Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
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   Table of Contents - Current issue
Coverpage
November-December 2015
Volume 19 | Issue 6
Page Nos. 607-728

Online since Monday, December 28, 2015

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EDITORIAL  

We're moving forward…join the momentum! p. 607
Ashish Sham Nichani
DOI:10.4103/0972-124X.172689  
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PRESIDENT’S MESSAGE Top

Research-introspect, initiate, implement p. 608
Praveen Bhasker Kudva
DOI:10.4103/0972-124X.172690  
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SECRETARY’S MESSAGE Top

Progressive alliance p. 609
Balaji Manohar
DOI:10.4103/0972-124X.172691  
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LETTERS TO EDITOR Top

Recurrent idiopathic gingival fibromatosis with generalized aggressive periodontitis: A rare case report p. 610
Narinder Dev Gupta, Lata Goyal
DOI:10.4103/0972-124X.172692  
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Author's Reply: Recurrent idiopathic gingival fibromatosis with generalized aggressive periodontitis: A rare case report p. 610
Ashwini Jadhav
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REVIEW Top

Oral health knowledge and awareness among pregnant women in India: A systematic review p. 612
Ramandeep Singh Gambhir, Ashutosh Nirola, Tarun Gupta, Tegbir Singh Sekhon, Samir Anand
DOI:10.4103/0972-124X.162196  
Pregnancy is a unique period during a woman's life and is characterized by complex physiological changes, which may adversely affect oral health. The present systematic review was conducted to assess knowledge and awareness regarding oral health among pregnant women in India. Relevant cross-sectional observational studies were included in the systematic review to assess the level of knowledge and awareness regarding oral health among pregnant women in India. Seven studies out of 255 were finally included in the present review after conducting both electronic and manual search of scientific databases. Potential biases were reported and appropriate data were extracted by the concerned investigators. Almost 67% of the subjects had good knowledge and awareness regarding oral health in one of the study findings. Knowledge regarding effect of decayed teeth on the appearance of the people was significantly related to the parity status of the subjects (P = 0.024) in other study reports. Very few subjects (17.1% and 37.5%) felt the need for visiting a dentist during pregnancy in two studies. The results of the present review showed that pregnant women had poor knowledge and awareness regarding oral health. Therefore, there is an urgent need for education and motivation of expectant mothers regarding oral health through various health promotion interventions.
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ORIGINAL RESEARCH Top

Relationship between interleukin 1α levels in the gingival crevicular fluid in health and in inflammatory periodontal disease and periodontal inflamed surface area: A correlative study p. 618
Kalaichelvi Govindarajan, Santhanakrishnan Muthukumar, Suresh Rangarao
DOI:10.4103/0972-124X.162197  
Background: Periodontitis has been suggested as a source of inflammation for pathological changes in distant sites. Interleukin-1 alpha (IL-1α) has shown to have specific roles in inflammation, immunity, tissue breakdown, and tissue homeostasis. This study assessed the correlation of periodontal inflamed surface area (PISA) index with the gingival crevicular fluid (GCF) levels of IL-1α, which would be helpful in evaluating the validity of PISA index in terms of reflection of the disease. Materials and Methods: A total of 40 subjects were recruited for this study and 20 subjects with healthy gingiva (Group I) served as controls and 20 subjects served as cases with periodontitis (Group II). Samples of GCF were obtained from one site in each patient by placing color-coded, calibrated, volumetric microcapillary pipettes extracrevicularly, and subjected to ELISA test. Results: There was a statistical significance for mean probing depth (PD) and periodontal epithelial surface area (PESA) (P < 0.01), mean bleeding on probing and PISA, IL-1α (P < 0.01) and PESA (P < 0.05) in Group I. Statistical significance was found between PISA and IL-1α in Group I (P < 0.01). A positive correlation was found in Group II between mean PD and mean attachment loss (P < 0.01), PISA, IL-1α and PESA (P < 0.01), PISA and IL-1α levels (P < 0.01) which was statistically significant. Conclusion: The inflammatory burden index was statistically significant in the periodontitis group correlating with higher IL-1α levels, which clearly indicates the validity of PISA index.
