Accuracy of cone-beam computerized tomography in determining the thickness of palatal masticatory mucosa.

BACKGROUND: The palatal masticatory mucosa is the main donor area of soft tissue and connective tissue grafts used for increasing the keratinized mucosa around teeth and implants, covering exposed roots and increasing localized alveolar ridge thickness. The aim of this study was to compare the thickness of the palatal masticatory mucosa as determined on a cone-beam computerized tomography scan versus thickness determined via bone-sounding. MATERIALS AND METHODS: A total of 20 patients requiring palatal surgery participated. Thickness of the palatal tissue was measured at various points radiographically and clinically. The two techniques were compared to determine the agreement of the two measurement modalities. RESULTS: Statistical analysis determined that there was no significant difference between the two methods. Moreover, the tissue thickness was shown to increase as the distance from the gingival margin increased, and the tissue over the premolars was thicker than the other teeth. CONCLUSION: Cone-beam computerized tomography can be used as a noninvasive method to accurately and consistently determine the soft tissue thickness of the palatal masticatory mucosa with minimal bias at different locations on the palate.

Primary tuberculous gingival enlargement - A rare clinical entity: Case report and brief review of the literature.

Tuberculosis (TB) is a chronic specific granulomatous disease and a major cause of death in developing countries. The clinical presentation of TB lesions of the oral cavity varies widely and can manifest as ulcerations, diffuse inflammatory lesions, granulomas and fissures. Oral lesions generally appear secondary to primary TB infection elsewhere, although primary infection of the oral mucosa by Mycobacterium tuberculosis has also been described. We hereby report a case of primary TB of the gingiva manifesting as gingival enlargement. Diagnosis was based on histopathological examination, complete blood count, X-ray chest and immunological investigations with detection of antibodies against M. tuberculosis. Anti-tuberculous therapy was carried out for over 6 months and was followed by surgical excision of the residual enlargement under local anesthesia. After 1-year follow-up, there was no recurrence of the disease. This case report emphasizes the need for dentists to include TB in the differential diagnosis of various types of gingival enlargements.

Gingival enlargement in von Willebrand disease: A case report.

von Willebrand disease (vWD) is an inherited bleeding disorder affecting both the sexes with a prevalence of approximately 1% in general population. The cause for bleeding in this disorder can be attributed to the primary deficiency or defect in von Willebrand factor (vWF) that results in the platelet adhesion abnormalities. It is characterized by bleeding episodes that may be severe and life threatening, menorrhagia in females, epistaxis, and gingival bleeding and enlargement. A case of 29-year-old female having all the characteristic features of vWD is presented. The family history revealed consanguineous marriage of the parents. The patient was initially on oral contraceptives, but later she underwent diagnostic hysteroscopy with endometrial ablation with roller ball to treat menorrhagia.

Comparative evaluation of 0.1% turmeric mouthwash with 0.2% chlorhexidine gluconate in prevention of plaque and gingivitis: A clinical and microbiological study.

BACKGROUND: The aim of our clinical trial was to assess the efficacy of 0.1% turmeric mouthwash as an anti-plaque agent and its effect on gingival inflammation and to compare it with 0.2% chlorhexidine gluconate by evaluating the effect on plaque and gingival inflammation and on microbial load. MATERIALS AND METHODS: 60 subjects, 15 years and above, with mild to moderate gingivitis were recruited. Study population was divided into two groups. Group A-30 subjects were advised chlorhexidine gluconate mouthwash. Group B-30 subjects were advised experimental (turmeric) mouthwash. Both the groups were advised to use 10 ml of mouthwash with equal dilution of water for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque and gingival index at day 0, on 14 (th) day, and 21 (st) day. Subjective and objective criteria were assessed after 14(th) day and 21(st) day. The N-benzoyl-l-arginine-p- nitroanilide (BAPNA) assay was used to analyze trypsin like activity of red complex microorganisms. RESULTS: On comparison between chlorhexidine and turmeric mouthwash, percentage reduction of the Plaque Index between 0 and 21 (st) day were 64.207 and 69.072, respectively (P=0.112), percentage reduction of Gingival Index between 0 and 21(st) day were 61.150 and 62.545 respectively (P=0.595) and percentage reduction of BAPNA values between 0 and 21(st) day were 42.256 and 48.901 respectively (P=0.142). CONCLUSION: Chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. Both the mouthwashes have comparable anti-plaque, anti-inflammatory and anti-microbial properties.

Evaluation of local drug-delivery system containing 2% whole turmeric gel used as an adjunct to scaling and root planing in chronic periodontitis: A clinical and microbiological study.

AIM: To compare the effect of experimental local-drug delivery system containing 2% whole turmeric (gel form) as an adjunct to scaling and root planing (SRP) with the effect achieved using SRP alone by assessing their respective effects on plaque, gingival inflammation, bleeding on probing pocket depth, relative attachment levels and trypsin-like enzyme activity of "red complex" microorganisms, namely, Bacteroides forsythus, Porphvromonas gingivalis and Treponema denticola. MATERIAL AND METHODS: Thirty subjects with chronic localized or generalized periodontitis with pocket depth of 5 to 7 mm were selected in a split-mouth study design. Control sites received SRP alone, while experimental sites received SRP plus experimental material (2% whole turmeric gel). Plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), probing pocket depth (PPD), relative attachment loss (RAL), microbiological study of collected plaque sample for trypsin-like activity of "red complex" by BAPNA assay were the parameters recorded on day 0, 30 days and 45 days. RESULTS: Both groups demonstrated statistically significant reduction in PI, GI, SBI, PPD; and gain in RAL. Significant reduction in the trypsin-like enzyme activity of "red complex" (BAPNA values) was observed for both the groups when compared to the baseline activity. Greater reduction was seen in all the parameters in the experimental group in comparison to the control group. CONCLUSION: The experimental local drug-delivery system containing 2% whole turmeric gel can be effectively used as an adjunct to scaling and root planing and is more effective than scaling and root planing alone in the treatment of periodontal pockets.