Free haem levels in gingival crevicular fluid and their relationship to periodontal clinical parameters, smoking and subgingival microbial composition.

BACKGROUND AND OBJECTIVES: Periodontitis caused by multifactorial polymicrobial infection results in a destructive inflammatory process and loss of tooth supporting tissues. Many putative bacterial virulence factors that cause host destruction are regulated by iron and haem. Therefore, this study investigated the free haem levels in the gingival crevicular fluid (GCF) at periodontitis sites in smokers and nonsmokers and their relationship to subgingival microbial composition. MATERIALS AND METHODS: A cross-sectional study was carried out on 78 patients with a split-mouth design who were divided into Group I A - periodontally healthy sites and Group I B - periodontally diseased sites in nonsmokers with chronic periodontitis and Group II A - periodontally healthy sites and Group II B - periodontally diseased sites in smokers. Clinical parameters recorded included a plaque and gingival index, papillary bleeding index, pocket probing depth, and clinical attachment level. The collected GCF samples were subjected to Biovision™ Hemin Colorimetric Assay Kit and subgingival plaque samples to BANA™ test. RESULTS: Increased GCF free haem concentration and positive BANA sites were seen at periodontitis sites compared to healthy sites, in both smokers and nonsmokers group. However, no difference was found in GCF free haem levels between smokers and nonsmokers, but it was statistically significant with respect to BANA-positive sites. CONCLUSION: Thus, this study concludes that the higher concentration of GCF free haem at diseased sites indicates that it could be used as a potential biomarker to determine active periodontal sites, also smoking and BANA results did not influence the biomarker levels.

A Three-Dimensional Finite Element Analysis of Aramany Class I Obturator Fabricated with Different Alloys.

AIM: The aim of the research was to develop a model that accurately represents an Aramany class I defect and its obturator prostheses fabricated with cobalt-chromium alloy and titanium alloy to compare the deflection and the stress distribution in the rehabilitated area. MATERIALS AND METHODS: Aramany class I defect and the obturator prostheses were generated geometrically using ANSYS 14.5; both were superimposed on each other to mimic the prostheses and the maxilla as one unit. Meshing of models was carried out using hypermesh software and materialistic properties were assigned. The 120 newton load was constituted on the teeth in different directions. STATISTICAL ANALYSIS USED: Statistical analysis of Finite element was not possible. Self-explanatory decoding results in the software were used. RESULTS: The stress distribution and deflection executed by ANSYS provided results that enabled the tracing of Von Mises stress and deflection field in the form of color-coded bands with values in mega pascal. CONCLUSIONS: The study shows that Von Mises stresses are higher for the frame work fabricated with cobalt-chromium alloy compared to titanium alloy. The framework made of titanium alloy showed more deflection than cobalt-chromium alloy.

Socket Shield: A Case Report.

It is fairly common to remove a severely compromised tooth and provide rehabilitation by means of an implant. Resorption of alveolar bone after extraction resulting in loss of bone height and width is an unpleasant sequelae causing difficulty in implant placement. Few procedures have been promoted to attain the required bone height and width, such as guided bone regeneration socket preservation with the use of various graft materials and barrier membranes. The disadvantages of these techniques are some amount of ridge height loss and loss of buccal/facial, ridge contour. The socket shield technique is a new method where a buccal segment of root is retained as a shield, which aids in retaining periodontal ligament on buccofacial aspect. The implant is placed (immediate placement) lingual to this shield. This maintains the alveolar ridge height and buccofacial contour, thus providing superior aesthetics. This case report shows placement of an implant in upper anterior region using this technique.

Bioactive glass versus autologous platelet-rich fibrin for treating periodontal intrabony defects: A comparative clinical study.

BACKGROUND: To compare treatment modalities: Open flap debridement (OFD) alone (Group I), OFD in combination with PerioGlas® (Group II), and OFD in combination with autologous platelet-rich fibrin (PRF) (Group III) for periodontal intrabony defects (IBDs). AIM: To evaluate on clinical and radiographic basis, effectiveness of PerioGlas®, and PRF in treating IBDs. SETTINGS AND DESIGN: IBDs selected on the basis of the inclusion criteria were randomly assigned to Groups I, II, and III by coin toss method. MATERIALS AND METHODS: The study was conducted on patients reporting to the department of periodontology and oral implantology. Thirty-eight patients with ninety periodontal IBDs of moderate to severe periodontitis were selected and assigned to Groups I, II, and III. In each patient, a minimum number of two sextants were present with pocket depths ≥5 mm in at least three teeth. STATISTICAL ANALYSIS: Statistical analysis based on mean values, standard deviation, and P values. RESULTS: Compared to baseline, 9 months postoperatively: (1) mean probing pocket depth reduction for Group I was 3.68 mm ± 0.72, for Group II was 5.57 mm ± 1.10, and for Group III was 6.11 mm ± 0.92. (2) The mean relative attachment level gain for Group I was 4.14 mm ± 0.76, for Group II was 6.57 mm ± 1.45, and for Group III was 6.74 mm ± 1.55. (3) Mean radiographic IBD fill for Group I was 69.29% mm ± 7.73, for Group II was 74.44% mm ± 8.57, and for Group III was 75.01% mm ± 7.85. CONCLUSION: This study shows marked improvements in the clinical parameters and radiographic outcomes with both PerioGlas® and autologous PRF to treat periodontal IBDs as compared to OFD alone.

Microbial contamination of contact lenses after scaling and root planing using ultrasonic scalers with and without protective eyewear: A clinical and microbiological study.

