Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
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   2012| October-December  | Volume 16 | Issue 4  
    Online since February 7, 2013

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Periodontitis and systemic diseases: A literature review
Abiodun O Arigbede, B Osagbemiro Babatope, M Kolude Bamidele
October-December 2012, 16(4):487-491
DOI:10.4103/0972-124X.106878  PMID:23493942
Studies have revealed possible link between periodontitis and different systemic diseases. There is need to review this interesting subject. The aims are: to provide a comprehensive literature that can easily be consulted, on the subject; to draw the attention of health practitioners to the impact of oral health on the general well-being; and to emphasize the need for a deeper interaction between medical and dental training. The Medline database was searched for relevant literature by combining each of the following terms, "oral health," "oral infection," "periodontitis," with "systemic diseases." Manual library search and review of bibliographies of published literature were also conducted. Periodontitis is a constant potential source of infection and has been considered as a separate risk factor for some cardiovascular, respiratory, endocrine, musculoskeletal, and reproductive system related abnormalities. Oral health impacts on the general well-being, and if comprehensive health care is ever to be achieved, oral health should not be seen as a separate, distant, and less important area of health, which is totally unrelated to lifespan and its quality.
  3 6,696 1,371
Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series
M Bhanu Murthy, Jasjit Kaur, Rupali Das
October-December 2012, 16(4):614-619
DOI:10.4103/0972-124X.106933  PMID:23493062
Melanin pigmentation often occurs in the gingiva as a result of an abnormal deposition of melanin, due to which the gums may appear black, but the principles, techniques, and management of the problems associated with gingival melanin pigmentation are still not fully established. Depigmentation procedures such as scalpel surgery, gingivectomy with free gingival autografting, electrosurgery, cryosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond bur, Nd: YAG laser, semiconductor diode laser, and CO 2 laser have been employed for removal of melanin hyper pigmentation. The following case series describes three different surgical depigmentation techniques: scalpel surgery, abrasion with rotary abrasive, and a diode laser. Better results of depigmentation were achieved with diode laser than conventional scalpel and with rotary abrasion with respect to esthetics. The results point out that lasers are an effective and a safe means to removal of hyperpigmentation from the gingiva. Healing was uneventful and no repigmentation occurred.
  2 5,307 1,018
Hereditary gingival fibromatosis
Prasad Vijayrao Dhadse, Ramareddy Krishnarao Yeltiwar, Prashant K Pandilwar, Suchitra R Gosavi
October-December 2012, 16(4):606-609
DOI:10.4103/0972-124X.106930  PMID:23492855
Hereditary gingival fibromatosis is a rare benign oral condition characterised by slow and progressive enlargement of both maxillary and mandibular attached gingiva. It may develop as an isolated disorder but can feature along with a syndrome. A case of 12 year old female child who presented with generalised severe gingival overgrowth, involving both the arches and covering almost the entire dentition, and had all the teeth remaining invisible within the confinement of gingival tissues. The excess gingival tissue, in this non-syndromic case was removed by conventional gingivectomy using local as well as general anaesthesia. The post-operative result was uneventful and the patient appearance improved considerably. Good aesthetic result was achieved to allow patient to practice oral hygiene measures. After treatment regular recall visits are necessary in order to evaluate oral hygiene and stability of periodontal treatment.
  2 2,680 305
A randomized, double‑blind clinical study to assess the antiplaque and antigingivitis efficacy of Aloe vera mouth rinse
Bathini Chandrahas, Avula Jayakumar, Anumala Naveen, Kalakonda Butchibabu, Pathakota Krishnanjaneya Reddy, Tupili Muralikrishna
October-December 2012, 16(4):543-548
DOI:10.4103/0972-124X.106905  PMID:23493442
Aims: To evaluate the efficacy of Aloe Vera mouth rinse on experimental plaque accumulation and gingivitis. Materials and Methods: In this randomized, controlled, and double-blind study, a total of 148 systemically healthy subjects were screened in the age group of 18-25 years. Finally, 120 subjects were requested to abstain from oral hygiene (tooth brushing) for 14 days and used a specially fabricated plaque guard. Following cessation of tooth brushing in the specified area, the subjects were randomly divided into Group A (test group) who received 100% Aloe vera, Group B (negative control group) who received placebo (distilled water), and Group C (positive control group) who received 0.2% chlorhexidine. The rinse regimen began on the 15 th day and continued for 7 days. Plaque accumulation was assessed by Plaque Index (PI) and gingivitis was assessed by Modified Gingival Index (MGI) and Bleeding Index (BI) at baseline (0), 7 th , 14 th , and 22 nd days. Results: There was statistically significant decrease in PI, MGI, and BI scores after the rinse regimen began in both Group A (test group) and Group C (chlorhexidine) compared with Group B. Mouth wash containing Aloe vera showed significant reduction of plaque and gingivitis but when compared with chlorhexidine the effect was less significant. Conclusion: Aloe vera mouthwash can be an effective antiplaque agent and with appropriate refinements in taste and shelf life can be an affordable herbal substitute for chlorhexidine.
