GLP-1 Agonists Can Affect Mood: A Case of Worsened Depression on Ozempic (Semaglutide).

Glucagon-like peptide-1 (GLP-1) receptor agonists have garnered significant attention in diabetes management, and they act by mimicking the effects of GLP-1, a hormone that regulates insulin secretion and appetite. While these medications have become increasingly popular, their impact on mood and other psychiatric manifestations remains uncertain because of inconsistent data. It has been shown to affect brain regions involved in emotional regulation. This case report underscores the adverse mood changes possibly linked to semaglutide and the need for further study in this area.

Malignant Tourette's Syndrome in an Adult on Deep Brain Stimulation Presenting With Rhabdomyolysis.

Tourette's syndrome (TS) patients experiencing severe tics and behavioral disturbances can have a rare complication called rhabdomyolysis (RML), which is characterized by the breakdown of muscle tissue. The occurrence of RML poses a significant physical and emotional risk to patients with TS by impacting the quality of life and in some cases causing severe damage. In this case report, we present the first documented case of RML resulting from severe tics in an adult with a diagnosis of TS. The patient exhibited severe tics and self-injurious behaviors that led to elevated creatine kinase and a subsequent diagnosis of RML requiring hospitalization with a complex hospital course. The patient did not have neuroleptic malignant syndrome as his laboratory parameters improved with the decrease in severity of tics. Our case highlights the potential complication of RML because of severe tics independent of neuroleptic drug use in a patient with TS.

Serotonin Syndrome with Monotherapy of Low-Dose Sertraline in an Adult Patient with Autism Spectrum Disorder.

Serotonin syndrome, also known as serotonin toxicity, is associated with increased serotonergic activity in the central and the peripheral nervous system. The symptoms can range from mild to potentially life threatening. Given the widespread use of serotonergic agents, the number of cases is on the rise. It is seen with therapeutic medication use, inadvertent interactions between drugs, and intentional self-poisoning, but still known cases with monotherapy of selective serotonin reuptake inhibitors are uncommon. Another known fact is that elevated whole blood serotonin, or hyperserotonemia, is one of the first biomarkers identified in autism spectrum disorder and is present in more than 25% of affected children. We present a case of a 32-year-old male with a history of autism spectrum disorder and depressive disorder who presented to the emergency department with restless agitation, neuromuscular excitability, and autonomic instability. He had been prescribed sertraline 50 mg which he had taken daily as prescribed for 4 days. On the fourth day, he presented to the emergency department with diffuse muscle stiffness, upper extremity tremors, ocular clonus, and inducible ankle clonus. He was diagnosed with probable serotonin syndrome utilizing Hunter's criteria. Patient's symptoms resolved within 24 hours with intravenous fluids, lorazepam, and discontinuation of sertraline. This case highlights the importance of a high degree of clinical suspicion in patients even on monotherapy of selective serotonin reuptake inhibitors in therapeutic doses, especially in children and adults with autism spectrum disorder. Due to preexisting hyperserotonemia, they may be more susceptible to serotonin syndrome than the general population.

Comparative Evaluation of Platelet-Rich Fibrin versus Connective Tissue Grafting in Treatment of Gingival Recession Using Pouch and Tunnel Technique: A Randomized Clinical Study.

Aims: The aim of the study was to compare the clinical efficacy of platelet-rich fibrin (PRF) and connective tissue grafting in the treatment of gingival recession (GR) using pouch and tunnel (P and T) technique. Materials and Methods: A total of 40 Class I or Class II GR defects in 17 patients were randomized treated with P and T with PRF (Group I, n = 20) and P and T with CTG (Group II, n = 20). The parameters measured were plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), horizontal gingival recession (HGR), vertical gingival recession (VGR), width of attached gingiva (WAG), width of keratinised gingiva (WKG), gingival thickness-mid buccal (GTMB), and gingival thickness interdental papilla (GTIP). Postsurgical discomfort level (PSDL), hypersensitivity score (HS), and patient esthetic score (PES) were recorded using visual analog scale (VAS). The PI, GI, PPD, CAL, HGR, VGR, WAG, WKG, GTMB, and GTIP were assessed at pretreatment (baseline) and 1-, 3-, and 6-month posttreatment. The PSDL, HS, and PES were assessed at baseline, day 10, 1, 3, and 6-month posttreatment. Results: P and T with PRF and CTG resulted in root coverage of 73.75% ± 7.80% and 70.83% ±8.26%, respectively. Patient response and acceptance for the surgical treatment modality showed less discomfort and better esthetics in Group I as compared to Group II. Conclusions: PRF treated sites were comparable to the gold standard CTG with better patient acceptance and a lesser invasive approach in terms of graft procurement.

Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser.

BACKGROUND: Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient's overall clinical diabetic management. OBJECTIVE: To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis. MATERIALS AND METHODOLOGY: After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-µm fiber optic delivery system. RESULTS: Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05). CONCLUSION: Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.

Prevalence of Periodontal Disease in Type 2 Diabetes Mellitus Patients: A Cross-sectional Study.

AIM: The aim of this study was to determine the prevalence of periodontal disease in type 2 diabetes mellitus (T2DM) patients of North India. MATERIALS AND METHODS: A total of 500 patients fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic characteristics, attitude for oral hygiene, and disease status. Based on eligibility 427 patients were finally recruited for statistical analysis. A partial-mouth periodontal examination (PMPE) protocol which assessed one maxillary quadrant and one mandibular quadrant was used to examine three fixed sites per tooth (mesiobuccal, midbuccal, and distobuccal). Gingival Index, Oral Hygiene Index-Simplified, Debris Index-Simplified, Calculus Index-Simplified (CI-S), probing pocket depth, and clinical attachment level were examined. RESULTS: More than 90% (95.1%) of the total diabetic participants had some degree of periodontal destruction. Of the total population, 27.1% of participants had good oral hygiene, 68.8% had fair oral hygiene, and 3.9% had poor oral hygiene status. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status was reported as 0.8%, 17%, and 29.4%, respectively. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status with poor glycemic control (glycated hemoglobin ≥8%) was 2.5%, 28.1%, and 30.7%, respectively. CONCLUSION: This single-centered cross-sectional study represents that more than 95% of type 2 diabetic patients have some periodontal destruction. These results may act as baseline data to promote the collaborative integrated management of diabetes for reducing its burden on society.

Efficacy of Platelet-rich Fibrin in Interdental Papilla Reconstruction as Compared to Connective Tissue Using Microsurgical Approach.

AIM: This study aims to evaluate autologous platelet-rich fibrin (PRF) and autogenous connective tissue graft (CTG) in interdental papilla (IDP) reconstruction with buccal and palatal split-thickness flap (STF) using microsurgical technique. MATERIALS AND METHODS: Forty Class I or Class II open gingival or cervical embrasure in maxillary anterior region in 14 patients were surgical treated for the reconstruction of IDP. For experimental Group I (STF with PRF, n = 20), surgical site was flushed with PRF fluid. PRF was then placed under the buccal flap and in the IDP region and squeezed. For experimental Group II (STF with CTG, n = 20) after the preparation of recipient site, CTG procured from palate was trimmed to the desired size and shape and placed at the site. Clinical parameters and patient satisfaction response recorded were plaque index, gingival index, probing pocket depth, clinical attachment level, height of IPD, and papilla index score (PIS). RESULTS: STF surgery in combination with PRF or CTG, are an effective procedure to increase IDP-height with mean values of 3.10 mm (87.3%) and 3.45 mm (95.8%) for Group I (STF + PRF) and Group II (STF + CTG), respectively. In terms of complete fill (CF) achieved at 3 months, in the present study, the result showed that 90% CF was obtained in Group I (STF + PRF) and 95% in Group II (STF + CTG). The patient response and acceptance for surgical treatment modality in terms of patient postsurgical discomfort score and patient esthetic score was higher for Group II (STF + CTG) than Group I (STF + PRF). CONCLUSION: Based on single-centered 3 months' follow-up, it may be concluded that STF surgery in combination with PRF or CTG is an effective procedure to increase IDP-height; however, a long-term multicentric randomized clinical trial may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG with STF.

Evaluation of peri-implant tissues around nanopore surface implants with or without platelet rich fibrin: a clinico-radiographic study.

OBJECTIVE: To comparatively evaluate peri-implant tissue changes around the nano-pore implant surface with or without platelet rich fibrin (PRF). MATERIAL AND METHODS: For the present study, a total of 17 patients was initially enrolled (6 females, 11 males), and 38 sites (19 control and 19 experimental sites) were randomly assigned to either group 1 (control), i.e. extraction site received immediate implants without any PRF, and group 2 (experimental), i.e. extraction sites received immediate implants with PRF. Clinical and radiographic parameters were recorded for 9 months after the implant-loading phase. RESULTS: Clinically, there was a significant (p < 0.001) increase in the peri-implant probing depth from the prosthetic phase up to 9 months in both the groups, and the increase was greater in the control group. However, the mean difference in the changes between the two groups was non-significant. The modified gingiva index for group 2 was significantly lower than that for group 1 in the prosthetic phase. Radiographically, in the control group and experimental group, there was a significant increase (<0.01) in bone loss (BL) in the mesial and distal aspect of the implant from the surgical to prosthetic phase, surgical up to 9 months and from the prosthetic phase up to 9 months. There was greater BL in the control group than in the experimental group in both the mesial and distal aspect of the implant; however the difference in BL was non-significant (<0.01). There was greater BL in the distal aspect than in the mesial aspect in both groups; however, the difference in BL was non-significant. CONCLUSION: PRF treatment may provide a way to prevent BL during the surgical-to-prosthetic phase. These results were based on a short-term, low sample randomized clinical study, therefore a long-term study with more sites and homogenous sampling is recommended.

