Comparative Clinical Evaluation of Semilunar Coronally Positioned Flap Alone and Semilunar Coronally Positioned Flap in Conjunction with Free Gingival Graft for Root Coverage.

Gingival recession accounts for apical migration of the gingival margin, resulting in exposure of the cementoenamel junction and root surface, with exposure of the root surface linked to deteriorated esthetic appearance and increased dentinal hypersensitivity. Various surgical techniques have been used to correct labial gingival recession defects. The present study evaluated and compared the results of semilunar coronally positioned flap (SCPF) alone and in conjunction with free gingival graft (FGG) for the treatment of Miller Class I and II gingival recession defects in maxillary anterior teeth. A total of 20 bilateral Miller Class I and II gingival recession sites were included and randomly allocated (n = 10 sites/group) to either the semilunar coronally positioned flap technique alone (SCPF group; control) or with FGG (SCPF+FGG group; test). Longitudinal alterations in probing depth (PD), recession width (RW), recession height (RH), width of keratinized tissue (WKT), and clinical attachment level (CAL) were measured and analyzed for both groups at 1-, 3-, 6-, and 12-month follow-ups. Both groups saw a significant decrease in RH, RW, and CAL and a significant increase in WKT. No statistically significant difference was observed in the final root coverage outcome between both groups in terms of RH, RW, and CAL, but a significant increase in WKT was seen with SCPF+FGG. Both techniques demonstrated optimal results without significant differences in the final root coverage outcomes except for WKT, which had a statistically significant increase in the SCPF+FGG group.

The Effect of Phase I Therapy on the Clinical Parameters, VSC Levels, and RBS Levels in Chronic Periodontitis Patients With Diagnosed Diabetes.

INTRODUCTION: The relationship between chronic periodontitis and type 2 diabetes mellitus (DM) is bidirectional. Halitosis or oral malodor has an effect on psychological and social life of persons, and is seen in individuals with diabetes. AIMS AND OBJECTIVES: The aim of this study was to find out the effect of phase I therapy on the clinical parameters, volatile sulfur compound (VSC) levels, and random blood sugar (RBS) levels in chronic periodontitis patients with diagnosed DM. MATERIALS AND METHODS: Our study included 80 patients with diabetes and chronic periodontitis. We collected subgingival plaque samples at 1 week and 1 month after scaling and root planing. The parameters measured were probing pocket depth and clinical attachment level for all the teeth at four sites per each tooth. RBS levels were recorded for all the patients. Malodor was measured with Tanita Breath Checker (Tanita India Private Limited, Mumbai, Maharashtra, India). RESULTS: We found a statistically significant reduction in clinical parameter levels, VSC levels, and N-benzoyl-DL-arginine-2-naphthylamide (BANA) levels in both the groups from baseline to 4 weeks with highest levels in diabetic chronic generalized periodontitis (CGP) and lowest in nondiabetic CGP at baseline. The mean intergroup comparison of BANA levels was statistically significant at all intervals of time between the two the groups. CONCLUSION: There is a significant correlation observed between oral malodor levels, RBS, and clinical parameters in the diabetic group.

Clinical and radiographic evaluation of platelet-rich fibrin as an adjunct to bone grafting demineralized freeze-dried bone allograft in intrabony defects.

BACKGROUND: Several bone graft materials are popularized in the treatment of intrabony defects. Demineralized freeze-dried bone allograft (DFDBA) is widely used in the treatment of intrabony defects. Platelet-rich fibrin (PRF) is autologous blood preparation which helps in wound healing and regeneration. Hence, this study focuses on evaluation of PRF, DFDBA, and their combination in the regeneration of intrabony defects. MATERIALS AND METHODS: A total of 39 sites with intrabony defects were randomly assigned into three groups: (Group I - Open flap debridement, Group II - DFDBA alone, and Group III- DFDBA + PRF). Parameters such as probing pocket depth (PPD), relative attachment level (RAL), and radiographic bone fill were measured at baseline, 3 months, and 6 months. Intragroup comparison at various study intervals was made using one-way ANOVA test. Intergroup comparison was made using Tukey's multiple post hoc test. RESULTS: Reduction in the PPD and greater difference in RAL was observed over the study period in all the three groups with greater reduction in DFDBA + PRF group. Reduction in the radiographic defect depths was observed over the study period in all the three groups with the greatest reduction of 38.99% in the DFDBA + PRF group. However, no statistically significant difference was reported by DFDBA versus DFDBA + PRF group. CONCLUSION: Combination of DFDBA and PRF improved the clinical and radiographic parameters compared to PRF and DFDBA alone. PRF was combined with DFDBA to produce a synergistic effect for treating intrabony defects in chronic periodontitis patients.