  2 4,267 778
Oral hygiene‑awareness and practice among patients attending OPD at Vyas Dental College and Hospital, Jodhpur
Nitika Jain, Dipika Mitra, KP Ashok, Jyothi Dundappa, Sweta Soni, Sameer Ahmed
October-December 2012, 16(4):524-528
DOI:10.4103/0972-124X.106894  PMID:23493177
Background: According to World Oral Health report 2003, the prevalence of periodontitis is 86% in India. Dental care can sometimes be a forgotten part of a healthy life style. While its importance is often underestimated, the need for regular dental care cannot be overstated. Oral health has been neglected for long in India. The scarce literature on dental health awareness, attitude, oral health-related habits and behavior among the adult population in Rajasthan prompted us to assess the preventive oral health awareness and oral hygiene practices in patients attending outpatient department of Vyas Dental College and Hospital (VDCH), Jodhpur through this study. Materials and Methods: A total of 500 patients in the age group 15-50 years were selected using random sampling technique. A self-administered structured questionnaire including 16 multiple choice questions was given to them. The results were analyzed using percentage. Results: The result of this study shows an acute lack of oral hygiene awareness and limited knowledge of oral hygiene practices. In Jodhpur, few people use tooth brush. Conclusions: Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about correct oral hygiene practices.
  1 10,262 1,090
Nano‑crystalline hydroxyapatite bone graft combined with bioresorbable collagen membrane in the treatment of periodontal intrabony defects: A randomized controlled clinical trial
Vijendra P Singh, Dilip G Nayak, Ashita S Uppoor, Dipen Shah
October-December 2012, 16(4):562-568
DOI:10.4103/0972-124X.106912  PMID:23493628
Aim: To evaluate the clinical outcome of nanocrystalline hydroxyapatite (NcHA) bonegraft (Sybograf ® ) in combination with collagen membrane (PerioCol ® ) compared with open flap debridement (OFD) only in the treatment of intrabony periodontal defects. Materials and Methods: Eighteen intrabony defects in 16 systemically healthy patients aged between 25-65 years, were randomly assigned to test and control groups. The Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession were recorded at baseline, and were reevaluated at 6 months. In addition to this, radiographic bone fill was assessed using digital software. At the test site NcHA bone graft and collagen membrane was placed, whereas at the control site only, OFD was done. Recall appointments were made at 7 th day, 1 st month,3 rd month, and 6 th month. Results: The data were subjected to statistical analysis using the Mann-Whitney 'U' Test and Wilcoxon signed rank sum test. In the control group, the mean reduction of PPD was 3.22±1.09 mm and CAL gain was 2.78±1.09 mm. In the test group, the mean PPD reduction of 4.33±0.5 mm and mean gain in CAL was 3.78±0.66 mm at 6 months. The mean increase in gingival recession was 0.55±0.72 mm in test and 0.44±0.52 mm in control group. Conclusion: The NcHA bone graft in combination with collagen membrane demonstrated better clinical outcomes compared with OFD alone.
