Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
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   2011| January-March  | Volume 15 | Issue 1  
    Online since June 23, 2011

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Effect of green tea catechin, a local drug delivery system as an adjunct to scaling and root planing in chronic periodontitis patients: A clinicomicrobiological study
Praveen Kudva, Syeda Tawkhira Tabasum, Nirmal Kanwar Shekhawat
January-March 2011, 15(1):39-45
DOI:10.4103/0972-124X.82269  PMID:21772720
Background: Evaluate the adjunctive use of locally delivered green tea catechin with scaling and root planing, as compared to scaling and root planing alone in the management of chronic periodontitis. Materials and Methods: Fourteen patients with two sites in the contralateral quadrants with probing pocket depth of 5−8mm were selected. Each of the sites was assessed for the plaque index, gingival index, and probing pocket depth at baseline and 21 days and for microbiological analysis at baseline, 1 week and 21 days. Test sites received scaling and root planing along with green tea catechin strips and control sites received scaling and root planning alone. Results: The result showed intercomparison of the plaque index and gingival index for test and control groups at 21 days was not significant with P>0.05, whereas the probing depth at 21 days was significant with P<0.001. Intercomparison between microbial results demonstrated a considerable reduction of occurrence of Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Fusobacterium species and Capnocytophaga in test. Conclusion: Green tea catechin local delivery along with scaling and root planing is more effective than scaling and root planing alone.
  8 4,957 795
Three-dimensional imaging in periodontal diagnosis - Utilization of cone beam computed tomography
Ranjana Mohan, Archana Singh, Mohan Gundappa
January-March 2011, 15(1):11-17
DOI:10.4103/0972-124X.82256  PMID:21772715
In the field of periodontology and implantology, assessment of the condition of teeth and surrounding alveolar bone depends largely on two-dimensional imaging modalities such as conventional and digital radiography. Though these modalities are very useful and have less radiation exposure, they still cannot determine a three-dimensional (3D) architecture of osseous defects. Hence, an imaging modality which would give an undistorted 3D vision of a tooth and surrounding structures is essential to improve the diagnostic potential. Cone-beam computed tomography (CBCT) provides 3D images that facilitate the transition of dental imaging from initial diagnosis to image guidance throughout the treatment phase. This technology offers increased precision, lower doses, and lower costs when compared with medical fan-beam CT. This review discusses all the finer details of CBCT which not only reveals 3D architecture of the periodontium but also helps to reconstruct it.
  7 13,012 1,558
Green tea extract for periodontal health
Babu Venkateswara, K Sirisha, Vijay K Chava
January-March 2011, 15(1):18-22
DOI:10.4103/0972-124X.82258  PMID:21772716
Tea, the commonly consumed beverage, is gaining increased attention in promoting overall health. In specific, green tea is considered a healthful beverage due to the biological activity of its polyphenols namely catechins. Among the polyphenols Epigallo catechin 3 gallate and Epicatechin 3 Gallate are the most predominant catechins. The antioxidant, antimicrobial, anticollagenase, antimutagenic, and c hemopreventive properties of these catechins proved to be helpful in the treatment of chronic diseases like periodontal disease. Studies have demonstrated that the type of processing mainly effects the concentration of catechins. Several epidemiological studies have proved that green tea also has some general health benefitting properties like antihypertensive, reduction of cardiovascular risk, antibacterial, antiviral, and antifungal activity. The present review concentrates on the effects of green tea in periodontal and general health.
  5 5,017 910
T-helper cells in the etiopathogenesis of periodontal disease: A mini review
KV Arun, Avaneendra Talwar, T. S. S. Kumar
January-March 2011, 15(1):4-10
DOI:10.4103/0972-124X.82255  PMID:21772714
Our traditional understanding of the T-helper (Th)1/Th2 paradigm in periodontal disease has undergone considerable changes in recent years. This review focuses on the Th subsets, including the recently identified cells of the CD4 lineage, their activation pathways and effector function in periodontal disease. The roles of Th17 and regulatory T (Treg) cells in disease pathogenesis have been explored. Newer Th subsets such as Th9 and Th22 cells and their potential role in periodontal disease have also been outlined.