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Evaluation of mRNA expression of the transcription factors of Th1 and Th2 subsets (T-bet and GATA-3) in periodontal health and disease - A pilot study in south Indian population p. 624
Nichenametla Rajesh, Kurumathur Vasudevan Arun, Tirumelveli Saravanan Subbu Kumar, Kondareddy Krishna Mohan Reddy, Swarna Alamelu, Bhimavarapu Ravinder Reddy
DOI:10.4103/0972-124X.164748  
Background: Based on their respective pro- or anti-inflammatory cytokine profiles, the Th1/Th2 paradigm explains pathogenic mechanisms involved in periodontal disease. Establishment of Th1 and Th2 subsets from a naive T-cell precursor depends on transcriptional regulation. The aim of this study was to compare the expression of master transcription factor regulators T-bet and GATA-3, respectively, to indicate the predominance of Th1 and Th2 subsets in the presence and absence of periodontal disease. Materials and Methods: A gingival tissue biopsy sample was obtained from each of 10 severe periodontitis patients (>5 mm attachment loss) and 10 periodontally healthy patients (no attachment loss). Biopsies were immediately processed by real-time reverse transcriptase polymerase chain reaction and the difference in mRNA expression of T-bet and GATA-3 was assessed for each group. Results: The mRNA expression of T-bet was marginally increased about 1.31-fold in disease, while the GATA-3 levels showed a significant decrease of 4.39-fold in disease. Conclusion: The advanced periodontal lesions lack Th2 cells, which produce anti-inflammatory cytokines. The biopsies were therefore dominated by Th1 cells, which activate macrophages and osteoclasts.
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Association of serum immunoglobulin-G to Porphyromonas gingivalis with acute cerebral infarction in the Chinese population p. 628
Zhang Zheng, Ning Ma, Youli Zheng, Li Zhang
DOI:10.4103/0972-124X.164750  
Background/Purpose: There is evidence supporting an association between ischemic stroke and periodontitis in western countries. Differing genetic backgrounds and lifestyles among populations may affect this association. The aim of our study was to determine whether antibody titers to Porphyromonas gingivalis are associated with acute cerebral infarction in the Chinese population. Materials and Methods: This case-control study was conducted on 88 acute cerebral infarction patients and 40 healthy control subjects. Serum immunoglobulin-G (IgG) antibody to P. gingivalis was analyzed by enzyme-linked immune sorbent assay. Serum lipids were determined with the automatic biochemical analyzer. Fibrinogen was measured using automated coagulation analyzer. High-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were quantified using commercial ELISA kits. The intima-media thickness of the common carotid arteries (IMT-CCA) was measured by ultrasonography. Results: The results showed that P. gingivalis IgG antibody levels were significantly higher in acute cerebral infarction cases than in healthy controls (mean ± standard deviation, 11.06 ± 1.49 vs. 9.15 ± 1.70, P < 0.001). There were significant correlations of P. gingivalis IgG titer with total cholesterol (r = 0.34, P = 0.001), low-density lipoprotein (r = 0.39, P < 0.001), apolipoprotein-B (r = 0.30, P = 0.004), hs-CRP (r = 0.35, P = 0.001), IL-6 (r = 0.27, P = 0.011), and IMT-CCA (left: r = 0.306, P = 0.004; right: r = 0.241, P = 0.024). Conclusion: Antibody titers to P. gingivalis are associated with acute cerebral infarction in the Chinese population.
