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REVIEW ARTICLE |
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Gene therapy and its implications in Periodontics |
p. 1 |
Swapna Mahale, Nitin Dani, Shumaila S Ansari, Triveni Kale DOI:10.4103/0972-124X.51886 PMID:20376232Gene therapy is a field of Biomedicine. With the advent of gene therapy in dentistry, significant progress has been made in the control of periodontal diseases and reconstruction of dento-alveolar apparatus.
Implementation in periodontics include:
-As a mode of tissue engineering with three approaches: cell, protein-based and gene delivery approach.
-Genetic approach to Biofilm Antibiotic Resistance.
Future strategies of gene therapy in preventing periodontal diseases:
-Enhances host defense mechanism against infection by transfecting host cells with an antimicrobial peptide protein-encoding gene.
-Periodontal vaccination.
Gene therapy is one of the recent entrants and its applications in the field of periodontics are reviewed in general here. |
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ORIGINAL ARTICLES |
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Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional study |
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Nupur Agarwal, Veerendra S.C. Kumar, Sheela A Gujjari DOI:10.4103/0972-124X.51887 PMID:20376233Aims and Objectives : Anemia of chronic disease (ACD) is one of the most common forms of anemia. It is defined as anemia occurring in chronic infections, inflammatory conditions or neoplastic disorders which are not due to marrow deficiencies or other diseases, and occurring despite the presence of adequate iron stores and vitamins. Periodontitis is one of the most prevalent chronic inflammatory diseases in humans. This study aimed at finding out if periodontitis, like other inflammatory conditions, could lead to anemia. Materials and Methods : Thirty chronic generalized periodontitis male patients with hemoglobin levels below 15 mg/dl and serum ferritin values above 30 ng/ml were selected. The various blood parameters recorded at baseline were hemoglobin levels(Hb), erythrocyte count (RBC), erythrocyte sedimentation rate (ESR), mean corpuscular volume(MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). Periodontal parameters recorded at baseline included: plaque index, gingival index, probing pocket depth, clinical attachment level. Periodontal treatment including surgery if required was carried out in all the patients. Periodontal status of patients was monitored by repeating evaluation of periodontal indices at three months and at the end of one year. The hematological values were again measured at the end of one year. Results: The results showed that correction of periodontal inflammation resulted in a significant increase in hemoglobin levels and erythrocyte counts. The erythrocyte sedimentation rate showed a reduction indicating resolution of periodontal inflammation. There was a significant, but much lesser, improvement in MCV, MCH and MCHC values. Conclusion: The results of this study showed that treatment of periodontitis leads to an improvement in hematocrit and other related blood parameters in chronic generalized periodontitis patients with anemia. This provides evidence that periodontitis like other chronic diseases may also cause anemia. |
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The location of cemento enamel junction for CAL measurement: A clinical crisis |
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KL Vandana, Ira Gupta DOI:10.4103/0972-124X.51888 PMID:20376234Background: We face various problems while measuring the Clinical attachment level (CAL) from Cemento-enamel junction (CEJ). This study aims to record and compare the CEJ location measurements using a xed reference point (FRP) [Custom made stent] before and after ap elevation. Materials and Methods: A custom made stent and UNC-15 probe were used. Recording of CEJ location was made using a UNC-15 (Hu-Friedy) probe, before (close CEJ) and after (Open CEJ) the reflection of the flap from the lower edge of the stent in those subjects who were indicated for flap surgery, at baseline. Results: We used statistical analysis involving intra-group comparison done by Paired-'t' test. The close and the open CEJ measurements demonstrated a, statistically, non-significant difference. The equi-measurements of close and open CEJ numerical data were remarkably lower than the under and overestimation of measurements. Thus, despite certain disadvantages of stent, the FRP provides a simple solution for CAL measurement. Conclusion: The results of this study confirms the objective of the study and strongly suggests that CAL measurements done without FRP is subjected to great variation and the diagnostic and prognostic interpretation of CAL should be viewed seriously in periodontics. |
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Gingival recession in school kids aged 10-15 years in Udaipur, India |
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Anmol Mathur, Manish Jain, Koushal Jain, Mahima Samar, Balasubramanya Goutham, Prabu Durai Swamy, Suhas Kulkarni DOI:10.4103/0972-124X.51889 PMID:20376235Aim : The study aimed to determine the incidence of gingival recession in the mandibular central incisor region among school children aged 10-15 years in Udaipur (India). Materials and Methods : A sample of 1800 males and female kids were examined in a mobile dental unit. World Health Organisation (WHO) rules and standards were followed. Result : Gingival recession, when compared, with respect to age, mean clinical crown length, anterior crowding and frenal involvement was significant (p less than 0.00) with respect to affected teeth. |
