Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
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   2010| January-March  | Volume 14 | Issue 1  
    Online since July 13, 2010

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Legal aspects in dentistry
Rajan Dhawan, Shivani Dhawan
January-March 2010, 14(1):81-84
  17,229 1,941 -
An update on periodontic-orthodontic interrelationships
Aous Dannan
January-March 2010, 14(1):66-71
DOI:10.4103/0972-124X.65445  PMID:20922083
Talking about periodontic-orthodontic interrelationships is related primarily to the 1960s, where a generalized increase in salivary bacterial counts, especially Lactobacillus, had been shown after orthodontic band placement. The purpose of this article is to provide the dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics by means of representing classical studies, and, to give an update on this topic by demonstrating the most recent opinions concerning periodontic-orthodontic interrelationships. Specific areas reviewed are the ability of orthodontic treatment to afford some degree of protection against periodontal breakdown, short-term and long-term effects of orthodontic treatment on the periodontium, and some mucogingival considerations. Topics considering orthodontic treatment in periodontally compromised patients were not included in this review. While past studies have shown that orthodontic treatment can positively affect the periodontal health, recent reviews indicate an absence of reliable evidence for the positive effects of orthodontic therapy on patients' periodontal status. Periodontic-orthodontic interrelationships are still controversial issues. However, a standard language between the periodontist and the orthodontist must always be established to eliminate the existing communications barrier, and to improve the outcomes of the whole treatment.
  10,816 2,405 12
Nicotine and periodontal tissues
Ranjan Malhotra, Anoop Kapoor, Vishakha Grover, Sumit Kaushal
January-March 2010, 14(1):72-79
DOI:10.4103/0972-124X.65442  PMID:20922084
Tobacco use has been recognized to be a significant risk factor for the development and progression of periodontal disease. Its use is associated with increased pocket depths, loss of periodontal attachment, alveolar bone and a higher rate of tooth loss. Nicotine, a major component and most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine affects gingival blood flow, cytokine production, neutrophil and other immune cell function; connective tissue turnover, which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues. Inclusion of tobacco cessation as a part of periodontal therapy encourages dental professionals to become more active in tobacco cessation counseling. This will have far reaching positive effects on our patients' oral and general health.
  7,984 1,096 16
Effect of retraction materials on gingival health: A histopathological study
Sushma Phatale, PP Marawar, Girish Byakod, Sanjay B Lagdive, Jitendra V Kalburge
January-March 2010, 14(1):35-39
DOI:10.4103/0972-124X.65436  PMID:20922077
Background: Gingival retraction methods are used in dentistry for impressions of subgingival crown margins, such as, mechanical, chemical, chemicomechanical, and surgical. These methods may injure the gingival sulcular epithelium. Hence, the present study is carried out to evaluate the effect of different retraction materials, such as, Expasyl, Magic Foam Cord, and impregnated retraction cord on the gingival sulcular epithelium. Materials and Methods: This study included 30 cases of bilateral premolar extraction patients with Loe and Silness gingival index zero. Retraction materials were kept in the dry, isolated labial gingival sulcus for the required time. The retraction materials were removed by rinsing with water. Retracted gingiva of 2 - 3 mm from the gingival margin along with the tooth was extracted and the decalcified sections were microscopically studied. Data analysis: Data were analyzed by applying the chi-square test. Results: This study showed better results with retraction paste as compared to the retraction cord, and there was a significant association between retraction materials and the relative degree of injury to the sulcular epithelium. Conclusion: There is a significant association between retraction materials and gingival sulcular epithelium. It can be stated that impregnated retraction cord, may be used commonly but it needs proper tissue manipulation and is technique sensitive. Newly advanced material in the form of retraction paste like Expasyl or Magic Foam Cord was found to be better than cord as assessed histologically, it respects periodontium.
