Prevalence of herpes virus in chronic periodontitis patients with and without type 2 diabetes mellitus: A clinico-microbiological study.

BACKGROUND: Unfavorable modifications of tooth and its surrounding structures result in periodontal complications. Viruses, in specific herpes virus, are known to increase disease severity in periodontal patients. Periodontitis is known to be more established in type 2 diabetes mellitus (DM2) patients. Hence, the detection of the viral load, its effect on the prevalence of periodontitis and the glycemic control status of patients are to be evidenced. The study aimed to reveal the association of herpes virus with periodontal parameters and its prevalence in DM2 patients. MATERIALS AND METHODS: The cross-sectional study involved a total of 120 patients falling into three groups; Group I (healthy), Group II (periodontitis without DM2) and Group III (periodontitis with DM2) were subjected for sampling. Subgingival samples of periodontitis patients were tested for clinical parameters, and DNA extraction was performed. The presence of herpes virus (Epstein-Barr virus [EBV-1] and human Cytomegalovirus [HCMV]) was detected using multiplex polymerase chain reaction primers. Glycemic status of patients was recorded as glycosylated hemoglobin and scored accordingly. Chi-square test was performed to analyze the association between the categorical variables, and t-test/Mann-Whitney U-test/analysis of variance/Kruskal-Wallis test was used for continuous data. RESULTS: Significant levels of EBV-1 were detected in Group III (n = 21, 52.5%), followed by Group II (n = 16, 40%) and Group I (n = 2, 5%) (P < 0.0001). HCMV was not detected. A significant association of EBV-1 to periodontal site-specific parameters was observed in Group II patients (P < 0.05). EBV-1 was predominant with poor glycemic status patients. CONCLUSION: This study revealed that the incidence of herpes virus infection in periodontal patients was higher in diabetic patients and the examined patients were prone to EBV-1 infections.

Is platelet rich fibrin a viable alternative to subepithelial connective tissue graft for gingival root coverage?

INTRODUCTION: One of the most common aesthetic concerns associated with the periodontal tissue is gingival recession. Covering the root surface exposed during the disease process with soft and hard tissue surgeries may decrease these problems. The aim of the study was to compare the clinical outcome of coronally advanced flap (CAF) procedure in root coverage with platelet-rich fibrin (PRF) or subepithelial connective tissue graft (SCTG) for the treatment of Miller's Class-I gingival recession. MATERIALS AND METHODS: The split mouth design consisted of 15 patients with a total of 30 sites with bilateral Miller's Class-I recession on anterior teeth. They were randomly assigned into PRF group (test) or SCTG group (control). STATISTICAL ANALYSIS: The values obtained were tabulated and analyzed using Mann--Whitney U-test and repeated measure ANOVA test. All the statistical tests were carried out using SPSS software. RESULTS: It was observed that both the autogenous grafts healed without any complications and at the end of 6 months the grafts were stable and recession coverage between 88-100% was achieved. CONCLUSION: CAF procedure with either PRF or SCTG were both effective in the treatment of Miller's Class-I gingival recessions. CAF with SCTG showed better root coverage than CAF with PRF. Use of PRF offered additional benefit of avoiding second surgical site. Therefore, PRF can be considered as a viable alternative to SCTG in certain cases.

A Cross-Sectional Study to Assess and Correlate Osteoporosis and Periodontitis among Postmenopausal Women: A Dual Energy X-Ray Absorptiometry Study.