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A comparative evaluation of the efficacy of probiotic and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A randomized controlled clinical study p. 633
Purnima Vidyesh Nadkerny, Potluri Leela Ravishankar, Virupapuram Pramod, Lavanya Abhay Agarwal, Saurabh Bhandari
DOI:10.4103/0972-124X.168491  
Background: The aim of our clinical trial was to assess and compare the antiplaque and anti-inflammatory potential of a probiotic mouthwash with 0.2% chlorhexidine and saline. Materials and Methods: A randomized parallel group study was designed for a period of 4 weeks on 45 systemically healthy subjects between 20 and 30 years having chronic gingivitis. The study population was divided into three groups. Group A - 15 subjects were advised experimental (probiotic) mouthwash. Group B - 15 subjects were advised positive control (chlorhexidine) mouthwash and Group C - 15 subjects into a negative control group (normal saline). Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, all the three groups were instructed to rinse their mouth with 10 ml of their respective mouthrinse, undiluted for 1 min twice daily, 30 min after brushing. Clinical parameters such as plaque index (PI), gingival index (GI), and oral hygiene index simplified (OHI-S) were assessed at baseline, 2 weeks and 4 weeks, respectively. Results: At day 28, the PI, GI, and OHI-S were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than saline. Conclusion: The probiotic mouthrinses tested was effectively used as an adjunct to mechanical plaque control in the prevention of plaque and gingivitis. Thus, the probiotic mouthrinse has a great therapeutic potential.
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The influence of soft tissue biotype on the marginal bone changes around dental implants: A 1-year prospective clinico-radiological study p. 640
Pragathi Raghavendra Bhat, Srinath Lakshman Thakur, Sudhindra Sushilendra Kulkarni
DOI:10.4103/0972-124X.168489  
Background: The peri-implant mucosa undergoes surgical and bacterial assaults in various stages of implant therapy, however, the literature on changes occurring in the peri-implant mucosa is minimal. This study was thus conducted to evaluate the change in the peri-implant mucosal thickness and its effect on the marginal bone levels around dental implants treated in a conventional two-stage implant therapy. Materials and Methods: A total of 36 implants were placed in 22 subjects. Two subjects dropped out. Thirty-three implants in 20 subjects were then evaluated. Initial mucosal thickness, marginal bone levels on radiographs, pain, and exudation were evaluated. All these parameters were recorded at the time of implant placement, at the time of cementation of final restoration, 6 months and 12 months post cementation/restoration. Results: The peri-implant mucosal thickness reduced from implant placement to second stage and till restorations and was statistically significant, in both the thick and thin biotypes, however, at 12 months there was a rebound of the tissue thickness, which was more in the thick biotype (P < 0.05). At 1-year follow-up, there was a reduction in the marginal bone levels, which was more in the thick biotype as compared to the thin biotype (P < 0.05). Conclusion: The mucosa at implant sites undergoes a reduction in thickness from the time of implant placement till the placement of final restorations. The placement of the final restorations and then end of active therapy leads to a rebound of the tissue thickness. Sites with thicker tissues preoperatively have a lesser bone loss and better rebound as compared to thinner tissues.
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A comparative evaluation of freeze-dried bone allograft with and without bioabsorbable guided tissue regeneration membrane Healiguide® in the treatment of Grade II furcation defects: A clinical study p. 645
Deept Jain, Dhruvakumar Deepa
DOI:10.4103/0972-124X.162198  
Background: Furcation defects represent one of the most demanding therapeutic challenges for periodontal therapy. Various treatment modalities have been tried with different success rates. The present study was undertaken to evaluate the efficacy of freeze-dried bone allograft (FDBA) with and without bioabsorbable guided tissue regeneration (GTR) membrane Healiguide® in the treatment of Grade II furcation defects. Materials and Methods: Ten patients with bilateral Grade II furcation defects were selected for the study. After phase I therapy, subjects were divided into two arms and treated in a split-mouth design. Ten defects were treated with FDBA alone in the control arm. Ten defects were treated with FDBA in conjunction with bioabsorbable GTR membrane Healiguide® in test arm. Clinical parameters like plaque index, gingival index, vertical probing depth, horizontal probing depth, and relative attachment level (RAL) were assessed at baseline, 3 months, and 6 months postoperatively. Results: At 6 months, clinical improvement was seen in both the arms with mean pocket depth reduction of 1.2 ± 1.032 mm and 1.7 ± 0.948 mm and mean horizontal probing depth reduction being 2.1 ± 1.969 mm and 1.6 ± 1.264 mm in control and test arm, respectively. Both surgical procedures resulted in a statistically significant reduction in vertical and horizontal probing depths. Conclusion: Both the arms demonstrated a significant improvement in the probing depth, horizontal furcation depth, and RAL at 6 months postsurgery in the treatment of Grade II furcation defects. However, on the intergroup comparison, there was no statistically significant difference in the results achieved between two arms.