  1 2,800 474
Effects of hyperbaric oxygen on aggressive periodontitis and subgingival anaerobes in Chinese patients
Tie-Lou Chen, Bing Xu, Jing-Chang Liu, Shu-Guang Li, De-Yi Li, Guo-chuan Gong, Zhi-Fen Wu, Shi-Long Lin, Yi-Jun Zhou
October-December 2012, 16(4):492-497
DOI:10.4103/0972-124X.106880  PMID:23493978
Objective: To investigate the effects of hyperbaric oxygen (HBO 2 ) on aggressive periodontitis (AgP), and subgingival obligate anaerobes in Chinese patients. Materials and Methods: Sixty cases of Chinese patients with AgP were randomly divided into two groups -the HBO 2 group (30 cases) and the control group (30 cases). Study teeth were divided into four groups -: the HBO 2 therapy, the HBO 2 + scaling scaling group, the scaling group and the control group. Subgingival anaerobic organisms were measured with anaerobic culture, and number of obligate anaerobes and facultative anaerobes and Bacteroides melaninogenicus was counted. Comparisons of changes in the clinical indices, and subgingival anaerobes were made between the groups. Results: Highly significant differences in gingival index (GI), probing depth (PD), attachment loss (AL), and Plaque index (PLI), and tooth odontoseisis (TO) were seen in the HBO 2 , the HBO 2 + scaling and the scaling groups when compared with the control group (P<0.01). The number of subgingival anaerobes as well as the types of obligate anaerobes and facultative anaerobes and the number of Bacteroides melaninogenicus were reduced markedly in these three treatment groups. Highly statistical differences in clinical indices, subgingival anaerobe number and types of obligate anaerobes and facultative anaerobes and Bacteroides melaninogenicus were found when comparisons were made between the HBO 2 + scaling and the HBO 2 groups, as well as between the HBO 2 + scaling and the scaling groups. Clinical follow-ups indicated that the GI, PD, AL, TO, PLI and subgingival anaerobes number of the three therapeutic groups were reduced more severely than the control group. Conclusions: HBO 2 had good therapeutic effects on Chinese patients with AgP. HBO 2 therapy combined with scaling and root planing was the most beneficial in the treatment of AgP. The therapeutic effect of HBO 2 on AgP is most likely through inhibition of the growth of subgingival anaerobes. Clinical follow-ups suggest that the effect could last more than 2 years.
  1 2,678 302
Gingival crevicular fluid alkaline phosphatase as a potential diagnostic marker of periodontal disease
Sheetal Sanikop, Suvarna Patil, Pallavi Agrawal
October-December 2012, 16(4):513-518
DOI:10.4103/0972-124X.106889  PMID:23493047
Background: Alkaline phosphatase (ALP) enzyme is involved in the destruction of the human periodontium. The present study was conducted to determine the presence and levels of ALP activity in gingival crevicular fluid (GCF) in periodontal health, gingivitis, and chronic periodontitis. Materials and Methods: GCF samples were collected from 45 sites which were divided into three equal groups of healthy samples and gingivitis and chronic periodontitis samples. Various clinical parameters were evaluated and the levels of ALP were estimated using a semi-autoanalyzer. Analysis of variance was employed to compare the ALP levels in different groups. Pearson's correlation coefficient was utilized to find the correlation between ALP levels and various clinical parameters. Results: Difference in the mean ALP levels between healthy and gingivitis groups was found to be nonsignificant (P>0.05) and that between the chronic periodontitis group and healthy as well as gingivitis groups was found to be highly significant (P<0.001). Significant correlations existed between ALP levels and gingival index, probing depths, as well as clinical attachment levels. Conclusion: The finding of the present study confirms the relationship between ALP level and periodontal disease, thus indicating that GCF ALP levels can be used as potential biochemical markers for the detection and progression of periodontal disease.
  1 4,259 665
Evaluation of Co-Q10 anti-gingivitis effect on plaque induced gingivitis: A randomized controlled clinical trial
Anirban Chatterjee, Abhishek Kandwal, Nidhi Singh, Amit Singh
October-December 2012, 16(4):539-542
DOI:10.4103/0972-124X.106902  PMID:23493408
Background: Deficiency of Co-Q10 has been found to be responsible for periodontal destruction; therefore, this study was undertaken to evaluate the anti-gingivitis effect of Co-Q10 on plaque induced gingivitis. Materials and Methods: Thirty subjects with plaque induced gingivitis were enrolled in a split mouth randomized controlled trial. For each subject, scaling was randomly performed for any two quadrants, followed by the topical application of Co-Q10 randomly in a previously scaled and as an unscaled quadrant for a period of 28 days. Four treatment options were planned: option A: scaling only; option B: Co-Q10 along with scaling; option C: Co-Q10. Results: Marked reduction in gingival, bleeding, and plaque scores were recorded at the sites where C0-Q10 was applied. Mean±S.D of aforementioned periodontal parameters at 28th day showed significant reduction for option A, B, and C when compared with baseline. Conclusion: Promising results were obtained after the solitary application of Co-Q10 as well as when it was used as an adjunct to scaling and root planing for treatment of plaque induced gingivitis.