Patient-centered Microsurgical Management of Gingival Recession using Coronally Advanced Flap with Either Platelet-rich Fibrin or Connective Tissue Graft: A Comparative Analysis.

PURPOSE: To evaluate autologous platelet-rich fibrin (PRF) and autogenous connective tissue graft (CTG) in gingival recession defects in conjunction with coronally advanced flap (CAF) using a microsurgical technique. MATERIALS AND METHODS: Forty-five Class I and II recession defects were randomly equally (n = 15) divided into three groups: Group I sites treated with CAF with PRF, Group II sites treated with CAF with CTG, and Group III sites treated with CAF alone using microsurgical approach. Parameters recorded were vertical gingival recession (VGR) and horizontal gingival recession (HGR), % complete root coverage (CRC), patient comfort score (PCS), patient esthetic score (PES), and hypersensitivity score (HS) at 10 days, 3 months, and 6 months. RESULTS: CAF surgery alone and in combination with PRF or CTG are effective procedures to cover denuded roots with mean VGR values of 1.26 ± 0.70 mm (74.4%), 1.26 ± 0.59 mm (58%), and 1.06 ± 0.79 mm (53.3%) for Groups I, II, and III, respectively. In terms of CRC achieved at 6 months, results showed that 100% CRC was obtained in 60% sites of Group I, 20% sites of Group II, and 27% sites of Group III. Patient response and acceptance for surgical treatment modality in terms of PCS and PES were highest for Group I (PRF and CAF) followed by Group III and Group II, and there was decrease in HS for Group I (PRF and CAF) while no significant changes in HS were observed for Group II and Group III. At the end of 6 months follow-up, there was a significant increase in gingival thickness measurements using transgingival probing in Group II, whereas nonsignificant changes were observed in Group I and Group III. CONCLUSIONS: A long-term multicenter randomized controlled clinical study may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG and CAF alone.

Central granular cell odontogenic tumor: Report of an unusual case.

Central granular cell odontogenic tumor (CGCOT) is an unusual benign odontogenic neoplasm characterized by the presence of granular cells associated with apparently inactive odontogenic epithelium. These tumors tend to occur in the posterior mandible and usually present as well-defined unilocular or multilocular radiolucent lesions. So far, only <40 cases of CGCOT have been described in the literature under various terminologies. Though these tumors were not considered as distinct entity in the recent WHO classification of odontogenic tumors, long-term follow-up is recommended as malignant counterpart of CGCOT has already been reported. The main aim of this article is to report an additional case of CGCOT to the literature, occurring in a 73-year-old male.

Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study.

OBJECTIVES: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (ß-TCP-Cl) in preserving extraction sockets. MATERIALS AND METHODS: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (ß-TCP-Cl), residual sockets (n = 15) were filled with ß-TCP-Cl. For the sockets randomly selected for Group II (ß-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. RESULTS: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (ß-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (ß-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (ß-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (ß-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (ß-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. CONCLUSION: The use of either autologous PRF or ß-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to ß-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.

Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis.

