Comparative evaluation of 2% turmeric extract with nanocarrier and 1% chlorhexidine gel as an adjunct to scaling and root planing in patients with chronic periodontitis: A pilot randomized controlled clinical trial.

CONTEXT: Nanoparticles, owing to their smaller size, penetrate regions inaccessible to other delivery systems, such as periodontal pockets. Thus, the present study aimed to comparatively evaluate efficacy of 2% curcumin with nanocarrier and 1% chlorhexidine gel as a local drug delivery (LDD) in the treatment of periodontal pockets. MATERIALS AND METHODS: Forty-five chronic periodontitis patients with pocket depth 5-7 mm in two or more teeth were selected. Full-mouth scaling and root planing (SRP) was done for all patients followed by random allocation to the three treatment groups, namely SRP group (Group 1), 2% curcumin with nanogel (Group 2), and 1% chlorhexidine gel (Group 3). Clinical parameter assessment and microbiological analysis of subgingival plaque samples for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was done at baseline, 21st day, and 45th day. RESULTS: The results showed that when the two LDD agents were used as an adjunct to SRP in chronic periodontitis, there was an improvement in all clinical parameters. Evaluation of microbiological parameters also showed a significant reduction in Aa, Pg, and Tf levels. Comparison of 2% turmeric extract with a nanocarrier system with 1% chlorhexidine gel showed that both the agents had a comparable antibacterial effect on the three selected periodontopathic bacteria. CONCLUSION: The present study showed that both the LDD agents showed an effective improvement of clinical and microbiologic parameters. 2% curcumin delivered with a nanocarrier system showed results comparable to chlorhexidine gel and hence shows promising future as an LDD agent in the treatment of periodontal pockets.

Comparative clinical evaluation of glycosylated haemoglobin level in healthy and chronic periodontitis patients: A chairside diagnostic method.

OBJECTIVE AND BACKGROUND: Glycosylated haemoglobin (HbA1c) level can consequently be interpreted as an average of the blood glucose present over the past 3-4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. MATERIALS AND METHODS: A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW+® Bayer Health Care, Tarrytown New York, USA), for estimating level of HbA1c. RESULT: Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test--5.66 ± 0.35%, control--5.17 ± 0.3% P = 0.003). CONCLUSION: Indians are at a high-risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.

Evaluation of Sealing Ability of Biodentine as Retrograde Filling Material by Using two Different Manipulation Methods: An In Vitro Study.

BACKGROUND: The study was aimed to evaluate the microleakage of Biodentine using two different manipulation methods by dye penetration. MATERIALS AND METHODS: A total of 60 single-rooted human maxillary permanent teeth were cleaned and obturated with gutta-percha using lateral condensation method. Standardized root-end cavities were prepared after apical resection. All teeth were divided randomly into two groups of 30 specimens and were filled with Biodentine by trituration and hand manipulation methods. The samples were coated with varnish and immersed in 1% methylene blue dye for 72 h. Then the teeth were sectioned longitudinally and observed under a stereomicroscope. The depth of dye penetration was measured in millimeters. RESULTS: There was highly statistical significant difference observed between Group I and Group II (P < 0.001) when dye penetration scores were compared. CONCLUSION: More microleakage was seen when Biodentine was manually manipulated as compared to machine trituration.

Comparative evaluation of sealing ability of four different restorative materials used as coronal sealants: an in vitro study.

BACKGROUND: The purpose of the present study was to evaluate and compare the sealing ability of glass ionomer cement (GIC), composite resin, gray mineral trioxide aggregate (GMTA) and white mineral trioxide aggregate (WMTA) when placed coronally as double - sealing material over gutta-percha in root canal treated teeth. MATERIALS AND METHODS: A sample of 70 freshly extracted human single rooted teeth were cleaned, shaped and obturated with gutta-percha and AH Plus. The gutta-percha was reduced to a depth of 4 mm from the cemento enamel junction using hot plugger and standardized access cavities with 4 mm depth were prepared at the coronal ends of the roots. The specimens were randomly divided into four groups containing 15 teeth each depending on the restorations they received in the coronal cavity. A positive control group of five teeth received no restorative barrier over gutta-percha. All root surfaces were covered with two coats of nail varnish, leaving only the access openings uncovered except teeth in the negative control group, which were completely covered with nail varnish. All teeth were immersed in India ink, cleared and observed under stereomicroscope for the depth of dye penetration. RESULTS: The results were tabulated and analyzed using Kruskal-Wallis test and multiple comparison between each group was carried out using Mann-Whitney test. The groups sealed with GMTA and WMTA showed least dye penetration than other groups and the difference was statistically significant. Highest dye penetration was seen with groups sealed with GIC and was statistically significant compared with other three groups. CONCLUSION: The results showed that the GMTA and WMTA provided significantly better coronal seal when compared to other two restorations. The composite resin also showed significantly better seal than the unsealed group and the group sealed GIC, which showed highest leakage that was equivalent to that of unsealed group.

Clinical and radiographic evaluation of regenerative potential of GTR membrane (Biomesh®) along with alloplastic bone graft (Biograft®) in the treatment of periodontal intrabony defects.

BACKGROUND AND OBJECTIVES: The primary goal of periodontal therapy is to restore the tooth supporting tissues lost due to periodontal disease. The aim of the present study was to compare the efficacy of combination of GTR membrane and alloplastc bone graft with open flap debridement (OFD) in treatment of periodontal intrabony defects. METHODS: Twenty paired intrabony defects were surgically treated using split mouth design. The defects were randomly assigned to treatment with OFD, GTR membrane+bone graft (test) or OFD alone (control). The clinical efficacy of two treatment modalities was evaluated at 6 months postoperatively by clinical, radiographical parameters. The measurements included probing pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), bone fill (BF), bone density (BD). RESULTS: The mean reduction in PD at 0 to 6 months was 3.20±0.82 mm and CAL gain of 3.10±1.51 mm occurred in the GTR membrane+bone graft (test) group; corresponding values for OFD (control) were 2.10±0.63 mm and 1.90±0.57 mm. Similar pattern of improvement was observed when radiographically postoperative evaluation was made. All improvement in different parameters was statistically significant (p<0.01). CONCLUSION: Treatment with a combination of collagen membrane and bone graft led to a significantly more favorable clinical outcome in intrabony defects as compared to open flap debridement alone.