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Evaluation of anorganic bovine-derived hydroxyapatite matrix/cell binding peptide as a bone graft material in the treatment of human periodontal infrabony defects: A clinico-radiographic study p. 651
Ghousia Fatima, Ravindra Shivamurthy, Srinath Thakur, Mohammad Abdul Baseer
DOI:10.4103/0972-124X.164766  
Background: Various bone graft materials have been used in the treatment of periodontal defects. A synthetic bone substitute material composed of P-15 with anorganic bone mineral has been scantly studied. Hence, the present study was aimed to evaluate and compare the efficacy of anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) in human periodontal infrabony defects with that of open flap debridement (OFD) alone. Materials and Methods: A split-mouth, randomized controlled clinical study was designed to investigate the efficacy of ABM/P-15. In this clinical trial, 10 patients having bilateral periodontal infrabony defects were treated either with ABM/P-15 or OFD and followed for a period of 9 months. At baseline and at 9 months probing pocket depth (PPD), relative attachment level (RAL), depth of a defect, and radiographic bone level were measured; and compared between test and control sites. Results: A statistically significant reduction (P < 0.001) in PPD was observed in test sites compared to control sites. Both sites showed a gain in RAL without any significant difference. Similarly, the radiographic evaluation revealed significantly higher radiographic defect fill in test sites as compared to control sites (P < 0.001). Conclusion: ABM/P-15 bone graft material appears to be useful and beneficial in the treatment of human periodontal infrabony defects.
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Comparative clinical evaluation of laterally positioned pedicle graft and subepithelial connective tissue graft in the treatment of Miller's Class I and II gingival recession: A 6 months study p. 659
Kirti Satish Dulani, Neeta Vijay Bhavsar, Sakshee Rahul Trivedi, Rahul Anil Trivedi
DOI:10.4103/0972-124X.164762  
Aim: The purpose of the study was to compare clinical outcomes of laterally positioned pedicle graft (LPPG) and subepithelial connective tissue graft (SCTG) for treatment of Miller's Class I and II gingival recession defects, at the end of 6 months. Materials and Methods: Sixty Miller's Class I or II gingival recession defects (≥3 mm) (n = 30 each) on the labial aspect of anterior teeth were treated by either of the above techniques. Clinical parameters including recession depth (RD), width of keratinized gingiva (WKG), percentage of root coverage (%RC), and complete RC were recorded at baseline and 6 months postoperatively. Data were recorded and statistical analysis was done for both intergroup and intragroup. Statistical Analysis Used: Paired t-test intragroup and Student's t-test intergroup. Results: In LPPG, RD decreased from 4.9 ± 0.99 mm to 1.1 ± 0.3 mm and WKG increased from 0.7 ± 0.87 to 4.5 ± 0.86 mm at 6 months, while in SCTG, RD decreased from 4.67 ± 1.12 mm to 0.46 ± 0.68 mm and WKG increased from 1.1 ± 0.99 to 5.33 ± 0.72 mm at 6 months postoperatively. The values of the soft tissue coverage remained stable for 6 months. Conclusions: Highly significant and effective soft tissue coverage was obtained by both techniques. LPPG resulted in effective soft tissue coverage for isolated deep narrow defects while SCTG in isolated and multiple, deep narrow and wide defects.