OBJECTIVE: To evaluate the efficacy of coronally advanced flap (CAF) procedure under microsurgical approach for the management of Miller's Class I and II gingival recession defects with the use of either platelet-rich fibrin (PRF) or amnion membrane (AM) in comparison to CAF alone. MATERIALS AND METHODS: A total of 45 sites with Miller's Class I or II gingival recession defect were randomly distributed for: Experimental Group I (CAF with PRF) sites (n = 15) which were treated with the microsurgical approach using CAF along with PRF; experimental Group II (CAF with AM) sites (n = 15) were treated with the microsurgical approach using CAF along with AM; control Group III (CAF alone) sites (n = 15) were treated with the microsurgical approach using CAF alone. Vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT) (using transgingival probing [TGP] and ultrasonography [USG]) and patients' response and acceptance were documented at baseline, 3 months and 6 months after surgical interventions. RESULTS: CAF alone and in combination with PRF or AM, were effective techniques for root coverage with average VGR values of 1.47 ± 0.92 mm (56%), 0.67 ± 1.23 mm (36%) and 0.60 ± 1.06 mm (33%) in Group I (CAF with PRF), Group II (CAF with AM), and Group III (CAF alone), respectively. Complete coverage (100%) was obtained in 33.3% sites of Group I (CAF with PRF), 26.6% sites of Group II (CAF with AM) and 13.3% in Group III (CAF alone). Patients' response and acceptance for surgical treatment modality in terms of patient esthetic score and decrease in hypersensitivity score was highest for Group I (CAF with PRF), whereas patient comfort score was highest for Group II (CAF with AM). At 6 months follow-up, significant increase in GT measurements (using TGP and USG) in Group I (CAF with PRF), whereas, nonsignificant increase for Group II (CAF with AM) and no change or decrease for Group III (CAF alone) as compared to baseline was observed. CONCLUSION: The present study observed enhancement in root coverage when PRF or AM are used in conjunction with CAF as compared to CAF alone. These results are based on 6-month follow-up. Therefore, the long-term evaluation may be necessary to appreciate the clinical effect of autologous PRF and AM.

Comparative evaluation of platelet-rich fibrin versus beta-tri-calcium phosphate in the treatment of Grade II mandibular furcation defects using cone-beam computed tomography.

OBJECTIVE: The objective of the study was to evaluate clinically and radiographically the efficacy of platelet-rich fibrin (PRF) versus ß-tri-calcium phosphate (ß-TCP) in the treatment of Grade II mandibular furcation defects. MATERIALS AND METHODS: Forty-five Grade II furcation defect in mandibular molars which were assigned to open flap debridement (OFD) with PRF Group I (n = 15), to OFD with ß-TCP Group II (n = 15), and to OFD alone Group III (n = 15) were analyzed for clinical parameters (probing pocket depth [PPD], vertical clinical attachment level [VCAL], horizontal clinical attachment level [HCAL], gingival recession, relative vertical height of furcation [r-VHF], and relative horizontal depth of furcation [r-HDF]) and radiographical parameters (horizontal depth of furcation [H-DOF], vertical height of furcation [V-HOF]) using cone-beam computed tomography (CBCT) at 6 months interval. RESULTS: For clinical parameters, reduction in PPD and gain in VCAL and HCAL were higher in Group II as compared to Group I. Change in r-VHF and r-HDF was greater in Group II as compared to Group I. Mean percentage clinical vertical defect fill was higher in Group II as compared to Group I (58.52% ± 11.68% vs. 53.24% ± 13.22%, respectively). On CBCT, mean change at 6 months for all parameters showed nonsignificant difference between the two experimental groups. Mean change in V-HOF was higher in Group I as compared to Group II, but mean change in H-DOF and furcation width was more in Group II as compared to Group I. CONCLUSION: For both experimental and control groups, there was statistically significant improvement at 6 months follow-up from baseline values.

Evaluation of cell proliferation in malignant and potentially malignant oral lesions.

AIMS: To evaluate the cell proliferation rate by the expression of proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizing region (AgNOR) counts and to assess its usefulness as a marker for malignant potential in oral epithelial lesions. MATERIALS AND METHODS: The study group included 30 cases of leukoplakia, 15 nondysplastic (NDL), 15 dysplastic (DL), 15 cases of oral squamous cell carcinoma (OSCC) and 5 cases of normal oral mucosa. Formalin fixed paraffin embedded tissues were subjected to immunohistochemical staining for PCNA and AgNOR technique. The PCNA labeling index (LI) and the AgNOR dots were evaluated for the entire sample. STATISTICAL ANALYSIS USED: ANOVA, Tukey honestly significant difference, Pearson's correlation. RESULTS: In this study, the AgNOR count of OSCC was lower than the DL lesions moreover the AgNOR counts were found to be higher in normal mucosa as compared to the DL and the NDL epithelium. The study results also showed that the mean AgNOR count failed to distinguish between DL and NDL lesions. Overall we observed increased PCNA expression from normal epithelium to NDL to DL lesion. CONCLUSIONS: Based on the findings of the present study on oral epithelial precancerous and cancerous lesions we conclude that mean AgNOR count alone cannot be a valuable parameter to distinguish between the normal, NDL, DL epithelium and OSCC but, on the other hand, we found out that PCNA can be a useful biomarker for delineating normal epithelium from DL epithelium and OSCC.