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Root coverage in class I gingival recession defects, combining rotated papillary pedicle graft and coronally repositioned flap, using a micro surgical approach: A clinical evaluation |
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Tella Asha Latha, Sabitha Sudarsan, KV Arun, Avaneendra Talwar DOI:10.4103/0972-124X.51890 PMID:20376236Background: The purpose of this case study was to evaluate the success and predictability of a rotated papillary pedicle graft in combination with the coronally advanced flap using surgical loupe (2.5X magnification) for the treatment of Miller's class I gingival recession. Materials and Methods: Fifteen systemically healthy patients with isolated gingival recession underwent the procedure. The probing depth, percentage root coverage, width of the keratinized gingiva and the gain in clinical attachment, papilla width, papilla height, area of the papilla at the donor site, were recorded at baseline, 3 months and 12 months. Results: All parameters except probing pocket depth, significantly improved from baseline to 12 months. The mean recession defect of 2.67 ± 0.03 mm present at baseline reduced to 0.13 ± 0.35 mm at the end of the 3 rd months and stabilized at 0.27 ± 0.59 mm at 12 months. The mean reduction in recession depth was 2.40 ± 0.03 mm at the end of the study. Complete recession coverage was obtained in 13 of the 15 (87%) of the cases treated with a mean percentage recession coverage at 12 months being 86 ± 35.19%. The gain in the width of the keratinized gingiva was 1.33 ± 0.13 mm at the end of the study. There was no postoperative morbidity from where the graft was harvested at the end of the study period. Conclusion: The use of magnification in mucogingival surgery resulted in achieving a high degree of success and predictability as well as an excellent esthetic outcome. |
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SHORT COMMUNICATIONS |
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Implant success!!!.....simplified |
p. 27 |
Kaushal K Luthra DOI:10.4103/0972-124X.51891 PMID:20376237The endeavor towards life-like restoration has helped nurture new vistas in the art and science of implant dentistry. The protocol of "restoration-driven implant placement" ensures that the implant is an apical extension of the ideal future restoration and not the opposite. Meticulous pre-implant evaluation of soft and hard tissues, diagnostic cast and use of aesthetic wax-up and radiographic template combined with surgical template can simplify the intricate roadmap for appropriate implant treatment.
By applying the harmony of artistic skill, scientific knowledge and clinical expertise, we can simply master the outstanding implant success in requisites of aesthetics, phonetics and function. |
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Is the role of probiotics friendly in the treatment of periodontal diseases !! |
p. 30 |
D Deepa, DS Mehta DOI:10.4103/0972-124X.51892 PMID:20376238Probiotics utilize naturally occurring bacteria to confer a health benefit when administered in adequate amounts. A few conventional foods containing probiotics are yogurt, fermented and unfermented milk, soy beverages etc. Most often, they come from two groups of bacteria, Lactobacillus or Bifidobacterium. Probiotics have been extensively studied for their health promoting effects. Scientific understanding of probiotics and their potential for preventing and treating periodontal conditions is at its infancy, but moving ahead. Extensive research to create a probiotic product intended to maintain dental and periodontal health is needed. |
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CASE SERIES |
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Rehabilitation using single stage implants |
p. 32 |
Jumshad B Mohamed, Sabitha Sudarsan, KV Arun, B Shivakumar DOI:10.4103/0972-124X.51893 PMID:20376239Implant related prosthesis has become an integral part of rehabilitation of edentulous areas. Single stage implant placement has become popular because of its ease of use and fairly predictable results. In this paper, we present a series of cases of single stage implants being used to rehabilitate different clinical situations. All the implants placed have been successfully restored and followed up for up to one year. |
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CASE REPORTS |
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Conservative management of amlodipine influenced gingival enlargement |
p. 41 |
Rashmi P Dhale, Mangesh B Phadnaik DOI:10.4103/0972-124X.51894 PMID:20376240Gingival enlargement is a well recognized unwanted effect associated mainly with anticonvulsant drugs, immunosuppressant drugs and calcium channel blockers. Amlodipine influenced gingival enlargement is comparatively less prevalent amongst calcium channel blockers. It causes aesthetic disfigurement, speech disturbances, abnormal tooth movement and difficulty in mastication. The management of drug influenced gingival enlargement is a challenge for the periodontist, mainly due to less understanding of its pathogenesis, difficulties in selection of proper line of management and recurrence of the enlargement. This report discusses the importance of conservative approach (scaling and root planning along with drug replacement) in the management of a case of amlodipine influenced gingival enlargement. The need for extensive surgery was decreased after this approach. |