  5 5,504 1,205
Oral health status of CHD and non-CHD adults of Lahore, Pakistan
Syed Akhtar Hussain Bokhari, Ayyaz Ali Khan, Mohammad Khalil, Mohammad Mohammad Abubakar, Mustahsen-u-rehaman , Mohammad Azhar
January-March 2011, 15(1):51-54
DOI:10.4103/0972-124X.82273  PMID:21772722
Background: Evidence on association of oral health and coronary heart diseases (CHD) is mounting in the literature. This study was designed to observe an association between status of oral health and cardiac diseases in Pakistani adults. Materials and Methods: A case-control study was conducted on CHD and non-CHD adults aged >30 years. Age-gender matched individuals without CHD, fulfilling the inclusion criteria as for CHD patients were selected for comparison. Bleeding on probing (BOP), periodontal pocket depth (PPD) and tooth loss were noted as oral health parameters. Results: 45 CHD patients and 35 non-CHD individuals were examined. 53.75% were males and 46.25% females, 37.5% subjects were uneducated, 65% belonged to lower income group, 58.75% subjects were ≥obese and 88.75% were non-smokers. Mean of percent sites of BOP ( p =0.007), PPD ( p =0.031) and tooth loss ( p =0.021) were significantly higher in study group. In stepwise logistic regression analysis, BOP and tooth loss showed a significant positive association with CHD; however, association of PPD was not significant. Conclusion: Oral health parameters were significantly higher in CHD patients. Bleeding on probing and tooth loss was positively associated with CHD after adjusting for other socio-demographic variables.
  4 2,178 234
Prevalence of periodontitis in the Indian population: A literature review
Jacob P Shaju, RM Zade, Manas Das
January-March 2011, 15(1):29-34
DOI:10.4103/0972-124X.82261  PMID:21772718
Background: Periodontitis is one of the major reasons for tooth loss in adults. India, with a population of over 1 billion, is bound to become a developed nation soon. This transition will require a population that is healthy, including in terms of periodontal health. Early studies done in India gave an indication that the population is highly susceptible to periodontitis. Aim: This paper reviews the prevalence of periodontitis in the Indian population. Settings and Design: Review of periodontitis prevalence studies on the Indian population. Materials and Methods: After identifying articles from PubMed and hand searching, the epidemiology of periodontitis is reviewed together with the case definition, study settings, type of population, age and other factors as all these are bound to affect the prevalence rates determined in various studies. Statistical Analysis: None. Results: This review identifies very limited number of studies that provide prevalence data and faces difficulty in comparing various studies due to nonstandardization of case definition and use of nonrepresentative samples. There is a high prevalence of periodontitis among the adults and the economically weak population. Conclusions: There is a very urgent need for standardized population-based studies with a robust design to identify the true prevalence of periodontitis, which in turn will help in planning oral health policies and creating the necessary infrastructure.
  4 9,851 2,885
Peripheral T-Cell lymphoma manifested as gingival enlargement in a patient with chronic lymphocytic leukemia
Aravind Buddula, Daniel Assad
January-March 2011, 15(1):67-69
DOI:10.4103/0972-124X.82272  PMID:21772726
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults and is associated with increased risk of malignancy. T-cell lymphoma associated with CLL has never been reported. The case report presents a unique case of peripheral T-cell lymphoma on the gingiva of a patient with CLL. A 66-year-old man with a history of CLL was referred to the Mayo Clinic, Department of Dental Specialties, for evaluation of swelling in the upper left posterior sextant. An intraoral examination revealed a soft tissue swelling in the area of teeth number 13 and 15, including the present edentulous ridge between number 13 and 15. An incisional biopsy was performed on the palatal aspect of tooth No. 15 and submitted for histologic evaluation. The histopathology revealed proliferation of large atypical cells beneath the epithelium, positive for antigens CD2, CD3, Beta-F1, TIA-1, and Granzyme B consistent for a diagnosis of a peripheral T-cell lymphoma. A team approach including the hematologist, general dentist and periodontist resulted in timely referrals leading to an early diagnosis and early intervention and treatment.
  2 2,549 190
Effect of pretreatment with ketorolac tromethamine on operative pain during periodontal surgery: A case-control study
Shital Hungund, Rohit Thakkar
January-March 2011, 15(1):55-58
DOI:10.4103/0972-124X.82274  PMID:21772723
Background: The efficacy of a nonsteroidal anti-inflammatory agent, ketorolac tromethamine, was evaluated in pain control after periodontal surgery. This type of agent acts peripherally by inhibiting the release of prostaglandins and minimizing the local inflammatory response. Thus, there may be an advantage in pretreatment administration of ketorolac tromethamine, 10 mg, compared with placebo on operative pain during periodontal surgery. Materials and Methods: Two groups of 40 outpatients from the Department of Periodontology, Darshan Dental College and Hospital, Udaipur, were selected for this study. Patients who were to undergo periodontal surgery were randomly given either one group 10 mg ketorolac immediately before surgery or the other group placebo tablets at least 30 minutes before administration of local anesthesia (LA). All procedures were performed under LA, and the total volume of anesthetic used was recorded. The duration of surgery from the time of incision to the placement of the last suture was recorded. At the completion of the surgery, patients were supplied with printed record forms and were asked to rate their subjective operative pain intensity using a visual analog scale. Statistical analysis: The data were analyzed using the student t test. Results: Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity of operative pain as compared with placebo. No adverse reactions related to preoperative medication were observed. Conclusions: The results of this study showed that 10-mg ketorolac administered immediately before periodontal surgery was effective for alleviating the operative painful sequelae.