Age of onset of dependence: Does it help our understanding of opioid dependence by generating meaningful categories or by acting as a useful dimension? A critical examination of the classic debate in psychiatry.

BACKGROUND: Category vs. dimension is a classic debate in psychiatry. Applying age of onset of dependence (AOOD) to categorize opioid dependence into early- (EO) and late-onset (LO) types provides a unique opportunity to critically examine this debate. AIM: To study if EO and LO subjects differ significantly on 'validating variables' from five explanatory domains: Clinical (severity), genetic (family history), psychological (sensation-seeking and impulsivity), neuropsychological (attention-concentration and executive functions), and neurophysiological (P300-evoked response potential). MATERIALS AND METHODS: In a cross-sectional design, 60 ICD-10 DCR-diagnosed opioid-dependent male subjects (30 with AOOD≤20 years and 30 with AOOD≥22 years) comprised the two index groups (EO and LO, respectively), with their respective age-matched control groups (EOC and LOC). They were administered an extensive battery of instruments and tests based on the above domains. RESULTS: The two groups differed significantly on only three out of nearly 30 variables tested. However, there emerged a clear and consistent pattern of continuum of scores across the groups and across all the variables: The EO subjects were the most impaired or affected, the LO subjects were intermediate, and the control groups fared the best. Further, nine test variables correlated significantly and meaningfully with AOOD when the dichotomy was abolished and the sample was combined into one. CONCLUSIONS: These results suggest that, in this particular case, the variable AOOD is more meaningful when it is used as a dimension rather than for generating categories perforce.

Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus.

PURPOSE: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). METHODS: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ≥200 mg/dL and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. RESULTS: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. CONCLUSIONS: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

Analysis of socket preservation using polylactide and polyglycolide (PLA-PGA) sponge: a clinical, radiographic, and histologic study.

The aim of this study was to evaluate the extraction socket healing and dimensional changes following alveolar ridge preservation using polylactide and polyglycolide (PLA-PGA) sponge. Fifteen patients were selected for alveolar socket preservation immediately following tooth extraction. Monoradicular maxillary and mandibular teeth were evaluated. The selected sockets had intact sockets walls with a minimum of 7 mm of residual alveolar bone height. The test sites were thoroughly debrided and grafted with PLA-PGA sponge, while the control sites underwent natural healing. Computed tomography (CT) measurements were taken at baseline and 6 months. After 6 months of healing, final CT measurements were performed, and trephine core biopsy specimens were obtained for histologic analysis. Implants were placed immediately after biopsy harvesting. All subjects completed the study, and all sites healed without adverse events and allowed for implant placement. The mean difference in socket height, width, and density after 6 months was statistically significantly higher in the test sites compared with control sites. Clinical measurement at the midbuccal site of the alveolar socket showed a mean loss of 2.45 ± 0.67 mm in the control group, compared with a mean gain of 1.28 ± 0.58 mm in the test group. All test sites showed minimal ridge alterations, and statistically significant differences were observed between the test and control sites with respect to bone composition and horizontal and vertical bone loss, indicating that PLA-PGA sponge is suitable for alveolar ridge preservation.

Efficacy of platelet-rich fibrin vs. enamel matrix derivative in the treatment of periodontal intrabony defects: a clinical and cone beam computed tomography study.

OBJECTIVE: To evaluate and compare the efficacy of platelet-rich fibrin (PRF) with enamel matrix derivative (EMD; Emdogain) in the treatment of periodontal intrabony defects in patients with chronic periodontitis, six months after surgery. METHODS: Forty-four (44) intrabony defects in 30 patients (15 males) were randomly allocated into two treatment groups: EMD (n = 22) and PRF (n = 22). Measurement of the defects was done using clinical and cone beam computed tomography at baseline and 6 months. Clinical and radiographic parameters such as probing depth, clinical attachment level, intrabony defect depth and defect angle, were recorded at baseline and 6 months post-operatively. Within group change was evaluated using the Wilcoxon signed rank test. Intergroup comparisons were made using the Mann-Whitney U test. RESULTS: Postsurgical measurements revealed that there was an equal reduction in probing depth and a greater but statistically non-significant attachment gain for the Emdogain group when compared to the platelet-rich fibrin group. The Emdogain group presented with significantly greater percentage defect resolution (43.07% ± 12.21) than did the platelet-rich fibrin group (32.41% ± 14.61). Post-operatively the changes in defect width and defect angle were significant in both groups, but upon intergroup comparison they were found to be statistically non-significantly different. CONCLUSION: Both Emdogain and platelet-rich fibrin were effective in the regeneration of intrabony defects. Emdogain was significantly superior in terms of percentage defect resolution.