Clinical and histological evaluation of concentrated growth factor membrane bandage after gingival depigmentation: A case series.

Concentrated growth factor (CGF) is a newer form of autologous platelet concentrate with an extra fibrin matrix and more growth factors than that observed with platelet-rich fibrin, due to its different centrifugation process. This case series evaluates the early wound healing with CGF membrane as a periodontal bandage after depigmentation. Three individuals were selected for a split-mouth study. After surgical depigmentation, the test site received CGF membrane. Both groups were covered by a periodontal pack. Participants were assessed on the 3rd and 5th days using a Visual Analog Scale and a Healing Index. Epithelization test was done with toluidine blue on the 5th day and tissue samples were taken for histological evaluation. The application of CGF membrane showed better healing and lesser inflammatory cells. Thus, a CGF membrane is helpful in protecting the raw wound region of depigmented sites, improving patient comfort, and for better healing.

Comparative evaluation of the levels of nod-like receptor family pyrin domain-containing protein (NLRP) 3 in saliva of subjects with chronic periodontitis and healthy controls.

Context: Periodontitis is an inflammatory disease which is ubiquitous. When there is an onset of infection, the innate immunity gets activated followed by the adaptive immune system. Inflammasomes identify the pathogen-associated molecular patterns or danger-associated molecular patterns and initiate inflammation. Nod- like receptor family pyrin domain-containing protein 3 (NLRP 3) is a protein belonging to the intracellular innate immune sensors that act against bacteria. The inflammasome acts along with the toll-like receptor pathways to initiate an action against pathogens. NLRP3 (also known as PYPAF-1 or cryopyrin) acts via apoptosis-associated speck-like protein (ASC). Aims: The study aimed at finding out the relation between levels of NLRP3 in chronic periodontitis and healthy subjects via the enzyme-linked immunosorbent assay (ELISA). Settings and Design: This was a Cross-sectional study. Materials and Methods: Clinical examination and saliva sampling of the study population was done. Reagents were prepared and NLRP3 levels were estimated using ELISA analysis. Statistical Analysis: Intergroup comparison was initiated using the unpaired t-test and for within the group (intragroup), the two-way analysis of variance was used. The Pearson correlation coefficient helped to determine the strength of linear association. Results: Increased levels of NLRP3 were seen in subjects suffering from chronic periodontitis. NLRP3 was also seen to be positively correlated to probing pocket depth, clinical attachment loss, gingival index, and plaque index. Conclusions: A positive correlation exists between NLRP3 and chronic periodontitis, and hence, NLRP3 can be a potential biomarker.

Comparative study using autologous platelet-rich fibrin and titanium prepared platelet-rich fibrin in the treatment of infrabony defects: An in vitro and in vivo study.

BACKGROUND: The platelet concentrates had been pioneered to be used in regenerative medicine since above a decade. AIMS AND OBJECTIVES: To compare the autologous platelet rich fibrin (PRF) and titanium prepared platelet rich fibrin (T-PRF) in the treatment of infrabony defects, clinically and radiographically and to compare the histologic difference between PRF and T-PRF by light microscopy and scanning electron microscopy (SEM). MATERIALS AND METHODS: The present study is a split mouth randomised controlled trial study in which 20 sites were selected and randomly assigned equally into 10 sites each in group A [Test group=T-PRF] and group B [Control group=PRF]. Clinical parameters were evaluated at baseline,3 months and 9 months. Radiographic parameters were evaluated at baseline and 9 months. Histologic differences between light microscopy and SEM for both PRF and T-PRF was studied after sequential processing. RESULTS: There was marked reduction in Probing Pocket depth and gain in Clinical Attachment Level in both the T-PRF and PRF groups from baseline to 9 months in intragroup comparisons. However, on intergroup comparisons, no statistical significance was seen. Radiographically, mean defect depths for both the groups showed statistically significant reduction from baseline values to 9 months on intragroup comparisons but not on intergroup comparisons. In-vitro evaluation, on both light and scanning electron microscopy, T-PRF showed denser fibril meshwork as compared to PRF. CONCLUSION: The clinical parameters and radiographic outcomes showed marked improvement at 9 months with both PRF and T-PRF in the treatment of infrabony defects from baseline values in intragroup comparison. However, statistically efficacy of T-PRF was not seen to be superior to that of PRF both clinically and radiographically. Histologic evaluation showed T-PRF had denser fibrils as compared to PRF in both light and scanning electron microscopy.

The antiplaque efficacy of white tea extract mouthrinse.