BACKGROUND: Periodontitis and osteoporosis are two diseases found worldwide and increase in intensity with increasing age of the patients. The severity of osteoporosis and periodontitis are found to be more in women during menopause. The aim of this study was to assess and correlate osteoporosis and periodontal disease among post-menopausal women. MATERIALS AND METHODS: The study consisted of 94 postmenopausal women in the age range of 45-65 years. All the women underwent dual-energy X-ray absorptiometry (DXA) scan to measure bone mineral density (BMD) and were graded as normal, osteopenic, and osteoporotic based on the T score obtained. Data regarding patient's educational level, socioeconomic status (SES), and body mass index (BMI) was recorded. A detailed periodontal examination was carried out using clinical parameters such as oral hygiene index (OHI), plaque Index (PI), probing pocket depth , and clinical attachment loss to check the level of periodontitis. The level of osteoporosis was correlated with the level of periodontitis. RESULTS: The DXA scan revealed that four women were normal, 44 were osteopenic and 46 were osteoporotic. There was no association found between BMD and OHI, PI, educational status, SES, and BMI. Slight periodontitis was observed in eight women, moderate periodontitis in 62, and severe periodontitis in 24 women. Result suggests that there was a statistical correlation between periodontitis and osteoporosis (P = 0.045). CONCLUSION: There is a definite correlation found between the severity of periodontitis and osteoporosis among postmenopausal women. A close cooperation between general practitioners and dentists in early diagnosis and treatment of both the diseases will reduce the risk and morbidity among postmenopausal women.

Evaluation of Irimedadi Taila as an adjunctive in treating plaque-induced gingivitis.

Ayurvedic drugs have been used since ancient times to treat diseases including periodontal diseases. Oral rinses made from ayurvedic medicines are used in periodontal therapy to control bleeding and reduce inflammation. To evaluate the efficacy of herbal preparation (Irimedadi taila) on reduction of plaque induced gingivitis. A total of 100 volunteers with clinical signs of mild to moderate gingivitis were selected and assigned to Group A (only scaling done) and Group B (scaling along with the use of Irimedadi taila). After recording the clinical parameters, the patients were instructed to use 2-3 drops of Irimedadi taila and gently massage the gums twice daily in Group B and oral hygiene instructions were given to all patients. Plaque and gingivitis assessment were carried out using the plaque index (Silness and Loe, 1964), Gingival index (Loe and Silness, 1963), and modified sulcular bleeding index (Mombelli et al.) at baseline and at 21 days post treatment. Statistically analysis was carried out using the student's paired t test for intra group comparison and unpaired t test for inter group comparison. Results showed that Irimedadi taila is effective in reducing gingival index and gingival bleeding index scores in comparison to scaling alone and the values are statistically significant with p < 0.0001. Irimedadi taila is effective in treatment of plaque induced gingivitis and can be effectively used as an adjunct to mechanical therapy.

Comparison of Gingival Biotype between different Genders based on Measurement of Dentopapillary Complex.

INTRODUCTION: Clinical and aesthetic outcomes after periodontal or implant surgical procedures are determined by anatomical and morphological characteristics of the gingiva like width of keratinized gingiva, thickness of gingiva and alveolar bone. Therefore, the knowledge of gingival biotype plays an important role in modifying the dental therapeutic procedures for the desired outcome and predictability. AIM: The aim of the present study was to assess and compare the gingival biotype among genders by clinical, photographic and radiographic parameters. MATERIALS AND METHODS: A total of 800 subjects (400 males and 400 females) were considered for the study. Width of keratinized gingiva (GW), transparency of the periodontal probe through the sulcus (TRAN) were assessed clinically; Crown Width/Crown Length ratio (CW/CL) and Papillary Height (PH) were assessed photographically; Gingival Thickness (GT1, GT2, GT3) and Alveolar bone Thickness (AT1, AT2, AT3) were assessed radiographically. The obtained data was correlated to compare the gingival biotype between males and females. The collected data was statistically analysed using Pearson correlation coefficient (r) with the corresponding 95% confidence interval. RESULTS: The TRAN at GT1, GT2 and GT3 as well as at AT1, AT2 and AT3 showed a very strong positive correlation in males (r>0.8) as compared to females (r<0.8). A very strong positive correlation was observed between GT1, GT2, GT3 and AT1, AT2, AT3 in males (r>0.9) as compared to females (r<0.7). CONCLUSION: There are definite differences in the gingival biotype among different genders with predominance of a thin gingival biotype with reduced alveolar bone thickness in females as compared to males.