  1 2,744 332
A comparative evaluation of whole blood total antioxidant capacity using a novel nitroblue tetrazolium reduction test in patients with periodontitis and healthy subjects: A randomized, controlled trial
Kranti Konuganti, Hema Seshan, Sameer Zope, Wilma Delphine Silvia
October-December 2012, 16(4):620-622
DOI:10.4103/0972-124X.106937  PMID:23493110
The investigation of disease-related oxidant-antioxidant imbalance is difficult due to the limited availability of specific biomarkers of oxidative stress, and the fact that measurement of individual antioxidant may give misleading picture because antioxidants work in concert through chain breaking reactions. Therefore, analysis of total antioxidant capacity may be the most relevant investigation. As the total blood is continuously exposed to oxidative stress, the aim of the current study was to investigate total blood antioxidant capacity in healthy and periodontitis patients by using novel Nitroblue Tetrazolium reduction test. The study was conducted on 30 non-smoking volunteers with age ranging between 18-40 years. They were categorized into two groups; chronic periodontitis group and healthy group, respectively. Total antioxidant capacity in whole blood was assessed using Nitroblue Tetrazolium reduction test. Results of the present study has shown that the total antioxidant capacity in whole blood in patients with periodontitis was significantly (P<0.005) lower than in control subjects. The reduced total blood antioxidant status in periodontitis subjects warrants further investigation as it may provide a mechanistic link between periodontal disease and several other free radical-associated chronic inflammatory diseases.
  1 2,028 257
Peri‑implant soft tissue management: Where are we?
Neel Bhatavadekar
October-December 2012, 16(4):623-627
DOI:10.4103/0972-124X.106938  PMID:23493178
Dental implants have evolved dramatically over the last decade, and so have our expectations from them in terms of functional and esthetic criteria. The maintenance and augmentation of the soft tissue has emerged as an area of concern and focus. The triad of anatomical peri-implant characteristics, soft tissue response to the implant material, and clinical skill form the fundamental principles in augmenting soft tissue. However, as clinicians, where are we with regards to the ability to augment and maintain soft tissue around dental implants, about 40 years after the first implants were placed? We now understand that peri-implant soft tissue management begins with extraction management. Our treatment modalities have evolved from socket compression post-extraction, to socket preservation with an aim to enhance the eventual peri-implant soft tissue. This short communication will assess the evolution of our thought regarding peri-implant soft tissue management, augmentation of keratinized mucosa around implants, and also look at some recent techniques including the rotated pedicle connective tissue graft for enhancing inter-implant papilla architecture. With newer research modalities, such as cyto-detachment technology, and cutting-edge bioengineering solutions (possibly a soft-tissue-implant construct) which might be available in the near future for enhancing soft tissue, we are certainly in an exciting era in dentistry.
  1 4,313 706
PAOO technique for the bimaxillary protrusion: Perio-ortho interrelationship
Subraya G Bhat, Vishal Singh, Mahalinga K Bhat
October-December 2012, 16(4):584-587
DOI:10.4103/0972-124X.106920  PMID:23493808
An increasing number of adult patients have been seeking orthodontic treatment, and a short treatment time has been a recurring request. To meet their expectations, a number of innovative techniques have been developed to accelerate orthodontic tooth movement. Significant acceleration in orthodontic tooth movement has been extensively reported following a combination of selective alveolar decortication and bone grafting surgery with the latter being responsible for the increased scope of tooth movement and the long-term improvement of the periodontium. Six patients who have been diagnosed as class I malocclusion with bimaxillary protrusion were selected. A modified corticotomy procedure was carried out The active orthodontic treatment was begun within 1 week after surgery and follow up. All the patients reported the minmalpain and mild swelling 2 days following the surgical procedure. The mean treatment time for these patients was 17.4 months, with the distalization of the canines being mostly completed in 8.5 months. Periodontallyaccelerated osteogenicsorthodontic tooth movement procedure or selective alveolar decortications or corticotomy approach is one of the surgical techniques developed to reduce the time for orthodontic treatment. This newer approach is leading to short orthodontic treatment time and great patient acceptance.