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Management of localized gingival recession by two-stage surgical procedure - Double pedicle flap with CTG and coronally advanced flap:
A novel technique |
p. 44 |
T Prasanth DOI:10.4103/0972-124X.51895 PMID:20376241Cosmetic treatments have become an integral part of periodontal treatment. One of the commonly used esthetic periodontal procedures is coverage of denuded root surface. While considering the elimination of these defects two criteria should be considered, the esthetic aspects and the functional aspects. This case report has describes a two stage surgical technique using double pedicle flap with connective tissue graft followed by coronally advanced flap for the treatment of a severe localized gingival recession measuring 15 mm. The recession measurement at the end of 12 months was 1 mm. It showed a predictable result at the end of one year. The advantages of this technique are excellent colour matching, dual blood supply to graft and very predictable results. The promising result suggest that this technique can be used in severe gingival recession cases with minimum amount of keratinized tissue. |
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Staining of palatal torus secondary to long term minocycline therapy |
p. 48 |
Aravind Buddula DOI:10.4103/0972-124X.51896 PMID:20376242Minocycline and other tetracycline analogs are well known to cause discoloring of alveolar bone, teeth and other tissues. The present case reports palatine torus discoloring, in a 91-year-old patient, after long term minocycline therapy. The patient was presented with staining of the palatal torus resulting from prior minocycline use for three-and-a-half years. The diagnosis of minocycline staining of palatal torus was done during a routine hygiene examination. The patient was informed that the bluish appearance of the palatal torus was the result of long term minocycline use. The patient was not willing to discontinue the antibiotic and was not concerned about the appearance. The clinician should inform patients on long term minocycline therapy about the possible side effects of staining of the alveolar bone, teeth and other soft tissue. |
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Platelet-rich-fibrin: A novel root coverage approach  |
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K Anilkumar, A Geetha, Umasudhakar , T Ramakrishnan, R Vijayalakshmi, E Pameela DOI:10.4103/0972-124X.51897 PMID:20376243Treatment of gingival recession has become an important therapeutic issue due to increasing cosmetic demand. Multiple surgical procedures have been developed to obtain predictable esthetic root coverage. More specifically, after periodontal regenerative surgery, the aim is to achieve complete wound healing and regeneration of the periodontal unit. A recent innovation in dentistry is the preparation and use of platelet-rich plasma (PRP), a concentrated suspension of the growth factors, found in platelets. These growth factors are involved in wound healing and postulated as promoters of tissue regeneration. This paper reports the use of PRF membrane for root coverage on the labial surfaces of the mandibular anterior teeth. This was accomplished using laterally displaced flap technique with platelet rich fibrin (PRF) membrane at the recipient site. |
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A case report of metastatic adenocarcinoma of the gingiva |
p. 55 |
Aravind Buddula DOI:10.4103/0972-124X.51898 PMID:20376244Localized gingival enlargement is often associated with specific systemic medication, abscess formation, trauma or reactive lesions. Scant literature is available reporting enlargement of gingiva due the metastasis of adenocarcinoma from lung. The case report presents a unique case of an adenocarcinoma in the lung metastasizing to the buccal and lingual interdental papillae of teeth numbering 34 and 35. A 72-year-old female was referred to the Mayo Clinic with a recent diagnosis of metastatic stage IV adenocarcinoma of the left lung presented with an abnormal mass located on the left posterior buccal keratinized tissue adjacent to teeth numbering 34-35. Biopsy of the lesion was performed for CK7, CK20, TTF-1 and p63. The tumor cells were positive for CK7 and TTF-1, and weakly positive for p63 suggesting a diagnosis of adenocarcinoma. The periodontist may be in the unique position to be the first oral health care provider to evaluate any biopsy suspicious intra-oral lesions. |
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PRACTITIONER SECTION |
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Tooth polishing: Relevance in present day periodontal practice |
p. 58 |
Charu Madan, Rhythm Bains, Vivek K Bains DOI:10.4103/0972-124X.51899 PMID:20376245Time has seen the emergence of more efficient and effective devices like jet abrasives. However, the role of rubber cups with prophy angles cannot be overlooked as they are still being widely used and provide an economical alternative. Owing to several shortcomings associated with the air polishing device using sodium bicarbonate (NaHCO 3 ), trends are shifting towards the usage of low abrasive powders. Recent demonstration of Glycine Powder Air Polishing (GPAP) in removing subgingival biofilm results in less gingival erosion than hand instrumentation or NaHCO 3 air-polishing. Despite the emergence of latest advances in polishing, data suggesting selective polishing of teeth is compelling. |
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