  7,549 1,194 17
Periodontitis and bone mineral density among pre and post menopausal women: A comparative study
Snophia Suresh, T.S.S Kumar, PK Saraswathy, KH Pani Shankar
January-March 2010, 14(1):30-34
DOI:10.4103/0972-124X.65434  PMID:20922076
Aim: The aim of the study was to assess the relationship between bone mineral density and periodontitis in premenopausal and postmenopausal women. Materials and Methods: Twenty women between the age group of 45-55 years were selected for this study. Ten premenopausal women with healthy periodontium constituted the control group and 10 postmenopausal women with ≥2mm of clinical attachment loss in >30% of sites constituted the study group. All patients were assessed for plaque index, probing depth and clinical attachment loss. Radiographs (six IOPA and two posterior bitewing) were taken and assessed for interproximal alveolar bone loss. The patients were scanned to assess the bone mineral density of lumbar spine (L2) and femur using dual energy X-ray absorptiometry (DEXA). Results: The bone mineral densities of lumbar spine (L2) and femur were significantly lower in the study group than the control group. Osteopenia of the lumbar spine and femur was observed in 60% whereas osteoporosis of lumbar spine was observed in 30% of cases in study group. Conclusion: Increased proportion of osteopenia and osteoporosis cases of lumbar spine and femur in postmenopausal women with periodontitis suggests that there is association between bone mineral density and periodontitis.
  5,650 1,008 9
Comparative evaluation of micronutrient status in the serum of diabetes mellitus patients and healthy individuals with periodontitis
Biju Thomas, Suchetha Kumari, K Ramitha, MB Ashwini Kumari
January-March 2010, 14(1):46-49
DOI:10.4103/0972-124X.65439  PMID:20922079
Background: Periodontal diseases are microbial induced chronic inflammatory conditions characterized by infiltration of leukocytes, loss of connective tissue, alveolar bone resorption, and formation of periodontal pockets. In response to periodontal pathogens, the leukocytes (PMN) elaborate destructive oxidants, proteinases and other factors. The balance between these factors, the antioxidants and endogenously synthesized antiproteinases determine the extent of periodontal damage. Diabetes mellitus is a metabolic disorder. Most of the complications of diabetes are due to hyperglycemia. Persons with diabetes are at a greater risk for periodontal disease Malnutrition is characterized by marked tissue depletion of antioxidant nutrients and impaired acute phase protein response to infections resulting in impaired healing. Diabetes mellitus also alters the micronutrient levels. Malnutrition is characterized by marked tissue depletion of antioxidant nutrients and impaired acute phase protein response to infections resulting in impaired healing. Malnutrition, which usually involves concomitant deficiencies of several essential macro and micro nutrients, therefore, has the potential to adversely influence the prognosis of periodontal infections. Objectives:This study has been conducted to evaluate and compare the serum levels of vitamin C, zinc and copper in diabetic and healthy individuals with periodontitis. Materials and Methods: In this case control study 60 subjects inclusive of both sexes were selected and divided into 3 groups of 20 each. Group 1 comprised of 20 subjects with type 2 diabetes mellitus and periodontal disease, Group 2 comprised of 20 healthy subjects with periodontal disease. And Group 3 comprised of 20 healthy subjects without periodontal disease. Venous blood samples were collected and centrifuged at 3000rpm for 15 minutes and the superanatant serum is collected to measure the vitamin C, zinc and copper levels. The vitamin C levels of clinical samples were measured using spectrophotometric quantitation (dinitrophenyl hydrazine method) and zinc and copper levels were measured using atomic absorption spectrophotometry. Results: The results showed that the levels of vitamin C and zinc decreased and copper levels increased in diabetic patients with periodontits compared to healthy individuals with periodontitis. Conclusion: It may be reasonable to suggest vitamin and/or mineral supplements for patients whose nutrition might be inadequate. Future research should focus on an evaluation of which nutrients may help to prevent the onset and progression of periodontal disease
  5,590 753 11
Postoperative bacteremia in periodontal flap surgery, with and without prophylactic antibiotic administration: A comparative study
Kanwarjit S Asi, Amarjit S Gill, Sunil Mahajan
January-March 2010, 14(1):18-22
DOI:10.4103/0972-124X.65430  PMID:20922074
