Gingiva as the primary site of extrapulmonary tuberculosis: A rare case report with brief review of literature.

Multiple strains of Mycobacteria cause tuberculosis (TB), a chronic, specific infectious granulomatous disease. It mainly occurs with pulmonary involvement when compared to extrapulmonary involvement. Primary oral occurrence is uncommon and oral lesions are usually secondary to pulmonary involvement. When there are no active pulmonary clinical manifestations of TB, the diagnosis of the very rare entity of primary gingival TB poses a great challenge to clinicians. In this case report, we discuss a case of primary gingival TB in a 24-year-old lactating mother. This article briefs the onset and course of the lesion during pregnancy and postpartum, elaborates the pathway to diagnosis, various investigations performed and the regimen of antitubercular therapy for 6 months, followed by complete resolution of the lesion without recurrence. This report also describes the significance of considering TB as a differential diagnosis in oral lesions and the various diagnostic methods available. It also emphasizes the sole importance of histopathology in the early detection of the lesion and its management.

Evaluation of the reactive oxygen metabolite levels in plasma, gingival crevicular fluid, and saliva in generalized chronic periodontitis patients before and after nonsurgical periodontal therapy: A case-control and interventional study.

BACKGROUND: Reactive oxygen metabolites (ROMs) produced in periodontitis could contribute to excessive tissue damage. Thus, treatment of chronic periodontitis may decrease the ROM levels. The aim of this study is to evaluate the ROM levels in plasma, saliva, and gingival crevicular fluid (GCF) in generalized chronic periodontitis (GCP) patients before and after nonsurgical periodontal treatment. MATERIALS AND METHODS: Two groups were included in this study. Group I consisted of 30 healthy controls (C) and Group II consisted of 30 subjects with GCP. Plaque index (PI), papillary bleeding index, Probing Depth (PD), and clinical attachment level were recorded. GCF, saliva, and plasma samples were collected from both groups. ROM levels were assessed. A baseline comparison was made between the two groups. Nonsurgical periodontal treatment was carried out for Group II subjects. Two months posttreatment, the clinical parameters and ROM levels in GCF, saliva, and plasma were reassessed in Group II, and the data were compared with their baseline values. Statistical analysis was done using SPSS 20 software and results were derived. RESULTS: Two months posttreatment, Group II exhibited significant reduction in ROM levels in plasma, saliva, and GCF with significant decrease in PI, bleeding on probing, probing depth, and attachment loss. CONCLUSION: Thus, significant oxidative stress may occur in chronic periodontitis and nonsurgical periodontal therapy may be regarded as an effective treatment modality to treat the diseased periodontium, thereby preventing possible systemic diseases in future.

Modified Widman flap and non-surgical therapy using chlorhexidine chip in the treatment of moderate to deep periodontal pockets: A comparative study.

INTRODUCTION: It is a well established fact that periodontitis is caused by a group of highly specific microorganisms, organized as a bio-film on the tooth surface. Hence, therapeutic modalities are directed against elimination or adequate suppression of these organisms. Thorough debridement of these sites is possible mainly by scaling and root planing (SRP) and open- flap debridement in deeper sites. Open- flap debridement includes conventional surgical procedures such as the modified Widman flap procedure. Surgical procedures, however, have a number of disadvantages and hence efforts have been on at improving various non-surgical approaches, which are directed more specifically at the microbial nature of periodontal disease. Use of local drug-delivery devices is one such approach. The combined therapy of SRP and local drug delivery has been showing promising results in improving all the parameters in periodontal disease. MATERIALS AND METHODS: This study compares the clinical, as well as, microbiological results of a split-mouth trial using modified Widman flap and non-surgical therapy of SRP and the use of a controlled release drug-delivery device (Chlorhexidine chip), in the management of moderate to deep pockets. RESULTS AND CONCLUSION: The results showed that the non-surgical most sites subjected to the non-surgical treatment were found to be maintainable without further deterioration, during the study period.