Clinical evaluation and comparison of the efficacy of coronally advanced flap alone and in combination with platelet rich fibrin membrane in the treatment of Miller Class I and II gingival recessions.

BACKGROUND: The aim of this study was to compare the clinical efficacy of coronally advanced flap (CAF) alone and in combination with autologous platelet rich fibrin membrane (PRF) in Miller's class I and II gingival recessions. MATERIALS AND METHOD: Thirty isolated Miller class I or II sites in 26 subjects were randomly divided into test (15 sites- CAF+PRF) and control (15 sites- CAF alone). Parameters probing pocket depth (PPD), Recession depth (RD), Clinical attachment loss (CAL), Keratinised tissue width (KTW) and Gingival tissue thickness (GTH) were evaluated at baseline, 3 months and 6 months postoperatively. Data was subjected to statistical analysis. P< 0.05 was considered statistically significant. RESULTS: Mean percentage root coverage was 91.00±19.98% and 86.60±23.83% for test and control group respectively. Difference between the groups in all parameters at baseline, 3 months and 6 months was non significant. Complete root coverage was obtained in 12 (80%) and 11 (73.3%) subjects in test and control group respectively. The difference was found to be non-significant. Both groups showed significant differences in all parameters at 3 and 6 months respectively except difference in gingival tissue thickness which was non-significant in control group at 3 months. CONCLUSION: Combination of PRF to CAF procedure did not provide any added advantage in term of recession coverage in Miller class I and II recessions. Long term trials with more sample size are needed to validate these findings.

Perspective of cardiologists on the continuation or discontinuation of antiplatelet therapy before dental treatment: a questionnaire-based study.

Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombi. These medications are associated with an increase in bleeding time and risk of intraoperative and postoperative hemorrhage in the dental office. There is some controversy regarding whether these agents should be temporarily discontinued before dental procedures. In order to gain insight into this controversy, a survey of 50 cardiologists was conducted regarding suggested guidelines for dentists in the management of patients who are taking anticoagulant medication.

Evaluation of the association between periodontal disease and diabetic retinopathy.

Periodontitis may act as a risk factor for diabetes and its various complications such as cardiorenal complications. The current literature is deficient regarding the association between periodontal disease and diabetic retinopathy (DR). This cross-sectional study of 100 type II diabetes patients sought to evaluate the association of periodontal disease with the occurrence and severity of DR. The results showed a definite association between periodontal disease status and the occurrence of DR, although a cause and effect relationship could not be established.

Is periodontal health a predictor of drug-induced gingival overgrowth? A cross-sectional study.

BACKGROUND: Gingival overgrowth is a common side-effect of amlodipine regimen on the oral cavity. There is controversy regarding the cause and effect relationship of periodontal health and drug induced gingival overgrowth. Therefore, this study was conducted to investigate and to assess the relationship between the periodontal health and the onset and severity of gingival overgrowth in hypertensive patients receiving amlodipine. MATERIALS AND METHODS: A total of 99 known hypertensive patients on amlodipine regimen were included in this study. Probing pocket depth (PPD) and clinical attachment loss (CAL) were noted on four sites of maxillary and mandibular anterior teeth. Gingival enlargement scores were assessed for each patient by employing the hyperplastic index. Oral hygiene status was evaluated using the calculus index (CI). Patients were divided into H, E and L groups based on their periodontal status and responders and non-responders based on their hyperplastic index scores. Differences in means of different periodontal variables in different groups were tested for significance by using ANOVA and unpaired Student t-test. Pearson's correlation coefficient was calculated to assess the correlation between different variables. For all analyses, P < 0.05 was considered to be significant. RESULTS: All the periodontal parameters were statistically highly significant (P = 0.00) amongst H, E and L groups and between responders and non-responders. Statistically highly significant Pearson correlation coefficients were found between mean PPD and mean hyperplastic score, mean CAL and mean hyperplastic score and mean calculus and mean hyperplastic score. CONCLUSION: The results of this study indicated a definite association between periodontal health and development and severity of amlodipine-induced gingival overgrowth.

Effect of phase I periodontal therapy on pro-coagulant state in chronic periodontitis patients--a clinical and haematological study.

STATEMENT OF THE PROBLEM: The increase in white blood cell count (WBC) and platelet count due to systemic inflammation and infection is considered a risk factor for cardiovascular diseases. These parameters increase in periodontal disease. A decrease in WBC and platelet counts by periodontal therapy may decrease the risk for cardiovascular disease. PURPOSE OF THE STUDY: The present study is a treatment intervention model to investigate the effect of non-surgical periodontal therapy on total leucocyte count (TLC), differential leucocyte count (DLC) and platelet count in patients with chronic periodontitis. MATERIALS AND METHODS: Thirty systemically healthy patients were included in the study. Probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), TLC, DLC, platelet count, bleeding time (BT) and clotting time (CT) were evaluated at baseline and at two weeks after phase I therapy. RESULTS: A statistically highly significant decrease in the percentage of sites exhibiting BOP was observed, i.e., from 78.1% at baseline to 18.1% two weeks postoperatively (p = 0.000). There was also a statistically significant decrease in TLC from 7595/mm3 at baseline to 6690/mm3 two weeks following phase I therapy (p = 0.02). There was also a statistically highly significant decrease in platelet count from 2.1 lac/mm3 preoperatively to 1.9 lac/mm3 at two weeks postoperatively (p = 0.003). CONCLUSION: The present study depicts the importance of periodontal therapy to reduce the TLC and platelet count, thereby possibly decreasing the risk for the development of cardiovascular disease by lowering the established risk factors for periodontal atherosclerosis.