BACKGROUND: Ultrasonic scaler is a preferential treatment modality among the clinicians. However, the aerosol/splatter generated is a concern for patients and practitioners. Therefore, the purpose of this study was to evaluate contamination of contact lenses of the dentist after scaling and root planing using ultrasonic scalers with and without protective eyewear. MATERIALS AND METHODS: Thirty patients were randomly selected for scaling and root planing and divided into 2 groups of 15 each. Group A - dentist wearing contact lenses and protective eyewear. Group B - dentist wearing only contact lenses. After scaling and root planing using ultrasonic scalers, the lenses were subjected to culture and 16S rRNA (16S ribosomal RNA) gene sequencing. RESULTS: In Group A - 15 out of thirty samples were contaminated, in Group B - all the thirty samples were contaminated. Most of the samples showed Gram-positive bacteria and 5 samples were contaminated with fungi. 16S rRNA gene sequencing of forty contaminated samples showed that 31 were contaminated with Streptococcus mutans and 9 with Staphylococcus aureus. CONCLUSION: Keeping in mind the limitation of the study for the absence of negative control, we would like to conclude that dental practitioners should better avoid contact lenses in a dental setup because of the risk of contamination of the contact lenses from the various dental procedures which can produce aerosol/splatter and if worn, it is recommended to wear protective eyewear.

Treatment of multiple gingival recessions with vista technique: A case series.

Gingival recession is a common manifestation in most populations. Gingival recession is clinically manifested by an apical displacement of the gingival tissues, leading to root surface exposure. Gingival recession may be a concern for patients for a number of reasons such as root hypersensitivity, erosion, root caries, and esthetics (Wennstrom 1996). Recently, new techniques have been suggested for the surgical treatment of multiple adjacent recession type defects. These are mainly derived from the coronally advanced flap, a supraperiosteal envelope technique in combination with a subepithelial connective tissue graft, or its evolution as a tunnel technique. The current case reports introduce a novel, minimally invasive approach applicable for both isolated recession defects as well as multiple contiguous defects in the maxillary anterior region. Access to the surgical site is obtained by means of an approach referred to as vestibular incision subperiosteal tunnel access.

A rare case of primary orofacial granulomatosis of gingiva during pregnancy.

Orofacial granulomatosis (OFG) comprises a group of diseases characterized by noncaseating granulomatous inflammation affecting the soft tissues of the oral and maxillofacial region. It is important to establish the diagnosis accurately because this condition is sometimes a manifestation of many systemic conditions like Crohn's disease or sarcoidosis. The clinical outcome of OFG patients continues to be unpredictable. Current therapies remain unsatisfactory. This article reports a rare case of isolated OFG with langhans type giant cells and inflammatory infiltrate without any systemic involvement, in which the condition was a manifestation of pregnancy. The diagnostic approach to and the treatment of OFG are reviewed.

Evaluation of the role of antibiotics in preventing postoperative complication after routine periodontal surgery: A comparative clinical study.

BACKGROUND AND OBJECTIVES: Aim of this randomly controlled clinical study was to evaluate the role of antibiotics to prevent postoperative complications after routine periodontal surgery and also to determine whether their administration improved the surgical outcome. MATERIALS AND METHODS: Forty-five systemically healthy patients with moderate to severe chronic periodontitis requiring flap surgery were enrolled in the study. They were randomly allocated to Amoxicillin, Doxycycline, and control groups. Surgical procedures were carried out with complete asepsis as per the protocol. Postoperative assessment of patient variables like swelling, pain, temperature, infection, ulceration, necrosis, and trismus was performed at intervals of 24 h, 48 h, 1 week, and 3 months. Changes in clinical parameters such as gingival index, plaque index, probing pocket depth, and clinical attachment level were also recorded. RESULTS: There was no incidence of postoperative infection in any of the patients. Patient variables were comparable in all the three groups. Though there was significant improvement in the periodontal parameters in all the groups, no statistically significant result was observed for any group over the others. CONCLUSION: Results of this study showed that when periodontal surgical procedures were performed following strict asepsis, the incidence of clinical infection was not significant among all the three groups, and also that antibiotic administration did not influence the outcome of surgery. Therefore, prophylactic antibiotics for patients who are otherwise healthy administered following routine periodontal surgery to prevent postoperative infection are unnecessary and have no demonstrable additional benefits.

Clinical and genetic aspects of generalized aggressive periodontitis in families of Tumkur district of Karnataka, India.

BACKGROUND: Aggressive periodontitis (AP) is a complex disease whose phenotype is determined by genetic and environmental influences on the affected individuals. About 45% of the adult population in India has periodontitis. In Tumkur district of Karnataka, India, consanguineous first cousin and uncle-niece marriages are common, with a high incidence of AP. These discrepancies in the expression of periodontal disease directed us to find genetic etiology with respect to the Tumkur population. The clinical and genetic aspects of AP from this area have been presented in this paper. MATERIALS AND METHODS: A total of nine families were ascertained at the Department of Periodontics, Sri Siddhartha Dental College and Hospital (Sri Siddhartha University), Tumkur. The clinical and radiographic data were gathered according to 1999 Consensus Classification of Periodontal Diseases. Peripheral blood samples were collected for total genomic DNA isolation using a Wizard TM Genomic Purification Kit (Promega, USA). The homozygosity mapping was carried out in a large consanguineous family to map a novel locus using autosomal markers from the CHLC/Weber Human Screening Set 10 (Research Genetics Inc., USA) at Indian Institute of Sciences, Bangalore. RESULTS: The pedigree analysis suggested that the disorder is segregating as an autosomal trait. The homozygosity mapping failed to identify a locus for generalized AP in the family. CONCLUSION: The disorder may not be segregating as an autosomal recessive trait and we could have been misled by consanguinity in the family. It could be a multifactorial trait, or it could be still segregating as an autosomal recessive trait, but the region of homozygosity could be small and we failed to detect it using microsatellite markers. Therefore, SNP-marker-based analysis is warranted in future.