Objectives: Many a times in clinical periodontology, the decision whether to prescribe prophylactic antibiotics or not , is perplexing.The present study was conducted to compare the bacteremias induced after periodontal flap surgeries with and without prophylactic antibiotics. Materials and Methods: The occurrence of postoperative bacteremia following periodontal flap surgery was studied in 30 patients. On these patients, 30 quadrant wise flap surgeries were carried out without any preoperative prophylactic antibiotics and 30 surgeries carried out after prophylactic administration of amoxycillin preoperatively. A blood sample was taken from each patient at the time of maximum surgical trauma and was cultured for micro-organisms and antibiotic sensitivity. Results: 18 out of 60 blood samples were positive for micro-organisms. There was a significant reduction in post operative bacteremia after amoxycillin prophylaxis (x - 7.96 with P<0.01) as post operative bacteremia was found in 14 of the non medicated patients as compared to only 4 of the pre medicated patients. The micro-organisms encountered in the study are as follows:- 1) Staphylococcus albus coagulase negative, 2) Klebsiella, 3) Psedomonas aerugenosa, 4) Streptococcus viridans, 5) Alpha hemolytic streptococcus, 6) Neisseria catarrhalis Conclusion: On the basis of the study, it is concluded that the incidence of postoperative bacteremia following periodontal flap surgery is not as high as previously reported. The clinical results show that Amoxicillin is highly effective in reducing postoperative bacteremia in periodontal flap surgery and thus in preventing the possible sequelae (Infective Endocarditis and other systemic maladies) in susceptible patients. However, cefotaxime and cephalexin may prove to be more effective in preventing the same.
  4,170 1,014 6
Evaluation of an aminobisphosphonate (alendronate) in the management of periodontal osseous defects
HR Veena, Deepak Prasad
January-March 2010, 14(1):40-45
DOI:10.4103/0972-124X.65438  PMID:20922078
Background and Objectives: Alendronate, an aminobisphosphonate, is capable of inhibiting periodontitis associated osteoclastic activity and hence is effective in protecting the alveolar bone in periodontitis. In the present study, we explored the efficacy of local delivery of alendronate on the alveolar bone following mucoperiosteal flap surgery. This is the first study to use polymer impregnated gel based delivery of alendronate. Materials and Methods: A total of 15 patients with chronic periodontitis in the age group of 35 - 55 years, of both sexes, with pocket depth of ≥ 5mm and radiographic evidence of identical osseous defects in the mandibular molar region bilaterally were included in this prospective study. A gel based drug delivery system of Alendronate was formulated. Following surgical flap debridement, 0.1 ml alendronate gel and 0.1 ml placebo gel was placed at the experimental and control sites respectively. Clinical and radiographic parameters were recorded at baseline, three months and six months post surgery. Results: Alendronate was more effective in improving clinical and radiographic parameters compared to placebo. Interpretation and Conclusion: Alendronate is effective in the management of periodontitis associated bone loss. Gel based local delivery of the drug addresses the critical concern of exposing the patient to adverse effects of systemic administration.
  4,277 788 8
Omega fatty acids and resolution of inflammation: A new twist in an old tale
Antush Mittal, V Ranganath, Ashish Nichani
January-March 2010, 14(1):3-7
DOI:10.4103/0972-124X.65426  PMID:20922071
Identification of the factors that regulate immune tolerance and control the appearance of exacerbated inflammatory conditions is crucial for the development of new therapies of inflammatory and autoimmune diseases. Resolution of inflammation and the return of tissues to homeostasis protect us against excessive tissue injury and promote the restoration of function and structure. Resolution of inflammation, which was considered a passive event, is actually an active process where new families of endogenous lipid mediators from omega-3 polyunsaturated fatty acids play an important role in removing proinflammatory mediators generated from arachidonic acid. These chemical mediator families, termed Resolvins and Protectins, are potent stereoselective agonists that control the duration and magnitude of inflammation, along with the Lipoxins as signals in resolution. This review examines the mapping of these circuits and recent advances in our understanding of the biosynthesis and actions of these novel proresolving lipid mediators. A search in the electronical databases PubMed and the Cochrane Central Register of Controlled Trials was carried out. The search strategy applied was: "Omega fatty acid" AND "resolution of inflammation," including articles from January 1,1985 to October 2009. This resulted in the identification of a total of 52 articles, which were analyzed in full text leading to consideration of only nine full texts.