  - 6,163 789
Gingival pemphigus vulgaris preceding cutaneous lesion: A rare case report
Saroj K Rath, M Reenesh
October-December 2012, 16(4):588-591
DOI:10.4103/0972-124X.106922  PMID:23493851
Pemphigus is a group of autoimmune diseases characterized by formation of intraepithelial bullae in skin and the mucous membrane. Pemphigus vulgaris affects the oral mucosa in nearly all cases. Pemphigus vulgaris is characterized by auto antibodies directed against desmosome-associated protein antigens (desmoglein-3) found in epithelial and epidermal intercellular substance. We report here a case of pemphigus vulgaris of gingiva in an adult female patient at an early stage followed by dermatologic involvement. Perilesional incision was taken and histopathological and direct immunofluorescence was done for identification of specific antibodies. The oral lesions were treated with 0.1% Triamcinolone acetonide ointment and Prednisolone 20 mg twice daily with multivitamins was administered systemically for skin lesion.
  - 4,894 250
Capillary hemangioma: An occasional growth of attached gingiva
Mahavir B Mishra, Kundendu Arya Bishen, Ashish Yadav
October-December 2012, 16(4):592-596
DOI:10.4103/0972-124X.106924  PMID:23493929
The capillary hemangiomas represent developmental hamartomatous lesions of vascular tissue and their growth stops after certain period of time, following which some of the hemangiomas may involute. Capillary hemangiomas are common tumors of infancy and adolescents. Although head and neck are the most prevalent sites for origin of hemangiomas, they are very rarely observed arising on attached gingiva. This paper presents a rare case report of capillary hemangioma on attached gingiva of posterior maxilla in an adult female. Surgical management was done by Widman's periodontal flap operation with satisfactory uneventful healing. The characteristic clinical and histo-pathologic features of vascular tumors and malformations, especially capillary hemangiomas are discussed.
  - 3,127 244
Acute myelomonocytic leukemia presenting with gingival enlargement as the only clinical manifestation
Lilian Menezes, Jyoti R Rao
October-December 2012, 16(4):597-601
DOI:10.4103/0972-124X.106926  PMID:23493961
A 34 year old woman reported for evaluation of generalized gingival swelling pain and bleeding. The patient also reported menstrual irregularities. Based on the oral and systemic examinations and hematological investigations, a provisional diagnosis of 'menstrual cycle associated gingivitis' was made. The patient was referred for a gynecologic consultation. At the three-week dental recall, a worsening of gingival overgrowth with a necrotic component was noted. The hematologic investigations revealed markedly elevated leukocyte counts. The clinical and hematological findings led us to a diagnosis of leukemia.This report emphasizes the importance of the dentist as well as the physician (in this case, the gynecologist) in correlating the oral, systemic and hematological findings in the diagnosis and also of regular recall in the management of a case.
  - 3,024 280
A case of well‑differentiated squamous cell carcinoma in an extraction socket
Salika Sheikh, Jovita Dísouza
October-December 2012, 16(4):602-605
DOI:10.4103/0972-124X.106928  PMID:23492825
Squamous cell carcinomas of the gingiva make up a significant percentage of oral squamous cell carcinomas and are one of the most common causes of death worldwide. Cancers of the gingiva often escape early detection, and hence an early intervention, since their initial signs and symptoms resemble common dental and periodontal infections. This article presents a case of a 29-year-old female patient who presented with a non-healing wound for about 1.5 months post-extraction. The wound was associated with pain and suppuration. A provisional diagnosis of alveolar osteitis was derived at with a differential diagnosis of osteomyelitis and carcinoma of the alveolus.The patient was advised a complete hemogram, orthopantomograph, and intra-oral periapical radiograph of the extraction socket. An incisional biopsy was carried out. Radiographs revealed extensive bone loss, and the biopsy report confirmed the diagnosis of well-differentiated squamous cell carcinoma of the alveolus.Carcinoma of the gingiva often mimics inflammatory lesions and hence is often misdiagnosed. Therefore, any oral lesion should strike a chord of suspicion, and practitioners should base their diagnosis on careful examination, and valid evidence.
