Reflex Gastroesophageal Disorders and Functional Dyspepsia: Potential Confounding Variables for the Progression of Chronic Periodontitis: A Clinical Study.

AIM: To probe into the possible connection between gastroesophageal reflux disorders (GERDs) and functionally occurring dyspepsia as a factor raising the risk of chronic periodontitis. MATERIALS AND METHODS: A cross-sectional study was carried out on 40 patients with chronic periodontitis with age group between 40-60 years. The test group included 20 people diagnosed with gastroesophageal reflux disease (GERD), according to the Montreal Definition and Classification agreement, and chronic periodontitis. Symptomatic diagnoses were done to confirm functional dyspepsia. The control group comprised 20 systematically healthy people suffering from chronic periodontitis. Indices measured included flow-rate of saliva, repetitive saliva swallowing test for swallowing function, papillary marginal attachment index of gingiva, oral hygiene index-simplified and decayed, missing, filled teeth index. Data was analyzed using SPSS version 22 (IBM Inc. Chicago, USA). Descriptive statistics, such as mean and standard deviation (SD) for continuous variables and frequency and percentage for categorical variables were determined. T test was performed for intergroup comparison and Pearson correlation test was done for evaluating correlation between various parameters. P ≤ 0.05 considered as significant. RESULTS: Statistically significant differences were observed between the test and control groups with regard to all the clinical parameters of interest. Pearson's correlation test revealed a strong negative correlation between salivary flow rate and OHI-S and DMFT scores. The RSST swallow function values demonstrated a moderate negative correlation with OHI-S scores, while OHI-I scores and DMFT scores were observed to be strongly correlated in a positive direction. A statistically significant difference was present in the probing depth and CAL levels between both the groups with higher levels in test group. CONCLUSION: GERD was linked to incremental incidences of chronic periodontitis and was established as an independent risk-raising factor.

Maintenance of Gingival Profile in the Esthetic Zone using Natural Tooth Pontic.

The extraction of periodontally compromised teeth in the anterior esthetic region is a challenging situation due to patients' psychological and esthetic demands. Irrespective of the replacement of missing teeth with the final prosthesis, the first line of management would be to provisionally restore the teeth at the earliest. Routine treatment options for replacement are time-consuming and expensive. Using the patient's natural tooth as a pontic offers the benefits of the same size, shape, color, and preservation of the gingival architecture. Using the patient's platelet concentrate (platelet-rich fibrin) facilitates early wound healing and preservation of the alveolar ridge shape following tooth extraction. With minimal or no preparation, the technique can be completed at the chairside, thereby avoiding laboratory costs. This case report details the procedure with a follow-up of a case where the natural extracted tooth of the patient was used as pontic to replace a missing anterior tooth.

Mapping the link between cardiac biomarkers and chronic periodontitis: A clinico-biochemical study.

BACKGROUND: Various risk factors are coupled with atherosclerotic complications, such as myocardial infarction and stroke. Periodontitis is considered one of them. AIMS AND OBJECTIVES: The objective of the study is to compare and correlate the occurrences of periodontitis with serum levels of cardiac-biomarkers in patients with coronary heart-disorders. MATERIALS AND METHODS: Of 70 individuals diagnosed with coronary artery diseases, 32 patients with chronic periodontitis constituted the test group, 31 without chronic periodontitis constituted the control group. Cardiac-biomarkers analyzed were Troponin T, Troponin I, Myoglobin; low density lipoprotein (LDL), high-density lipoprotein, very LDL (VLDL), total cholesterol (TC), and highly sensitive C-reactive protein (Hs-CRP). Periodontal characteristics were drawn from the plaque index (PI) and gingival index, probing depth (PD), clinical attachment loss, and periodontal inflammatory surface area (PISA). STATISTICAL ANALYSIS: In order to separate any association between cardiac biomarkers and clinical parameters of periodontitis, detailed statistical analysis through independent t-test and Pearson test of correlation was done. RESULTS: Statistically significant differences were seen not only in PI, PD, and PISA between both the groups (P < 0.05), but also between various cardiac parameters of test and control groups (P < 0.001). Positive relations were seen in the test group, between cardiac biomarkers such as TC, VLDL, Hs-CRP, and Troponin T with periodontal parameters such as PD and PISA. CONCLUSION: The study reveals, a strong association between periodontitis and diseases of cardiovascular nature, highlighting the need for awareness and timely medical interventions to prevent periodontitis from scaling up and interfering with the risk of cardiovascular problems.

Periodontally accelerated osteogenic orthodontics: Novel perio-ortho interrelationship.

Periodontally accelerated osteogenic orthodontics (PAOO) is a clinical procedure that incorporates selective corticotomy, particulate grafting, and application of optimal orthodontic forces. It reduces treatment time, increases stability of teeth, and prevents relapse of orthodontic tooth movement (OTM). The present case report highlights the technique and principles of PAOO for rapid OTM.