  4,068 938 3
Retrograde peri-implantitis
Jumshad B Mohamed, B Shivakumar, Sabitha Sudarsan, KV Arun, T.S.S Kumar
January-March 2010, 14(1):57-65
DOI:10.4103/0972-124X.65444  PMID:20922082
Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation.
  4,207 707 6
Clinical evaluation of regenerative potential of type I collagen membrane along with xenogenic bone graft in the treatment of periodontal intrabony defects assessed with surgical re-entry and radiographic linear and densitometric analysis
NK Sowmya, AB Tarun Kumar, DS Mehta
January-March 2010, 14(1):23-29
DOI:10.4103/0972-124X.65432  PMID:20922075
Background and Objectives: The primary goal of periodontal therapy is to restore the tooth supporting tissues lost due to periodontal disease. The aim of the present study was to compare the efficacy of combination of type I collagen (GTR membrane) and xenogenic bone graft with open flap debridement (OFD) in treatment of periodontal intrabony defects. Materials and Methods: Twenty paired intrabony defects were surgically treated using split mouth design. The defects were randomly assigned to treatment with OFD + collagen membrane + bone graft (Test) or OFD alone (Control). The clinical efficacy of two treatment modalities was evaluated at 9 month postoperatively by clinical, radiographical, and intrasurgical (re-entry) parameters. The measurements included probing pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), bone fill (BF), bone density (BD) and intra bony component (INTRA). Results: The mean reduction in PD at 0-9 month was 3.3±0.82 mm and CAL gain of 3.40±1.51 mm occurred in the collagen membrane + bone graft (Test) group; corresponding values for OFD (Control) were 2.20±0.63 mm and 1.90±0.57 mm. Similar pattern of improvement was observed when radiographical and intra-surgical (re-entry) post operative evaluation was made. All improvement in different parameters was statistically significant (P<0.01). Interpretation and Conclusion: Treatment with a combination of collagen membrane and bone graft led to a significantly more favorable clinical outcome in intrabony defects as compared to OFD alone.
  4,019 672 5
Phagocytic activity of peripheral blood and crevicular phagocytes in health and periodontal disease
K Asif, Shaila V Kothiwale
January-March 2010, 14(1):8-11
DOI:10.4103/0972-124X.65427  PMID:20922072
Background: Neutrophils constitute the main phagocytic cell system in mammalian host defense against an infecting agent. Abnormalities in leukocyte number and function are associated with increased susceptibility to periodontal diseases. The purpose of this study is to evaluate the in vitro phagocytic properties of crevicular and peripheral blood neutrophils in healthy and periodontitis subjects. Patients and Methods: A total of 30 subjects, that is, 10 patients in each of the following three groups: healthy controls, chronic periodontitis (CP), and localized aggressive periodontitis (LAP), were included in the study. The neutrophils were isolated from the peripheral blood and gingival crevice and tested for phagocytosis of Candida albicans. The percentage of leukocytes with ingested C. albicans was determined by light microscopy. Results: A significant reduction in the phagocytic activity of crevicular fluid polymorphonuclear neutrophils (CF-PMN) of LAP subjects (mean: 54.3±7)(P<0.001) was observed, compared to healthy controls (mean: 74.2±9) and chronic periodontitis subjects (mean: 69±9)(P=0.352). The mean percentage of peripheral blood polymorphonuclear neutrophils (PMNs) with phagocytosis of opsonized C. albicans in LAP patients was significantly reduced (mean: 74.9±5)(P<0.0068) compared to the phagocytic activity of neutrophils from controls (mean:82.1±3) and chronic periodontitis subjects (mean: 82.0±5)(P=0.970). There was no significant reduction in the phagocytic activity of CF PMNs (mean: 69±9) (P=0.35) and peripheral blood PMNs (mean: 82.5)(P=0.97) in the chronic periodontitis group when compared to the control group. Conclusion: The phagocytic activity of both crevicular and peripheral neutrophils in subjects with periodontitis is altered, increasing the susceptibility to periodontitis. Thus individual susceptibility may be an additional and important modifying factor in the pathogenesis of periodontal disease.