Comparative Evaluation of Efficacy of Iontophoresis with 0.33% Sodium Fluoride Gel and Diode Laser Alone on Occlusion of Dentinal Tubules.

INTRODUCTION: Dentinal Hypersensitivity (DH) is one of the most commonly encountered clinical problems. Literature reveals no specific therapy to satisfactorily eliminate dentinal hypersensitivity. AIM: The aim of this study was to assess and compare the efficacy of iontophoresis with 0.33% Sodium Fluoride (NaF) gel and diode laser alone in dentinal tubule occlusion. MATERIALS AND METHODS: This in vitro study included 20 teeth with intact root surfaces unaltered by extraction procedure for specimen preparation. Each tooth was cleaned, air dried and cut into three sections. Total 60 sections were prepared (30 longitudinal and 30 transverse sections), which were acid etched. In control group, no treatment was carried. In iontophoresis treatment group, samples were inserted into a foam tray containing 0.33 % NaF Gel and subjected to 1.5 mA output current for three minutes. In laser treatment group, specimens were lased with 980 nm diode laser at 0.5 W/PW (62.2J /cm2) in a noncontact mode for 30 seconds. Specimens were evaluated under Scanning Electron Microscope (SEM) at 10KV to 20KV under x 2000, x5000 magnification for surface characteristics and patency of dentinal tubules. Total number of tubules visible, open, completely and partially occluded were recorded in each microphotograph and compared. RESULTS: On comparison, laser group showed the least number of open tubules i.e., 130 (31.1%) followed by iontophoresis group, 155 (51.32%) and control group 417 (100%). CONCLUSION: Diode laser application provided better results as compared to iontophoresis on occlusion of dentinal tubules. Hence, it can be used to treat the patients with DH.

Estimation and Comparison of Salivary Calcium, Phosphorous, Alkaline Phosphatase and pH Levels in Periodontal Health and Disease: A Cross-sectional Biochemical Study.

INTRODUCTION: In oral diagnostics there is a great challenge to determine biomarkers for screening and evaluating the disease activity. Biomarkers can also serve as a useful tool to measure the efficacy of the therapy. AIM: To evaluate and compare the levels of salivary calcium, phosphorous, alkaline phosphatase and pH levels in periodontally healthy subjects and patients with gingivitis and periodontitis. MATERIALS AND METHODS: The present study consisted of 150 subjects aged between 20-45 years who were divided into three groups; periodontally healthy, gingivitis and chronic periodontitis. Prior to the clinical examination the demographic details, relevant information of the subject, gingival index, plaque index, Oral Hygiene Index (OHI) and pH were recorded. Biochemical assay of saliva i.e., inorganic calcium, phosphorous and alkaline phosphatase were estimated by colorimetric method. ANOVA and Tukey's test were applied for statistical analysis. RESULTS: The mean levels of biomarkers studied were; inorganic calcium (12.55µg/dl), phosphorous (14.50µg/dl), alkaline phosphatase (49.62µg/dl) and pH (11.65). There was a gradual increase in these levels as the condition progressed from health to gingivitis or periodontitis which was statistically significant at p<0.001. CONCLUSION: Based on these results, it can be concluded that, the biomarkers like salivary calcium, phosphorous, alkaline phosphatase and pH can be considered for evaluating the diagnosis and prognosis of periodontal tissues in disease and health.

The Conformation of Thermoresponsive Polymer Brushes Probed by Optical Reflectivity.

We describe a microscope-based optical setup that allows us to perform space- and time-resolved measurements of the spectral reflectance of transparent substrates coated with ultrathin films. This technique is applied to investigate the behavior in water of thermosensitive polymer brushes made of poly(N-isopropylacrylamide) grafted on glass. We show that spectral reflectance measurements yield quantitative information about the conformation and axial structure of the brushes as a function of temperature. We study how parameters such as grafting density and chain length affect the hydration state of a brush, and provide one of the few experimental evidences for the occurrence of vertical phase separation in the vicinity of the lower critical solution temperature of the polymer. The origin of the hysteretic behavior of poly(N-isopropylacrylamide) brushes upon cycling the temperature is also clarified. We thus demonstrate that our optical technique allows for in-depth characterization of stimuli-responsive polymer layers, which is crucial for the rational design of smart polymer coatings in actuation, gating, or sensing applications.