OBJECTIVE: This study was conducted to assess the antiplaque efficacy of a mouthwash containing white tea. It also assessed the antibacterial properties of white tea against Prevotella intermedia (Pi), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans (Aa) in vitro. MATERIALS AND METHODS: Forty-five subjects with healthy periodontium were randomly chosen and were divided into three groups and advised to use mouthwashes A, B, and C (Group A, white tea; Group B, distilled water [placebo]; Group C, chlorhexidine) for 4 days. They were advised to refrain from any kind of mechanical oral hygiene techniques. Plaque index (PI) was checked on day 1 and 5. In vitro testing for against Pi, Pg, and Aa against white tea extract was undertaken. RESULTS: PI significantly increased from day 1 to day 5 (P < 0.01) in Groups A, B, and C. In inter-group comparison, there was a statistical significant difference between white tea mouthrinse group and placebo group, chlorhexidine group and placebo group and also chlorhexidine group and white tea mouthrinse group. However, chlohexidine showed superior antiplaque activity. In vitro test, white tea showed effective inhibition against all three bacterial strains Pi, Pg, and Aa at 1% concentration. CONCLUSION: White tea mouthrinse potently inhibits plaque formation although not as comparable to chlorhexidine mouthrinse. Hence, for those preferring herbal products, white tea mouthrinse is a good option.

To compare the effect of the local delivery of hyaluronan as an adjunct to scaling and root planing versus scaling and root planing alone in the treatment of chronic periodontitis.

BACKGROUND: Hyaluronan is a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics and cell migration and proliferation. Studies have demonstrated its anti-inflammatory, antibacterial, and regenerative effects. The present study aimed to assess the clinical effects of the subgingival application of 0.8% hyaluronic acid gel as an adjunct to scaling and root planing (SRP) in the treatment of generalized chronic periodontitis. MATERIALS AND METHODS: Patients with chronic periodontitis were recruited to participate in a study with a split-mouth design and provided informed consent. One hundred sites were included in the study and divided into fifty test sites and fifty control sites. These were assessed for plaque index (PI), gingival index (GI), pocket probing depths, and relative attachment level (RAL) at-pretreatment (baseline), 4, and 12 weeks posttreatment. The patients received full-mouth SRP. A 0.8% hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the t-test, analysis of variance (test) followed by Bonferroni post hoc test. RESULTS: A significant reduction in PI and GI was observed in both groups at 12 weeks (P < 0.05). Significant reduction in the pocket probing depths and gain RAL was observed in both the groups as compared to baseline (P < 0.05). The hyaluronan group compared to control at 12 weeks showed statistically significant reduction in the probing pocket depth and gain in RAL (P < 0.05). CONCLUSION: The subgingival application of 0.8% hyaluronan gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.

Peripheral giant cell granuloma: This enormity is a rarity.

Peripheral giant cell granuloma (PGCG) is an infrequent exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative granuloma, or giant cell hyperplasia. Lesions vary in appearance from smooth, regularly outlined masses to irregularly shaped, multilobulated protuberances with surface indentations. Ulcerations of the margin are occasionally seen. The lesions are painless, vary in size, and may cover several teeth. It normally presents as a purplish-red nodule consisting of multinucleated giant cells in the background of mononuclear stromal cells and extravasated red blood cells. This case report describes the unusual appearance of a PGCG extending from left maxillary interdental gingiva to palatal area in 32-year-old female patient.

Attitudes of dental professionals toward tobacco use.

BACKGROUND: The habit of tobacco consumption has plagued all nations from time immemorial. While tobacco use is decreasing in many developed countries, it is increasing in developing countries like India. Health care professionals have a key role to play to motivate and advise tobacco users to quit. AIM: The aim was to assess the attitudes and practice of dental professionals in Mumbai and Navi Mumbai toward tobacco cessation and the potential barriers faced. MATERIALS AND METHODS: Questionnaire-based survey was conducted with 500 dental surgeons in Mumbai and Navi Mumbai. The questionnaire contained close-ended questions and assessed the smoking status of the professional, whether they impart tobacco cessation advice to their patients, whether the professional is trained for basic intervention, whether they would be eager to undergo training and also the potential barriers encountered by the professional. STATISTICAL ANALYSIS USED: The SPSS version 17 was used. Frequencies and percentages were used to determine distributions of the responses for each of the variables. Chi-square test was used for analysis. RESULTS: It was observed that the majority of dental clinicians do not use tobacco and although 93% believed that it is the role of the dental professional to offer advice, 21% do not. Potential barriers reported were: Little chance of success, lack of training, lack of time, lack of remuneration, and the possibility of losing patients. CONCLUSIONS: Dental professionals must expand their horizon and armamentarium to tobacco intervention strategies inclusive of their regular preventive and therapeutic treatment modalities. Furthermore, the dental institutions (schools) should include tobacco intervention in the curriculum, but it should not be just theoretical knowledge rather it must have a practical component.