An innovative and less invasive management of recurrent pyogenic granuloma in the esthetic zone: A case report with 18-month follow-up.

Pyogenic granuloma (PG) is a nonneoplastic, tumor-like growth commonly seen in the oral mucosa or skin. Although nonpathological, its existence might lead to complications such as secondary infections or diastema formation. Hence, surgical removal of the growth seems mandatory. Histopathologic and radiographic evaluation is essential for accurate diagnosis and to rule out malignancy. A 28-year-old systemically healthy female patient reported with a swelling which involved the interdental space of maxillary left central and lateral incisors. The lesion initially developed as a "pimple-like" swelling and gradually increased in size over 2 years. It was managed in a novel method by reflecting a papilla preservation flap, excising the lesion from inside the flap till healthy tissue was visible, and then exposing to diode laser to prevent recurrence. Subsequent histopathologic examination confirmed the diagnosis of PG. This novel, less invasive esthetic procedure employed a papilla preservation flap and laser irradiation technique. This simple modification not only helped in healing by primary intention and producing a good esthetic outcome but also showed no recurrence till date.

Neutrophil elastase levels in the gingival crevicular fluid following hyaluronan gel application in the treatment of chronic periodontitis: A randomized split-mouth study.

BACKGROUND: Neutrophils are the predominant leukocytes in the periodontium, which prevent infection from periodontal pathogens and subsequent tissue destruction. A potentially destructive role has been elucidated, especially due to elastase enzyme. Controlling its levels might be crucial in minimizing the tissue destruction. Hyaluronan, known to inhibit the release of this enzyme from neutrophils, might be a viable option to treat chronic periodontitis. AIMS: The aim of this study is to evaluate and compare the effects of 0.2% hyaluronan gel adjunctive to scaling and root planing on the levels of elastase in gingival crevicular fluid (GCF). SETTINGS AND DESIGN: This split-mouth study included eighty (forty experimental and forty control) sites from twenty patients representing both sexes. MATERIALS AND METHODS: GCF samples were collected from all the eighty sites; simultaneously, clinical periodontal parameters were recorded. Enzyme-linked immunosorbent assay was used to determine the levels of elastase at baseline and 6 weeks after therapy, following mechanical debridement and subsequent subgingival placement of the experimental drug. STATISTICAL ANALYSIS USED: With the aid of statistical software (SPSS Version 13), Student's t-test and Pearson's correlation test were performed. RESULTS: There was a mean reduction in the elastase levels from baseline to 6 weeks after therapy in the experimental group. However, the difference between the groups was not statistically significant. CONCLUSIONS: Adjunctive use of hyaluronan following mechanical debridement resulted in comparable reduction in the elastase levels, suggesting that this substance has an inhibitory effect on elastase, and subsequent tissue destruction. Further long-term studies are mandatory to validate the results of this study.

Comparative evaluation of soft and hard tissue dimensions in the anterior maxilla using radiovisiography and cone beam computed tomography: A pilot study.

AIMS: To assess and compare the thickness of gingiva in the anterior maxilla using radiovisiography (RVG) and cone beam computed tomography (CBCT) and its correlation with the thickness of underlying alveolar bone. SETTINGS AND DESIGN: This cross-sectional study included 10 male subjects in the age group of 20-45 years. MATERIALS AND METHODS: After analyzing the width of keratinized gingiva of the maxillary right central incisor, the radiographic assessment was done using a modified technique for RVG and CBCT, to measure the thickness of both the labial gingiva and labial plate of alveolar bone at 4 predetermined locations along the length of the root in each case. STATISTICAL ANALYSIS USED: Statistical analysis was performed using Student's t-test and Pearson's correlation test, with the help of statistical software (SPSS V13). RESULTS: No statistically significant differences were obtained in the measurement made using RVG and CBCT. The results of the present study also failed to reveal any significant correlation between the width of gingiva and the alveolar bone in the maxillary anterior region. CONCLUSIONS: Within the limitations of this study, it can be concluded that both CBCT and RVG can be used as valuable tools in the assessment of the soft and hard tissue dimensions.