ABSTRACT
Background: Periodontal disease, characterized by inflammation and infection of the supporting structures of teeth, poses a significant oral health challenge. Traditional periodontal surgery and non-surgical therapy, such as scaling and root planing, are established treatment approaches for addressing periodontal disease. Materials and Methods: The study enrolled 120 adult patients diagnosed with moderate to severe periodontal disease. Participants were randomly allocated to one of two groups: the traditional surgery group (TSG) or the non-surgical therapy group (NSTG). In the TSG, patients underwent traditional periodontal surgery, which included flap surgery and grafts when deemed necessary. The surgical procedures were performed by experienced periodontal surgeons. In contrast, the NSTG received non-surgical therapy in the form of scaling and root planing administered by trained dental hygienists. Outcome measures encompassed clinical parameters and patient-centered outcomes. Periodontal pocket depth and clinical attachment level, both measured in millimeters, were assessed at baseline, 3 months, and 6 months. Patient-reported outcomes, including pain, discomfort, and satisfaction, were collected through standardized questionnaires at each follow-up visit. Results: Patients in the TSG experienced a notable reduction in pocket depth from a baseline of 6.8 mm to 3.7 mm at the 6-month mark, resulting in a change of -3.1 mm. Conversely, the NSTG exhibited a reduction from 6.7 mm to 4.0 mm, with a change of -2.7 mm. In the TSG, the baseline attachment level of 7.2 mm decreased to 5.1 mm at 6 months, indicating a change of -2.1 mm. In the NSTG, the attachment level decreased from 7.1 mm to 5.5 mm, resulting in a change of -1.6 mm. Patients in the TSG reported an average pain score of 3.6 on a 1-10 scale, discomfort of 4.2, and satisfaction of 7.8. In contrast, patients in the NSTG reported lower pain (2.1) and discomfort (2.9) scores but similar satisfaction levels (8.4). Conclusion: In this randomized controlled trial (RCT), both traditional periodontal surgery and non-surgical therapy demonstrated improvements in clinical parameters and patient-reported outcomes. Traditional surgery resulted in greater reductions in periodontal pocket depth and clinical attachment loss at the 6-month follow-up.
ABSTRACT
The aim of the present report was to discuss a unique case of gingival plasma cell granuloma (PCG) in a hypertensive patient on Amlodipine therapy. Also, we attempt to emphasize the importance of considering primary and advance investigations before making a definite diagnosis. PCG is an extremely rare, reactive, non-neoplastic lesion characterized by the predominance of polyclonal plasma cells. Drug-induced gingival overgrowth is a known side effect of Amlodipine. A hypertensive 60-year-old female patient reported with a chief complaint of swollen gums and discomfort in the upper front teeth region. A provisional diagnosis of Amlodipine-induced gingival overgrowth, combined gingival overgrowth, and fibroma was suggested. Surprisingly, histopathology revealed it to be a plasma cell lesion which was confirmed by advanced investigations, thereby establishing a confirmatory diagnosis of PCG.
ABSTRACT
Peripheral ossifying fibroma (POF) represents a non-neoplastic, reactive lesion of gingiva. The precise etiopathogenesis of POF is unclear; however, it is suggested to originate from the connective tissue of periodontal ligament. This lesion predominantly occurs in the maxillary anterior region. The standard treatment protocol involves surgical excision followed by the biopsy of lesion. The reactive nature and unpredictable course attribute to a high recurrence rate of the lesion; hence, proper postoperative monitoring and follow-up of the lesion are necessary. The present case was surgically managed using diode laser and did not show any sign of recurrence during the follow-up period of 6 months. Minimum intraoperative bleeding and postoperative pain, ease of operation, and patient's acceptance enable laser-assisted growth excision as a better treatment modality to other conventional surgical procedures, thus offering diode laser as a viable and effective treatment alternative in the management of massive overgrowth.
ABSTRACT
Acute myeloid leukemia (AML) is a malignant neoplasm of myeloid series defined by the presence of immature blast cells (>30%) in peripheral circulation. Oral manifestations are the potential indicators of systemic health and disease. Oral cavity is the frequently and early involved sites in AML. Gingival overgrowth due to leukemia is one such condition encountered by periodontists. Hence, understanding, identifying, and correlating oral manifestations with systemic diseases are the ultimate responsibility of every dental clinician because of its lethal and unpredictable course. In the present case, we are discussing an undiagnosed case of AML who presented to us with oral complaints.
ABSTRACT
BACKGROUND: Maternal micronutrient deficiencies are commonly associated with clinical indicators of placental dysfunction. OBJECTIVE: We tested the hypothesis that periconceptional multiple-micronutrient supplementation (MMS) affects placental function. DESIGN: We conducted a double-blind, randomized, placebo-controlled trial of MMS in 17- to 45-y-old Gambian women who were menstruating regularly and within the previous 3 mo. Eligible subjects were pre-randomly assigned to supplementation with the UNICEF/WHO/United Nations University multiple micronutrient preparation (UNIMMAP) or placebo on recruitment and until they reached their first antenatal check-up or for 1 y if they failed to conceive. Primary outcome measures were midgestational indexes of utero-placental vascular-endothelial function [ratio of plasminogen-activator inhibitor (PAI) 1 to PAI-2 and mean uterine-artery resistance index (UtARI)] and placental active transport capacity at delivery [fetal to maternal measles antibody (MMA) ratio]. RESULTS: We recruited 1156 women who yielded 415 pregnancies, of which 376 met all of the inclusion criteria. With adjustment for gestational age at sampling, there were no differences in PAI-1 to PAI-2 or MMA ratios between trial arms, but there was a 0.02-unit reduction in UtARI between 18 and 32 wk of gestation (95% CI: -0.03, -0.00; P = 0.040) in women taking UNIMMAP. CONCLUSIONS: Placental vascular function was modifiable by periconceptional micronutrient supplementation. However, the effect was small and supplementation did not further affect other variables of placental function. This trial was registered at www.controlled-trials.com as ISRCTN 13687662.