  2 5,954 490
Evaluation of local drug-delivery system containing 2% whole turmeric gel used as an adjunct to scaling and root planing in chronic periodontitis: A clinical and microbiological study
Roobal Behal, Amita M Mali, Suhit S Gilda, Anant R Paradkar
January-March 2011, 15(1):35-38
DOI:10.4103/0972-124X.82264  PMID:21772719
Aim: To compare the effect of experimental local-drug delivery system containing 2% whole turmeric (gel form) as an adjunct to scaling and root planing (SRP) with the effect achieved using SRP alone by assessing their respective effects on plaque, gingival inflammation, bleeding on probing pocket depth, relative attachment levels and trypsin-like enzyme activity of "red complex " microorganisms, namely, Bacteroides forsythus, Porphvromonas gingivalis and Treponema denticola. Material and Methods: Thirty subjects with chronic localized or generalized periodontitis with pocket depth of 5 to 7 mm were selected in a split-mouth study design. Control sites received SRP alone, while experimental sites received SRP plus experimental material (2% whole turmeric gel). Plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), probing pocket depth (PPD), relative attachment loss (RAL), microbiological study of collected plaque sample for trypsin-like activity of "red complex" by BAPNA assay were the parameters recorded on day 0, 30 days and 45 days. Results: Both groups demonstrated statistically significant reduction in PI, GI, SBI, PPD; and gain in RAL. Significant reduction in the trypsin-like enzyme activity of "red complex" (BAPNA values) was observed for both the groups when compared to the baseline activity. Greater reduction was seen in all the parameters in the experimental group in comparison to the control group. Conclusion: The experimental local drug-delivery system containing 2% whole turmeric gel can be effectively used as an adjunct to scaling and root planing and is more effective than scaling and root planing alone in the treatment of periodontal pockets.
  2 4,191 928
Plasma cell granuloma of gingiva
Balaji Manohar, S Bhuvaneshwari
January-March 2011, 15(1):64-66
DOI:10.4103/0972-124X.82275  PMID:21772725
Plasma cell granuloma is a rare benign lesion characterized by the infiltration of plasma cells; primarily occurring in the lungs. It is also seen to occur in the brain, kidney stomach, heart, and so on. In the intraoral region it is seen to involve the tongue, oral mucosa, and gingiva. This case presents a 42-year-old female, with an enlargement in the maxillary anterior region, treated by excisional biopsy. Histological evaluation revealed plasma cell infiltrates in the connective tissue. The immunohistochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma.
  1 4,036 406
Accidental identification of accessory mental nerve and foramen during implant surgery
Sudhindra Kulkarni, Sampath Kumar, Sujata Kamath, Srinath Thakur
January-March 2011, 15(1):70-73
DOI:10.4103/0972-124X.82270  PMID:21772727
The accessory mental nerve and the corresponding foramen are not a very common occurrence. In the current case report, we present the notice of an accessory mental nerve in the mandibular molar area during implant placement. The case was managed well without any complications.
  1 3,163 291
Inhibitory effect of cranberry juice on the colonization of Streptococci species: An in vitro study
Ragini Sethi, Vivek Govila
January-March 2011, 15(1):46-50
DOI:10.4103/0972-124X.82271  PMID:21772721
Background: Dental biofilm harboring oral bacteria is highly correlated with the progression of dental diseases. The existence of micro organisms as polyspecies in an oral biofilm and dental plaque has profound implications for the etiology of periodontal disease. The adhesion of streptococci to the tooth surface is the first step in the formation of dental plaque. Antiadhesive agents which can disrupt the biofilm formation can be an effective alternative to antibacterial therapy. Materials and Methods: A total of 10 patients both male and female between the age group of 20-40 years were included in the study. Plaque samples were taken and subjected to culturing on rabbit's blood agar plate for the growth of streptococci colonies for 24-48 h. The streptococci colonies were identified and was further subjected to subculturing for 24-48 h with disc containing ethyl alcohol+cranberry extract (Group A) and water+cranberry extract (Group B). Both these groups A and B were further divided into subgroups I, II, III, IV, and V according to concentration 1:2, 1:4, 1:40, 1:100 and 1:600 respectively. Results: Zone of inhibition of Group A with subgroup I disc was 2 mm. while with subgroups II, III, IV, V disc was 4mm. Whereas the zone of inhibition seen of Group B was same (2mm) in subgroups I, II, III, IV discs however a significant zone of inhibition (10mm) was observed in subgroup V disc. Conclusion: Cranberry juice (active ingredient: Non dialyzable material) inhibits the adhesion and reverses the coaggregation of various oral micro organisms. The present study revealed that cranberry gel in highly concentrated (1:600) form has an inhibitory effect on the colonization of the streptococci species, and thus can be beneficial in the inhibition of dental plaque formation.