A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser.

Introduction: Dark or black coloured gingiva is an esthetic concern especially in subjects with high lip line or gummy smile. Gingival depigmentation procedure is a type of perioplastic surgery where the gingival epithelium is excised with various techniques to lighten the colour of the gingiva. The aim of this study was to compare the clinical efficacy of gingival depigmentation procedure with conventional scalpel technique and diode laser application. Methods: This split mouth randomized study was conducted on 12 subjects (18-40 years of age), exhibiting melanin hyperpigmentation of gingiva. The anterior labial sextant of maxilla and mandible were divided into two halves involving three anterior teeth i.e. central incisor, lateral incisor and canine on each side. The divided areas were randomly allotted for depigmentation procedure either with scalpel technique or diode laser operating at 980 nm wavelength. Various parameters such as bleeding, pain, difficulty of procedure and wound healing were assessed and compared between the two techniques. The level of melanin pigment was assessed with Dummette Gupta index and photographic analysis with the help of adobe software. The subjects were followed up to one year to see for recurrence of melanin pigmentation. Results: Bleeding during surgery, pain score and difficulty of procedure assessed by the operator were statistically higher for scalpel technique as compared to laser technique. Wound healing did not show any statistical significant difference between both techniques. Gingival depigmentation procedures with scalpel as well as laser technique were effective when compared preoperatively and at consecutive postoperative visits, and this was statistically significant. Comparison of melanin depigmentation procedure between scalpel and laser technique did not show any significant differences at all postoperative intervals. Conclusion: The findings of the present study suggest that gingival depigmentation was effective with both scalpel and laser techniques. However, the laser treated sites showed reduced pain experienced by the patient and better operator comfort. Slight melanin repigmentation was observed in three subjects treated with scalpel depigmentation procedure at the end of one year.

Efficient photocatalytic hydrogen production in water using a cobalt(III) tetraaza-macrocyclic catalyst: electrochemical generation of the low-valent Co(I) species and its reactivity toward proton reduction.

A very efficient homogeneous system for visible-light driven hydrogen production in water is reported. This comprises the [Co(CR)Cl2](+) cobalt(III) tetraaza-macrocyclic complex (Cat1) as a noble metal-free catalyst, [Ru(bpy)3]Cl2 as a photosensitizer and ascorbate/ascorbic acid as a sacrificial electron donor and buffer. This system gives up to 1000 turnovers at pH 4.0 versus the catalyst with a relatively low photosensitizer/catalyst ratio (10/1) and a high concentration of catalyst (1 × 10(−4) M), thus producing a significant amount of H2 (12.3 mL for 5 mL of solution). It also exhibits long-term stability (more than 20 hours). The efficiency of Cat1 has been compared under the same experimental conditions to those of three other H2-evolving catalysts, which are known to operate in water, [Co{(DO)(DOH)pn}Br2] (Cat2), [Co(dmbpy)3]Cl2 (Cat3) and [Rh(dmbpy)2Cl2]Cl (Cat4). These comparative studies show that Cat4, although based on a noble metal, is about four times less active, while Cat2 and Cat3 produce more than one hundred times less hydrogen than Cat1. The low-valent CoI form of Cat1 has been successfully electrogenerated in CH3CN. Its high stability can be related to the high catalytic performance of the Cat1 system. We have also shown that in acidic aqueous solution (photocatalytic conditions) reduction at a slightly more negative potential than the Co(II)/Co(I) couple is needed to ensure efficient catalysis; this reduction is performed by the photogenerated [Ru(II)(bpy)2(bpy(˙−))](+) species.

Microabrasion using 18% hydrochloric acid and 37% phosphoric acid in various degrees of fluorosis - an in vivo comparision.

