Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population.

This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA1c levels, retinopathy and nephropathy (P < 0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm2, PPD 4-6 mm (%) and PPD ≥ 7 mm (%) emerged as significant predictors for elevated HbA1c in regression model (P < 0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.

Clinical evaluation of the marginal gingiva as a donor tissue to augment the width of keratinized gingiva: Series of 2 cases with 3-year follow-up.

The indications to increase the width of keratinized gingiva have not been proven beyond doubt; however it becomes indispensable in certain clinical situations. Inspite of frequently encountered complications, palate is considered most preferred area to harvest the free gingival graft (FGG). This procedure aimed at investigating the potential of buccal marginal gingiva as a donor to augment keratinized gingiva. To the best of our knowledge, no such cases have been documented in the literature. FGG harvested from maxillary buccal marginal gingiva was used to augment gingiva in the mandibular anterior region for two patients. This not only improved plaque control but also resulted in acceptable esthetic results over 3 years. Furthermore, gingiva at donor sites gained its normal form and was in harmony with the neighboring teeth. It may be concluded that buccal marginal gingiva may provide a predictable substitute to other donor tissues to augment gingiva.