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Platelet Rich Fibrin in double lateral sliding bridge flap procedure for gingival recession coverage: An original study p. 665
Vijayalakshmi Rajaram, Ramakrishnan Thyegarajan, Ashwath Balachandran, Geetha Aari, Anilkumar Kanakamedala
DOI:10.4103/0972-124X.164764  
Background: Gingival recession is a common occurrence in periodontal disease leading to an unaesthetic appearance of the gingiva. The effect of platelet-rich fibrin (PRF), when used along with double lateral sliding bridge flap (DLSBF), remains unknown. The aim of this study is to evaluate the effect of PRF in conjunction with DLSBF for multiple gingival recessions. Materials and Methods: Twenty systemically healthy individuals exhibiting Grade II gingival recession on their mandibular central incisors were recruited in this study. These patients were randomly assigned into two groups: DLSBF and PRF + DLSBF. The clinical parameters that were evaluated in this study were gingiva recession height, gingiva recession width, width of keratinized gingiva, clinical attachment level, and probing depth. PRF was procured from the patient's blood at the time of the surgery and used for the procedure. The follow-up was performed at 12 and 24 weeks postsurgery. Results: Statistically significant difference was observed between the clinical parameters at baseline and 12 and 24 weeks within the groups. There was no statistically significant difference, between the groups. Mean root coverage (RC) was 80% ±29.1% in the DLSBF group and 78.8% ±37.6% in the DLSBF + PRF group with no statistically significant difference. Conclusion: From the results obtained in this study, the addition of PRF to DLSBF gives no additional benefits to the clinical parameters measured in RC.
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Etiology and occurrence of gingival recession - An epidemiological study p. 671
Sarpangala Mythri, Suryanarayan Maiya Arunkumar, Shashikanth Hegde, Shanker Kashyap Rajesh, Mohamed Munaz, Devasya Ashwin
DOI:10.4103/0972-124X.156881  
Objectives: Gingival recession is the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth. It is frequently observed in adult subjects. The occurrence and severity of the gingival recession present considerable differences between populations. To prevent gingival recession from occurring, it is essential to detect the underlying etiology. The aim of the present study was to determine the occurrence of gingival recession and to identify the most common factor associated with the cause of gingival recession. Methods: A total of 710 subjects aged between 15 years to 60 years were selected. Data were collected by an interview with the help of a proforma and then the dental examination was carried out. The presence of gingival recession was recorded using Miller's classification of gingival recession. The Silness and Loe Plaque Index, Loe and Silness gingival index, community periodontal index were recorded. The data thus obtained were subjected to statistical analysis using Chi-square test and Student's unpaired t-test. Results: Of 710 subjects examined, 291 (40.98%) subjects exhibited gingival recession. The frequency of gingival recession was found to increase with age. High frequency of gingival recession was seen in males (60.5%) compared to females (39.5%). Gingival recession was commonly seen in mandibular incisors (43.0%). Miller's class I gingival recession was more commonly seen. The most common cause for gingival recession was dental plaque accumulation (44.1%) followed by faulty toothbrushing (42.7%). Conclusion: Approximately half of the subjects examined exhibited gingival recession. The etiology of gingival recession is multifactorial, and its appearance is always the result of more than one factor acting together.
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Periodontal disease status and associated risk factors in patients attending a Dental Teaching Hospital in Rawalpindi, Pakistan p. 678
Syed Akhtar Hussain Bokhari, Agha Mohammad Suhail, Abdul Razzaq Malik, Mian Farrukh Imran
DOI:10.4103/0972-124X.156882  
Background: Investigators have identified an association of socio-demographic and medical factors with periodontal risk. This study observed status and association of periodontal disease and associated risk factors/indictors. Materials and Methods: All patients attending a dental teaching hospital were interviewed for socio-demographic and medical information through a structured questionnaire. Participants were examined for periodontal status using the community periodontal index (CPI), by a single examiner during September to November 2012. An association of age, gender, smoking habit, systemic conditions, and oral hygiene measures with periodontal status ([periodontitis CPI score ≥3]/nonperiodontitis [CPI score ≤2]) was analyzed by applying Chi-square test and forward selection stepwise regression analysis. Results: One thousand nine hundred and eighteen patients were examined during the study period. The findings revealed that 63.5% of the subjects had CPI score ≤2 (nonperiodontitis), while 34.5% were found with CPI score ≥3 (periodontitis). Age, gender, occupation, smoking, diabetes, arthritis, cardiovascular disease, kidney disease, stress, medications, and oral hygiene habits of using tooth powder or tooth brushing were significantly (P ≤ 0.037) associated with periodontal status. Regression analysis showed a significant association of age, occupation, and smoking with periodontitis. Conclusion: This study observed prevalence of periodontitis in one-fourth of study sample. The study confirmed various socio-demographic risk factors/indictors associated with increased risk of periodontitis.