Peripheral giant cell granuloma: a case report.

Peripheral giant cell granuloma is a rare exophytic lesion that develops on the gingiva and alveolar ridge. Although the precise etiology of this lesion is unknown, it could represent a local reaction to trauma or irritation. Management requires a surgical excision of the lesion and elaborate recall due to possible recurrence. This report describes the clinical and histopathological features and management of a peripheral giant cell granuloma as it appeared in the maxillary anterior region of a 35-year-old female patient.

Effect of lycopene in the treatment of periodontal disease: a clinical study.

PURPOSE: Several epidemiologic studies have suggested a role of tomato products in decreasing the risk of the development of diseases related to oxidative stress (cancer and other chronic diseases). Oxidative stress may result in periodontal tissue damage either directly or indirectly. Lycopene, a powerful antioxidant and the main carotenoid in tomato products possesses the greatest quenching ability of singlet oxygen among the various carotenoids and is effective in protecting blood lymphocytes from NOO-radical damage. Hence, the aim of the present study is to compare the effect of systemically administered lycopene as an adjunct to scaling and root planing in patients with gingivitis and periodontitis. MATERIALS AND METHODS: Twenty systemically healthy patients were involved in a randomized, double-blind, parallel study and based on their clinical signs were divided into two groups of mild to moderate periodontitis (A) and moderate gingivitis (B). The subjects under the groups A and B were randomly distributed between the two treatment groups: test group (n = 5), 4 mg lycopene/day for 2 weeks with oral prophylaxis (full mouth scaling and root planing (SRP) completed within 24 hours) and controls (n = 5), receiving only oral prophylaxis. Pre- and post-therapeutic periodontal parameters were evaluated. RESULTS: In group A, statistically significant improvement in CAL was reported in test group as compared to control group. In group B, the difference between pretreatment and post-treatment bleeding on probing scores was found to be statistically non-significant in both groups. CONCLUSION: Results show that lycopene is a promising treatment modality as an adjunct to full mouth SRP of the oral cavity in patients with moderate periodontal disease. CLINICAL SIGNIFICANCE: Modulation of the free radical production seems to be essential for the inhibition of tissue destruction, and treatment with antioxidants, like lycopene, which is the most potent among them will block the production of free ROS or its effects might prove to be therapeutically valuable.

Amlodipine- induced gingival overgrowth: a case report.

Drug-induced gingival overgrowth occurs in genetically susceptibIe individuals as a side effect of various drugs. There is a gross disfiguring enlargement of gingiva mostly in the anterior region leading to difficulty in mastication, speech and maintenance of oral hygiene. In this case report, amlodipine-induced gingival enlargement and its management are discussed. Drug substituion, appropriate non-surgical and surgical treatment along with excellent plaque control lead to the regression and prevention of recurrence of drug-induced gingival overgrowth.

From stem to roots: Tissue engineering in endodontics.

The vitality of dentin-pulp complex is fundamental to the life of tooth and is a priority for targeting clinical management strategies. Loss of the tooth, jawbone or both, due to periodontal disease, dental caries, trauma or some genetic disorders, affects not only basic mouth functions but aesthetic appearance and quality of life. One novel approach to restore tooth structure is based on biology: regenerative endodontic procedure by application of tissue engineering. Regenerative endodontics is an exciting new concept that seeks to apply the advances in tissue engineering to the regeneration of the pulp-dentin complex. The basic logic behind this approach is that patient-specific tissue-derived cell populations can be used to functionally replace integral tooth tissues. The development of such 'test tube teeth' requires precise regulation of the regenerative events in order to achieve proper tooth size and shape, as well as the development of new technologies to facilitate these processes. This article provides an extensive review of literature on the concept of tissue engineering and its application in endodontics, providing an insight into the new developmental approaches on the horizon. Key words:Regenerative, tissue engineering, stem cells, scaffold.

'Nanodentistry': Exploring the beauty of miniature.

Feynman's early vision in 1959 gave birth to the concept of nanotechnology. He saw it as an unavoidable development in the progress of science and said that there is plenty of room at the bottom. Since then, nanotechnology has been part of mainstream scientific theory with potential medical and dental applications. Numerous theoretical predictions have been made based on the potential applications of nanotechnology in dentistry, with varying levels of optimism. While a few layers of nanotechnologic capability have become a reality for oral health in the last decade, many of these applications are still in their puerile stage .The most substantial contribution of nanotechnology to dentistry till date, is the more enhanced restoration of tooth structure with nanocomposites. The field of nanotechnology has tremendous potential, which if harnessed efficiently, can bring out significant benefits to the human society such as improved health, better use of natural resources, and reduced environmental pollution. The future holds in store an era of dentistry in which every procedure will be performed using equipments and devices based on nanotechnology. This article reviews the current status and the potential clinical applications of nanotechnology in dentistry. Key words:Nanotechnology, nanodentistry, nanocomposites.

Biofilms: A microbial home.

Microbial biofilms are mainly implicated in etiopathogenesis of caries and periodontal disease. Owing to its properties, these pose great challenges. Continuous and regular disruption of these biofilms is imperative for prevention and management of oral diseases. This essay provides a detailed insight into properties, mechanisms of etiopathogenesis, detection and removal of these microbial biofilms.