  1 3,811 429
Probiotics in periodontal health and disease
Anirban Chatterjee, Hirak Bhattacharya, Abhishek Kandwal
January-March 2011, 15(1):23-28
DOI:10.4103/0972-124X.82260  PMID:21772717
Macfarlane Burnett stated in 1962 that "By the late twentieth century, we can anticipate the virtual elimination of infectious diseases as a significant factor in social life". Probiotics have become of interest to researchers in recent times. Time has come to shift the paradigm of treatment from specific bacteria elimination to altering bacterial ecology by probiotics. The development of resistance to a range of antibiotics by some important pathogens has raised the possibility of a return to the pre-antibiotic dark ages. Here, probiotics provide an effective alternative way, which is economical and natural to combat periodontal disease. Thus, a mere change in diet by including probiotic foods may halt, retard, or even significantly delay the pathogenesis of periodontal diseases, promoting a healthy lifestyle to fight periodontal infections.
  1 10,079 1,785
Fibrin glue application in conjunction with tetracycline hydrochloride root conditioning and semilunar coronally repositioned flap in the treatment of gingival recession
Joann Pauline George, M. L. V. Prabhuji, KB Shaeesta, Flemingson Lazarus
January-March 2011, 15(1):74-79
DOI:10.4103/0972-124X.82259  PMID:21772728
The purpose of this case report is to present the results of Fibrin Adhesive System (FAS) application, a topical biological tissue adhesive in the treatment of maxillary buccal recessions. A 40-year-old male patient presented with a pair of class I buccal recession defects on maxillary cuspids. Clinical parameters were recorded at baseline, 1 month, and 3 months. Semilunar coronally repositioned flap (Tarnow's technique), root debridement, root conditioning with tetracycline hydrochloride solution and one of the defect was treated with FAS application. Significant recession, height reduction, and attachment gain were observed with the FAS application defect site. About 50% of root coverage was noted in the FAS-treated defect and almost no root coverage in the defect site with no FAS application. Semilunar coronally repositioned flap with FAS application is an effective procedure for root coverage in anterior teeth. The addition of FAS improves the amount of root coverage, especially in relatively shallow defects.
  - 4,042 540
Hard and soft tissue augmentation to enhance implant predictability and esthetics: 'The perio-esthetic approach'
V Bagavad Gita, SC Chandrasekaran
January-March 2011, 15(1):59-63
DOI:10.4103/0972-124X.82276  PMID:21772724
Dental implants are being increasingly applied in the restoration of partial and completely edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as, periodontal infection, trauma, and tooth loss. These create an anatomically less favourable foundation for ideal implant placement. For prosthetic-driven dental implant therapy, reconstruction of the alveolar bone, through a variety of regenerative surgical procedures has become predictable. This article documents the soft and hard tissue treatment management of a patient with Generalized Chronic Periodontitis, who required hard and soft tissue augmentation of the ridge, prior to implant placement. We augmented the height and width of the ridge (Seibert's Class III ridge deficiency) using an Autogenous J-shaped graft involving the chin and lower border of the mandible, followed by soft tissue augmentation of the ridge with a subepithelial connective tissue graft. A significant increase in the ridge dimensions was achieved.
  - 3,785 643
Against all odds
Ashish Sham Nichani
January-March 2011, 15(1):1-1
DOI:10.4103/0972-124X.82252  PMID:21772712
  - 1,352 179
Evidence Based Education System
Lalit Kumar Mathur
January-March 2011, 15(1):2-2
  - 1,278 152
A new beginning
Balaji Manohar
January-March 2011, 15(1):3-3
DOI:10.4103/0972-124X.82254  PMID:21772713
  - 1,413 157
Pulpal perio relations: Interdisciplinary diagnostic approach - I
Ashutosh Nirola, Sunanda Grover, Ajay Sharma, Damanjeet Kaur
January-March 2011, 15(1):80-82
DOI:10.4103/0972-124X.82257  PMID:21772729
Lesions of pulpal and periodontal origin may perpetuate from either the infections of dental pulp or periodontium or alveolar bone. This review focuses on interdisciplinary diagnostic approach towards lesions of periodontal or endodontic origin.
  - 5,079 785