Assessment of Serum Parameters in Stable Coronary Artery Disease Patients in Correlation with Healthy and Chronic Periodontitis Patients.

Background: Periodontitis is a chronic inflammatory disease and has been strongly associated with elevation of systemic markers such as C-reactive protein (CRP), fibrinogen (FIB), and lipid profile, which have also been significantly associated with coronary heart disease (CHD). Hence, there is a need to assess the possible association between chronic periodontitis and coronary artery disease. Materials and Methods: A study included 100 subjects divided into four groups. Group I: stable coronary artery disease with chronic periodontitis, Group II: stable coronary artery disease without chronic periodontitis, Group III: chronic periodontitis without coronary artery disease, and Group IV: healthy controls. Gingival index, Russell's periodontal index, pocket depth, and clinical attachment level were recorded. Venous blood was collected from the patients, and serum fibrinogen, CRP, and lipid profile levels were estimated. Results: The intragroup comparison of biochemical and periodontal parameters showed statistically significant results with P < 0.05. The intergroup comparison of serum FIB, total cholesterol, high density lipoprotein, low density lipoprotein, and clinical attachment level showed statistical significant results (P = 0.000, P = 0.000, P = 0.001, P = 0.025, and P = 0.000, respectively) between Groups I and III. Conclusion: The results of the study indicate that there might a possible correlation between coronary artery disease and chronic periodontitis, but periodontitis-cardiovascular link is complex and difficult to define though there is sufficient evidence for their association. Leakage of pro-inflammatory cytokines from the ulcerated periodontium causes the production of acute-phase proteins by the liver. To prove the relationship, further studies should be considered making use of other markers of inflammation with prospective randomized controlled studies involving large population.

Classification systems for gingival recession and suggestion of a new classification system.

BACKGROUND: Gingival recession is one of the most usual esthetic concerns associated with the periodontal tissues. Classification of such condition is important to diagnose, determine the prognosis, and frame the treatment plan. Various classifications have been put forward since decades to classify gingival recession. Miller's classification is the widely used classification among all classifications, but certain drawbacks have been noted in this classification. Therefore, an effort is made to review most commonly used classification systems for gingival recession, and their drawbacks further come up with a proposal of new classification system for gingival recession.

Osteoporosis and periodontitis: is there a possible link?

BACKGROUND: Periodontitis and osteoporosis are two diseases found worldwide having the main characteristic of increasing intensity with age. Periodontitis is associated with resorption of the alveolar bone. Osteoporosis is characterized by bone loss leading to structural bone transformation. The association between periodontitis and osteoporosis is continually being examined. The aim of this study is to examine the condition of periodontal tissues in patients suffering from osteoporosis and establish a possible link. MATERIALS AND METHODS: Cross-sectional study with 200 samples having test (n = 100) and control group (n = 100) were checked for periodontal condition. A total of 100 patients diagnosed as having osteoporosis based on bone mineral density at distal end of radius were regarded as test group and 100 subjects included in control group were healthy. Periodontal parameters measured were plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). Statistical test performed were Student's paired t-test and unpaired t-test and Pearson's correlation coefficient. RESULTS: Probing depth and CAL were significantly negatively co-related with T-score in test group when compared with control group. This meant an inverse relationship in between the T-score and the clinical parameters, PD and CAL. Furthermore, some difference was noted in test group in PI, GI and PD, CAL and T-score when compared with the controls. CONCLUSION: Thus, we conclude that there is a definite relationship between osteoporosis and periodontitis based on PD and CAL.

Evaluation of antiplaque and antigingivitis effect of herbal mouthwash in treatment of plaque induced gingivitis: A randomized, clinical trial.

BACKGROUND: Ayurvedic drugs have been used since ancient times to treat diseases including periodontal diseases. Oral rinses made from ayurvedic medicines are used in periodontal therapy to control bleeding and reduce inflammation. The aim of this clinical study is to verify the efficacy of herbal mouthwash containing Pilu, Bibhitaka, Nagavalli, Gandhapura taila, Ela, Peppermint satva, and Yavani satva on reduction of plaque and gingivitis. MATERIALS AND METHODS: A total of 100 volunteers with clinical signs of mild to moderate gingivitis were selected and assigned to Group A (only scaling done) and Group B (scaling along with the use of herbal mouthwash). After recording the clinical parameters, the patients were instructed to use herbal mouthwash 15 ml for 30 s twice daily after food in Group B and oral hygiene instructions were given to all patients. Plaque and gingivitis assessment were carried out using the plaque index (Silness nd Loe, 1964), Gingival index (Loe And Silness, 1963), Gingival bleeding index (Ainamo and Bay, 1975) at baseline and at 21 days of the herbal mouthwash use. Statistically analysis was carried out using the student's t-test for normally distributed data and Wilcoxson test or Mann-Whitney U-test for skewed data. RESULTS: Our results showed that herbal mouthwash was effective in treatment of plaque induced gingivitis in Group B when compared with the Group A. CONCLUSION: Herbal mouthwash is effective in treatment of plaque induced gingivitis and can be effectively used as an adjunct to mechanical therapy with lesser side-effects.

Intentional replantation of periodontally compromised hopeless tooth.

Aesthetic considerations have influenced the management of dental maladies in varying degrees for many years. Even single tooth mal-alignment makes the patient to approach a dentist. Intentional replantation is a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth. Many authors agree that it should be reserved as the last resort to save a tooth after other procedures have failed or would likely to fail. The main reason of failure in replanted teeth is root resorption, specifically ankylosis or replacement resorption. Although the success rate is not always high, intentional replantation may be a treatment alternative that deserves consideration to maintain the natural dentition and avoid extraction of the tooth. Here is case report of a patient desiring alignment of malpositioned periodontally involved anterior single tooth due to various causes treated by intentional replantation.

Herpes zoster of trigeminal nerve after dental extraction.

Herpes zoster is an uncommon acute viral infection caused by reactivation of varicella zoster virus. During the prodromal stage, the only presenting symptom may be odontalgia, which may prove to be a diagnostic challenge for the dentist. Practicing dentist may carry out emergency treatment that might result in irreversible damage or may delay the appropriate treatment. With an ever-increasing number of elderly and immunocompromised patients reporting to the dentist, the dental profession can expect to encounter an increased number of herpes zoster patients. Dentist must be familiar with the presenting signs and symptoms of patients experiencing the prodromal manifestations of herpes zoster of the trigeminal nerve. This article focuses on the difficulties in management of such cases, and one such case is reported here.

New anesthetic technique in periodontal procedures.

Periodontal procedures require injection of local anesthetic solution to avoid patient discomfort. Multiple injections are required to anesthetize the anterior maxilla in the region of the premolars to incisors. Anterior middle superior alveolar nerve block is a single palatal injection technique, which anesthetizes the facial and palatal gingiva as well as pulp in the region of the maxillary central incisors to the premolars without any collateral facial anesthesia. This case series presents the application of the anterior middle superior alveolar nerve block in periodontal therapy.