  3,756 587 8
Management of infrabony defects in mandibular molars in a patient with generalized aggressive periodontitis using autogenous bone graft from maxillary tuberosity
Sangeeta Singh
January-March 2010, 14(1):53-56
DOI:10.4103/0972-124X.65443  PMID:20922081
This clinical case report presents a technique utilizing autogenous cancellous bone from maxillary tuberosity to fill two infrabony defects distal to mandibular molars in a patient diagnosed with aggressive periodontitis. After debridement a 6 mm defect was present distal to mandibular right first molar and 6.5 mm defect was present distal to mandibular second molar of same side. Autogenous bone graft from maxillary tuberosity was placed in both the defects. There was a significant bony fill present six months post surgery and probing depth reduced by 7mm on both the sites.
  3,016 612 2
Osteoplant acts on stem cells derived from peripheral blood
Vincenzo Sollazzo, Annalisa Palmieri, Ambra Girardi, Ilaria Zollino, Giorgio Brunelli, Giuseppe Spinelli, Francesco Carinci
January-March 2010, 14(1):12-17
DOI:10.4103/0972-124X.65429  PMID:20922073
Objectives: The osteoplant is an equine, flexible, heterologous, deantigenic, cortical, and spongy bone tissue, totally reabsorbable, used for implantation of bone tissue, to restore skeletal, even weight-bearing structures. However, how the osteoplant alters osteoblast activity to promote bone formation is poorly understood. Materials and Methods: To study how the osteoplant induces osteoblast differentiation in mesenchymal stem cells, the expression levels of bone-related genes, and mesenchymal stem cell markers are analyzed, using real time Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Results: The osteoplant causes induction of osteoblast transcriptional factors such as osterix (RUNX2), and of bone-related genes such as osteopontin (SPP1) and osteocalcin (BGLAP). In contrast the expression of ENG (CD105) is significantly decreased in stem cells treated with osteoplant, with respect to untreated cells, indicating the differentiation effect of this biomaterial on stem cells. Conclusion: The obtained results can be relevant to better understand the molecular mechanism of bone regeneration and as a model for comparing other materials with similar clinical effects.
  2,746 365 1
Treatment of protruding osseo integrated dental implant
Aravind Buddula, Phillip Sheridan, Ayman Balshe
January-March 2010, 14(1):50-52
DOI:10.4103/0972-124X.65440  PMID:20922080
Titanium dental implants have been used in the treatment of partial or complete edentulism. The height and width of the residual alveolus and surrounding anatomical structures can determine the proper position and path of insertion of dental implants. The following case report describes the treatment of a malpositioned osseo integrated dental implant with an apex perforating the buccal cortex of alveolar bone. A 61-year-old male was referred by his local dentist for the chief complaint of a swelling at site of tooth 14 where an implant was present. Intraoral clinical examination revealed an implant supported porcelain fused to metal crown replacing the maxillary right first premolar. A peri-apical radiograph of the implant revealed no signs of peri-implant bone loss or radiolucency. Surgical exploration and modification of the protruding implant. The area healed uneventfully without the need of explantation of the implant in site of tooth 14. We felt that the conservative treatment provided was prudent and treatment of choice and anticipate that the implant will most likely continue to function for a lifetime.
  2,737 353 2
Rapidly progressing periodontology
CD Dwarakanath
January-March 2010, 14(1):2-2
DOI:10.4103/0972-124X.65425  PMID:20922070
  2,364 390 -
Molecular Biology of Periodontium
D Arunachalam
January-March 2010, 14(1):87-87
  1,940 506 -
JISP is in PubMed
D Arunachalam
January-March 2010, 14(1):1-1
DOI:10.4103/0972-124X.65424  PMID:20922069
  2,091 330 -
8 th Asian Pacific Society of Periodontology Meeting - Singapore (29-30 August 2009)
Mark Bartold
January-March 2010, 14(1):85-86
  2,166 190 -
Can we help?
Rajvir Malik
January-March 2010, 14(1):80-80
DOI:10.4103/0972-124X.65441  PMID:20922085
  1,751 216 -