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Evaluation of oral health attitude and behavior among a group of dental students in Puducherry, India: A preliminary cross-sectional study p. 683
Jananni Muthu, Gayathri Priyadarshini, Sivaramakrishnan Muthanandam, Saravanakumar Ravichndran, Pratebha Balu
DOI:10.4103/0972-124X.164744  
Context: Oral behavior reflects individual perception on oral health. Behavior and attitude of oral health providers, especially dentists, towards oral health affect their capacity to deliver oral health care services. This attitude plays a important role in determining the oral health condition of population. Aim: The purpose of this study is to evaluate the oral health attitude and behavior among a group of dental students in India and to find any gender-based differences in terms of oral health attitude and behavior. Materials and Methods: A total of 282 dental students of Indira Gandhi Institute of Dental Sciences, SBV University, Puducherry, India participated in the study. A simplified English version of Hiroshima University Dental-Behavioral Inventory (HU-DBI) was adopted. Statistical Analysis Used: SSP version 2.80 software was used to analyze the data. Chi-square test was used to find the differences in the distribution of “yes” among students from the different academic year as well as between male and female students. Statistical significance was set at P ≤ 0.05. Results: Statistical significance was observed for the responses between the students from different academic years brushing frequency, careful brushing of teeth, using brush with hard bristles, careful self-evaluation of brushing and satisfied appearance of teeth and gums. Male students preferred to use a tooth brush with hard bristles and regular mouth washes than female students. With regards to worrying about bad breath, male students had more “yes” responses than females. Conclusions: Oral health attitude and behavior increased with the increasing levels of dental education, and no significant differences were observed among male and female dental students.
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CASE REPORTS/CASE SERIES WITH DISCUSSIONS Top

Gingival enlargement in myelodysplastic syndrome p. 687
Navia George, Vediyera Chandroth Santhosh, Harish Kumar, Saumiya Gopal
DOI:10.4103/0972-124X.164761  
The myelodysplastic syndrome (MDS) is characterized by peripheral blood cytopenias and increased risk of transformation to acute myeloid leukemia. This syndrome affects blood cell production and behavior. MDS is difficult to diagnose because of the absence of symptoms in the early stage of the disease. Often it is accidentally discovered during a routine physical exam/blood test. Till date, only a few cases of gingival enlargement associated with MDS are reported in the literature. Here is a remarkable case of gingival enlargement heralding the presence of MDS.
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Ankyloglossia with cleft lip: A rare case report p. 690
Kritika Jangid, Aurelian Jovita Alexander, Nadathur Doraiswamy Jayakumar, Sheeja Varghese, Pratibha Ramani
DOI:10.4103/0972-124X.162207  
Ankyloglossia or tongue-tie is a congenital anomaly affecting the tongue, which is characterized by thick, short lingual frenulum. This condition causes many difficulties such as limited tongue protrusion, breastfeeding difficulties, speech impairment and lack of self-confidence. It is very rarely associated with any other congenital craniofacial disorders such as cleft lip, X-linked cleft palate, Van der Woude syndrome, Smith-Lemli-Opitz syndrome, Orofacial digital syndrome, Beckwith Weidman syndrome or Simpson-Golabi-Behmel syndrome. This article presents a rare case of ankyloglossia associated with cleft lip treated with diode laser in a 12-year-old Indian boy who had undergone surgical correction of associated cleft lip soon after birth. Correction of ankyloglossia at a young age would lead to enhanced phonetics, improved oral hygiene, and overall personality development.