Gingivitis and plaque prevention using three commercially available dentifrices: A comparative clinical and microbiological randomized control parallel study.

AIM: The aim of the study was to compare the clinical and microbiological efficacy of Group I-delmopinol dentifrice, Group II-chlorhexidine, and Group III-triclosan-containing regularly used control dentifrice on plaque formation and gingivitis. MATERIALS AND METHODS: A total of 45 healthy volunteer students fulfilling the inclusion criteria are recruited for this randomized control parallel study. All the individuals were randomly assigned into 3 groups depending on the dentifrice prescribed. After the selection of individuals, thorough scaling and polishing were performed for all the individuals, and in a 4 days' washout period, they were refrained from regular oral hygiene maintenance and 0.9% NaCl (normal saline) rinse was prescribed to obtain plaque regrowth. Microbiological morphotypes were assessed using darkfield microscope. STATISTICAL ANALYSIS: The data were analyzed using the SPSS-software 19.00 program. The intragroup comparison of clinical parameters was done using Kruskal-Wallis ANOVA test, and intergroup comparison was done by Mann-Whitney U-test. The intragroup comparison of clinical parameters including modified staining index, the supragingival microbiota such as cocci, bacilli, and spirochetes scores was done at various study intervals using one-way ANOVA, and intergroup comparison was done using Tukey's multiple post hoc test. RESULTS: The results showed that statistically significant correlation between Group II and Group III at 15 and 30 days and between Group I and Group II at 30 days with cocci and bacilli but not spirochetes. CONCLUSION: Group II showed better plaque and gingivitis reduction compared to other active groups. To validate the results of the present study, further long-term studies with larger sample size and evaluation using known and proven study designs on gingivitis patients are needed.

Estimate of CRP and TNF-alpha level before and after periodontal therapy in cardiovascular disease patients.

INTRODUCTION: Epidemiological studies show that individuals with periodontitis have a radically amplified threat to develop cardiovascular disease. CRP& TNF-α, are acute phase proteins monitored as a marker of inflammatory status, which have been identified as a major risk factor for atherosclerotic complications. Elevated CRP & TNF-α level in periodontitis patients have been reported by several groups. The present study was performed to determine whether presence of periodontitis and periodontal therapy could influence the serum levels of CRP & TNF-α in cardiovascular disease patients. METHODS: Forty cardiovascular disease subjects participated in the study. They were classified into two groups. Group A (Control) where no periodontal treatment was given, Group B (Test) where periodontal treatment (scaling & root planing) was performed. Periodontal clinical parameters like OHI-S, probing pocket depth, were evaluated together with serum CRP, TNF-α, at baseline and reassessed after 8 weeks for all the subjects in both the groups. RESULTS: The CRP & TNF-α levels in both the groups decreased but the decrease in the Group A was minimal and was not statistically significant (P > 0.05); whereas in Group B where periodontal therapy was performed, there was statistically significant decrease. CONCLUSION: It can be concluded from the study that there can be a possible causal relationship between pathogenesis of periodontal disease and CVD as inferred from the statistical significant outcome in the form of decreased inflammatory biomarkers after the periodontal treatment.

Oral hygiene and periodontal status of teenagers with special needs in the district of Nalgonda, India.

OBJECTIVES: To assess oral hygiene status, oral hygiene practices and periodontal status among 14-17-year-old visually impaired, deaf and dumb, intellectually disabled and physically challenged and normal teenagers in the district of Nalgonda, South India. MATERIALS AND METHODS: Seven hundred and fifty teenagers in the age group of 14-17 years, constituting visually impaired, deaf and dumb, intellectually disabled, physically challenged and normal teenagers, were studied. Oral hygiene status and periodontal status were assessed using clinical indices and compared. RESULTS: Among the five groups chosen for the study, the intellectually disabled group had the highest plaque scores and poor oral hygiene. The visually impaired and deaf and dumb had better oral hygiene compared with other disability groups. Physically handicapped showed higher loss of attachment scores and deleterious and parafunctional habits. Normal teenagers had good oral hygiene and lower plaque scores. Oral health status relied basically on proper use of oral hygiene aids and training of the groups by their care takers. CONCLUSION: Disabled groups showed poor oral hygiene and higher incidence of periodontal disease, which may be attributed to the lack of coordination, understanding, physical disability or muscular limitations. Hence, more attention needs to be given to the dental needs of these individuals through ultimate, accurate and appropriate prevention, detection and treatment.