AIMS AND OBJECTIVES: The aim of this study was to assess the efficacy of 18% hydrochloric acid and 37% phosphoric acid by an in vivo comparison. METHODS: Sixty fluorotic permanent maxillary central incisors from 30 patients were divided into 3 categories. The teeth received 5 seconds (mild fluorosis), 20 seconds (moderate fluorosis) and 30 seconds (severe fluorosis) application of 18% hydrochloric acid on 11 and 37% phosphoric acid on 21. Standardized intraoral photographies were taken immediately before, after, and one month after treatment. Vinyl polysiloxane impression of the patient were made before and after the treatment. A scanning electron microscopic (SEM) evaluation was carried out on the models to judge the surface alterations. Wilcoxon and Mann-Whitney tests were used to verify the hypothesis. RESULTS: A statistically significant result was obtained in the reduction of white spot opacities, intensity of stains and the total area occupied by the stains in mild and moderate fluorosis teeth. Results of severe fluorosis had an unpredictable outcome. An SEM evaluation revealed good improvement in the surface texture of mild and moderate fluorosis teeth. Teeth with severe fluorosis showed only a slight improvement. CONCLUSION: A microabrasion procedure is effective for treating mild and moderate fluorosis cases.

Desmoplastic ameloblastoma: a rare odontogenic neoplasm with unusual radiographic and histomorphological presentation.

Desmoplastic ameloblastoma (DA) is a newly recognised, rare odontogenic neoplasm that is a histological variant of ameloblastoma. In this type, the islands of ameloblastoma are surrounded and often compressed by a dense and sometimes hyalinised fibrous connective tissue. Although ameloblastomas are usually located in the mandible, this variant often occurs in the anterior maxilla. In view of the paucity of DA case series and only limited understanding of its biological behaviour and prognosis, proper treatment strategies for DA are not entirely defined so far. The purpose of this paper was to review the literature and to demonstrate a rare case for an improved understanding of the behaviour and prognosis of DA.

Lobulated capillary haemangioma: a common lesion in an uncommon site.

Pyogenic granuloma (PG) is a well-known localised granulation tissue overgrowth. It remains an aetiopathological enigma, with trauma, inflammatory and infectious agents being the suspected causative factors. It is a relatively common benign mucocutaneous lesion occurring intraorally or extraorally and is more common in women in the second decade of their lives than in men. Although it is a common lesion it may present with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such lesion can be quite challenging. This case report drives attention towards the uncommon location of PG of lobular capillary haemangioma type occurring on anterior palate. Surgical excision of the lesion was planned because of the discomfort attributed to large size of the lesion and hindrance in mastication.

Effects of citric acid and EDTA on periodontally involved root surfaces: a SEM study.

AIM: Root debridement by scaling and root planing may not completely remove contaminated cementum particularly in more apical areas. The smear layer formed during root planing inhibits cell migration and attachment leading to impaired marginal periodontal healing. The present study was done to compare the morphological effects of root surface demineralization using citric acid and EDTA as root-conditioning agents. MATERIALS AND METHODS: Thirty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: Group I: Hand instrumentation and conditioning with normal saline for 5 minutes as control; group II: Hand instrumentation and conditioning with citric acid (pH 1) for 5 minutes and group III: Hand instrumentation and conditioning with EDTA (pH-7.4) for 5 minutes. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules. RESULTS: The mean efficacy of smear layer removal was compared between groups I and II, groups I and III and groups II and III, it was found to be statistically significant at 5%. When the mean diameter of the dentinal tubules and mean total surface area occupied by the dentinal tubule orifices was compared between groups II and III it was found to be statistically significant at 1% level of significance. CONCLUSION: Citric acid causes greater degree of morphological alterations than EDTA and is considered to be a better root-conditioning agent. However, the use of EDTA cannot be ruled out. CLINICAL SIGNIFICANCE: This study supports the hypothesis that demineralizing agents can be used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots and helps in choosing an appropriate agent for root conditioning.