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Semilunar vestibular technique: A novel procedure for multiple recession coverage (a report of two cases) p. 694
Nymphea Pandit, Inder Kumar Pandit, Deepika Bali, Shaifi Jindal
DOI:10.4103/0972-124X.162204  
The procedures for root coverage have been greatly refined over the past few decades. Still as compared to the other periodontal surgical procedures, predictability of mucogingival procedures remains uncertain which is more in patients who present with multiple recessions or recession complicated with periodontal involvement. Techniques which claim success almost always involve a second surgical site. A novel technique avoiding second surgical site and good predictability for multiple recessions was described by Dr. P.D. Miller in a conference at Pune in 2011. A semilunar vestibular incision technique described by Dr. P.D Miller was performed on two patients who presented with multiple recessions in the maxillary anterior teeth. About 90–100% root coverage was observed when the patients were on a follow-up for 1-year with a significant increase in the vestibular depth. The semilunar vestibular incision technique used in two cases resulted in predictable root coverage with a good color blend, an esthetic marginal morphology and most importantly the avoidance of the second surgical site.
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Idiopathic gingival fibromatosis p. 698
Nitin Hemchandra Dani, Dinkar Parveen Khanna, Vaibhavi Hitesh Bhatt, Chaitanya Pradeep Joshi
DOI:10.4103/0972-124X.162206  
Idiopathic gingival fibromatosis (IGF) is a rare hereditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements, mostly associated with some syndrome. This case report describes a case of nonsyndromic generalized IGF in an 18-year-old male patient who presented with generalized gingival enlargement. The enlarged tissue was surgically removed by internal bevel gingivectomy and ledge and wedge procedure. The patient was regularly monitored clinically for improvement in his periodontal condition as well as for any recurrence of gingival overgrowth.
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Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry p. 701
Abhijit Ningappa Gurav, Abhijeet Rajendra Shete, Ritam Naiktari
DOI:10.4103/0972-124X.162205  
Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect.
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Oral telangiectatic granuloma with an intrabony defect p. 705
Akanksha Rathore, Tanya Jadhav, Anita Kulloli, Archana Singh
DOI:10.4103/0972-124X.164745  
Oral telangiectatic granuloma is a benign hyperplastic lesion occurring in response to trauma or chronic irritation in the oral cavity. The characteristic histological appearance comprises of typical granulation tissue with a proliferation of small thin-walled blood vessels in the loose connective tissue. We describe a case of a 36-year-old female who had a swelling in the left maxillary region which was associated with the intrabony defect. An internal bevel gingivectomy was performed, and the histopathological report was suggestive of telangiectatic granuloma. The intrabony defect was managed with the placement of platelet rich fibrin plug in the defect. A follow-up at 6 months showed no recurrence and no loss in the width of keratinized tissue. The aim of this case is to highlight the rare association of intrabony defect with telangiectatic granuloma and the need for histopathological diagnosis in such lesions.
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Assessment of oral health status among endosulfan victims in endosulfan relief and remediation cell - A cross-sectional survey p. 709
Mundoor Manjunath Dayakar, Dasappa Shivprasad, Anitha Dayakar, Cherian Anna Deepthi
DOI:10.4103/0972-124X.156869  
Background: Endosulfan is a highly toxic agrichemical used in the cashew plantations. The Stockholm Convention held in April 2011 recommended a global ban on the manufacture and use of endosulfan because of its adverse effects on human health and the environment. Its impact on the quality of food, water, and beverages; and its ability to cause neurobehavioral disorders, congenital malformations in female subjects, and abnormalities related to the male reproductive system are studied, but however information regarding the oral health of endosulfan victims is scant. Objectives: To assess the oral health status of the endosulfan victim in rehabilitation center. Method and Methodology: A cross sectional study on 18 subjects of 4-50 years of age were interviewed and examined using modified WHO oral health assessment proforma (1997) in Endosulfan Relief and Remediation Cell in Kokkada, Belthangady Taluk, Dakshina Kannada district, Karnataka, India. Results: Among the subjects, 10 (>50%) were found to be in age group <20 years. The overall oral health status of the endosulfan victim's in rehabilitation center considered to be poor, as many of the subjects suffered from major medical problems like mental retardation, physical disabilities etc. Conclusion: This study emphasizes the need for special attention from government and voluntary organization to improve overall health status of the victims.
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NEWS AND EVENTS Top

News and Events p. 712
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AUTHOR INDEX, 2015 Top

Author Index, 2015 p. 718
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TITLE INDEX, 2015 Top

Title Index, 2015 p. 726
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