Perio-ortho interdisciplinary approach in a 50-year-old patient: A case report with 5-year follow-up.

Esthetic demands for correction of irregularities of dentition are becoming a prime concern even in patients above the age of 40 years. Severe periodontitis, being insidious, if present simultaneously, complicates the situation. Periodontally compromised adult patients requiring the treatment for malaligned teeth are encountered very frequently in daily practice, and the correction of these requires a combined perio-ortho interdisciplinary approach. The present case report deals with a 5-year follow-up of a case whose prime concern was rotated anterior teeth in the maxillary arch. However, along with this, severe periodontitis was also present. Open flap debridement along with osseous grafting was done wherever required, followed by fixed adjunctive orthodontic treatment. After the completion of orthodontic treatment, a fixed retainer in the form of splinting was given and the entire treatment met the esthetic along with functional demands of the patient. Early 6 months followed by yearly follow-ups reflected clinical and radiographic improvements in the dentition.

Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients.

BACKGROUND: Simvastatin (SMV), a new locally delivered drug of class statins, is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins, besides having lipid-lowering abilities, also have pleiotropic effects like host modulation and bone regeneration. The present study was designed to investigate the effectiveness of SMV, 1.2 mg, in an indigenously prepared biodegradable controlled-release gel as an adjunct to scaling and root planing (SRP). MATERIALS AND METHODS: A total of 60 sites, with pocket depth ≥5 mm, two from each of 30 patients after SRP, were categorized into two treatment groups, for subgingival placement of placebo (Gp 1) or SMV (Gp 2). Clinical parameters were recorded at baseline and at 1, 3 and 6 months comprising plaque index, gingival index, probing pocket depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical gain, INFRA 1 and angle of the defect, INFRA 2 from baseline to 6 months. RESULTS: All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal condition in both the groups but significant reductions in PPD (p= 0.04), and INFRA 1 (p= 0.000), along with gain in CAL (p= 0.02) and INFRA 2 (p= 0.000) were observed in Gp 2. In one site, an unexpected 5 mm decrease in INFRA 1 was found. CONCLUSION: Local drug delivery of SMV enhanced the beneficial effect of SRP, in pocket reduction, gain in CAL and bone fill.