Comparative Evaluation of Microbial Flora of Endodontic Origin in Teeth with Endo-Perio Lesions.

Background: Endodontic microbial flora plays a pivotal role in the development and persistence of periodontal endodontic lesions (PELs). Understanding the composition and prevalence of microbial species in PELs is essential for effective treatment strategies. Materials and Methods: Microbial samples were collected from 50 teeth diagnosed with PELs. Sterile paper points were used to obtain samples from the root canals. Deoxyribonucleic acid (DNA) was extracted and subjected to polymerase chain reaction (PCR) amplification of the 16S ribosomal RNA (rRNA) gene to identify bacterial species. The obtained data were analyzed using statistical methods. Results: The microbial analysis revealed a diverse range of bacterial species in PELs. The most prevalent species were Porphyromonas gingivalis (32.5%), Treponema denticola (28.0%), and Fusobacterium nucleatum (22.5%). Streptococcus mutans (9.0%) and Actinomyces naeslundii (8.0%) were also frequently detected. Additionally, Prevotella intermedia (7.0%), Aggregatibacter actinomycetemcomitans (3.5%), and Enterococcus faecalis (2.5%) were present in lower frequencies. Conclusion: The presence of a diverse microbial flora in teeth with PELs underscores the polymicrobial nature of these lesions. The predominance of periodontal pathogens such as Porphyromonas gingivalis, Treponema denticola, and Fusobacterium nucleatum suggests a strong association between periodontal and endodontic infections. A comprehensive understanding of the microbial profile in PELs is crucial for tailored therapeutic approaches targeting the specific pathogens involved.

Clinical management of deep osseous defects in cases of peri-implantitis among indian patients.

Peri-implantitis is recognized as a complex pathology which could be defined as infectious inflammatory lesions that usually develop in the tissues around the implants. There are many protocols for the effective management of peri-implantitis that include mechanical debridement, the use of antiseptics and local/systemic antibiotics, and access and regenerative surgery formulated for the treatment of peri-implantitis. This study aims to evaluate the clinical outcomes of a mixed protocol for the regeneration of deep osseous defects. Records obtained from 27 patients who had already received treatment for peri-implantitis on one or more implants were retrospectively examined within the proposed time period between 24 and 30 months after their surgical treatment. A total of 33 implant sites were included and examined retrospectively. Descriptive statistics were calculated that include mean, SD, medians and confidence intervals at 95%. At the baseline, the mean Probing Depth was 8.19 ± 1.23 mm; Bleeding on Probing (BOP) was present on 29 out of 33 treated areas; pus was instead present on 17 out of 33 sites. At the time of final examinations, BOP was present on 9 out of 33 sites; pus was present only on two surgical sites. To conclude, a combined chemical-mechanical and regenerative decontamination therapy is effective in the treatment of peri-implantitis. Further investigation, which includes a control group and/or histologic findings, might be needed to ascertain the clinical results reported in the clinical studies.

Massive gingival enlargement in a nine-year-old paediatric patient: A rare case report.

Gingival enlargement (GE) is a well-known clinical phenomena with the primary aetiology being plaque and poor oral hygiene. Many reasons for GE have been known. Most of the time good oral hygiene is sufficient to achieve normal healthy gingiva. GE is a heterogeneous group of disorder characterized by progressive enlargement of the gingiva with an increase in submucosal connective tissue elements. Some of them are inherited and iatrogenic while others are idiopathic. In this case, we report a case with massive idiopathic GE in a 9-year-old female child; treatment received, histopathological description and follow-up are discussed.

Effectiveness of Platelet-Rich Fibrin in the Treatment of Intrabony Defects with or Without Bone Graft: A Clinical Comparative Study.

BACKGROUND: Periodontal diseases are a group of inflammatory diseases causing alveolar bone loss and eventually leading to loss of teeth. The present study was evaluated the effectiveness of platelet-rich fibrin (PRF) in the treatment of intrabony defects with or without bone graft. MATERIALS AND METHODS: Thirty subjects with the presence of intrabony defects were enrolled. All subjects were included irrespective of age and gender. A questionnaire was prepared for extracting demographic and personal details of all the patients. William probe and moth mirror-tweezers set was used for carrying out clinical examination of all subjects. Random and unbiased division of all the subjects was done with ten patients in each group as follows: Group I: Subjects in which treatment was carried out using PRF with demineralized bone matrix, Group II: Subjects in which treatment was carried out using PRF alone, and Group III: Subjects in which treatment was carried in the form of open flap debridement (OFD). Pretreatment and posttreatment clinical variables were assessed which included plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively were calculated. RESULTS: Mean PI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean PI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the PI among the three study groups at follow-up. Mean GI among Group 1, Group 2, and Group 3 at baseline was 0.78, 0.8, and 0.84, respectively. Mean GI among Group 1, Group 2, and Group 3 at 9 months follow-up was 0.56, 0.55, and 0.72, respectively. Significant results were obtained while comparing the GI among the three study groups at follow-up. Significant difference was seen in PD, RAL, and GR from baseline to 9 months in all groups (P < 0.05). CONCLUSION: PRF leads to significantly better improvement in the clinical parameters on follow-up in comparison to OFD alone in patients with the presence of intrabony defects.

Role of natural salivary defenses in the maintenance of healthy oral microbiota in children and adolescents.

AIM: The present study served the purpose of assessing the levels of salivary immunoglobulin A (IgA), immunoglobulin G (IgG), proteins, calcium, inorganic phosphorus, and alkaline phosphatase levels in caries-free and caries active children. MATERIALS AND METHODS: Stratified randomized sampling method was used to include 40 subjects in the age group 12-15 years having a full complement of permanent dentition except for third molars. The selected pediatric subjects were further divided into two groups of 20 each based on DMFS score, Group-I - Caries free (DMFS score = 0) and Group-II - Caries active (DMFS score ≥10). Unstimulated midmorning saliva samples were collected and analyzed colorimetrically and by radial immunodiffusion method for constituents of saliva understudy. RESULTS: The mean salivary IgA levels in children in Group-I (caries-free children) was 10.63 ± 2.85 mg/dL which was statistically higher as compared to caries active children in Group-II (8.50 ± 1.43 mg/dL).The mean salivary protein level in children of Group-II was statistically higher at 3.28 ± 0.12 mg/dL as compared to Group-I (2.89 ± 0.11 mg/dL). CONCLUSION: The present study showed decreased levels of salivary immunoglobulin A and high concentration of salivary protein in children with increased caries experience which is indicative of the protective role of salivary constituents in caries-free children.