  - 5,451 282
Narrow diameter implant in posterior region
Jumshad B Mohamed, Md. Nazish Alam, Arif Salman, SC Chandrasekaran
October-December 2012, 16(4):610-613
DOI:10.4103/0972-124X.106932  PMID:23492972
Dental implants placement can sometimes be limited due to physical conditions, wherein the horizontal space is limited by adjacent teeth and roots or situations in which there is narrow alveolar ridge, By using a narrow diameter implant (NDI), the need for bone augmentation can be avoided. In situations where there is limited horizontal space, a NDI may be the only option to replace a missing tooth.
  - 2,523 334
Re-Lie-Ability……student / teacher of the year???
Ashish Sham Nichani
October-December 2012, 16(4):483-484
DOI:10.4103/0972-124X.106874  PMID:23495282
  - 1,538 194
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October-December 2012, 16(4):629-631
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  - 1,253 75
Correlation between "ABO" blood group phenotypes and periodontal disease: Prevalence in south Kanara district, Karnataka state, India
Gurpur Prakash Pai, Mundoor Manjunath Dayakar, Mulki Shaila, Anitha Dayakar
October-December 2012, 16(4):519-523
DOI:10.4103/0972-124X.106892  PMID:23493096
Background: The correlation between certain systemic diseases and ABO blood group is a well-documented fact. The association between periodontal disease and ABO blood group is not studied in relation to a specific geographic location. Here is a study conducted on a group of patients belonging to South Kanara district of Karnataka state. Materials and Methods: A total of 750 subjects aged between 30and 38 years belonging to South Kanara district were selected on random basis. The study subjects were segregated into healthy/mild gingivitis, moderate/severe gingivitis, and periodontitis group, based on Loe and Silness index and clinical attachment loss as criteria. The study group was further categorized and graded using Ramfjord's periodontal disease index. Blood samples were collected to identify ABO blood group. Results: Prevalence of blood group O was more in South Kanara district, followed by blood groups B and A, and the least prevalent was AB. The percentage distribution of subjects with blood groups O and AB was more in healthy/mild gingivitis group (group I) and moderate/severe gingivitis group (group II), while subjects with blood groups B and A were more in periodontitis group III. There was increased prevalence of subjects with blood groups O and AB with healthy periodontium, while subjects with blood groups B and A showed inclination toward diseased periodontium. Conclusion: There is a correlation existing between periodontal disease and ABO blood group in this geographic location. This association can be due to various blood group antigens acting as receptors for infectious agents associated with periodontal disease. This broad correlation between periodontal disease and ABO blood group also points toward susceptibility ofthe subjects with certain blood groups to periodontal disease.
  - 4,324 599
Biocompatibility and cytotoxic evaluation of drug‑loaded biodegradable guided tissue regeneration membranes
Nebu G Thomas, George P Sanil, Rajmohan Gopimohan, Jayachandran V Prabhakaran, George Thomas, Amulya K Panda
October-December 2012, 16(4):498-503
DOI:10.4103/0972-124X.106883  PMID:23492817
Background: In periodontology, Guided Tissue Regeneration (GTR) is based on the concept of providing a space for entry of cells with regenerative potential into the wound environment to initiate the regeneration of structures lost due to periodontal disease. First generation GTR membranes were primarily non-absorbable membranes like expanded polytetrafluorethylene which required a second surgery for its removal. This led researchers to explore absorbable materials like collagen and synthetic biodegradable polymers to fabricate GTR membranes. In the present study, biodegradable Polylactic acid (PLA) is used to fabricate membranes with the potential to be used for GTR therapy. Materials and Methods: Biocompatibility of the PLA membranes were evaluated in a subcutaneous guinea pig model. Antimicrobial effect of the drug-loaded PLA membranes were assessed against a drug-resistant Staphylococcus aureus bacterial isolate. The cytocompatibility of the drug-loaded membranes were evaluated using HeLa cell lines. Results: The PLA membranes were shown to be biocompatible. The drug-loaded PLA membranes showed significant activity against the bacterial isolate. Among the drug-loaded membranes, tetracycline-loaded membrane showed minimal cellular toxicity. Conclusion: The results of this study indicate that biodegradable drug-releasing polylactide membranes have the potential to be used for periodontal regeneration. It has the necessary characteristics of a GTR membrane like biocompatibility, space maintaining ability, and tissue integration. Among the various antimicrobial agents loaded in the PLA membranes, tetracycline-loaded membranes exhibited minimal cellular toxicity against HeLa cells; at the same time showing significant activity against a pathogenic bacterium.
  - 4,048 366
A randomised study to compare salivary pH, calcium, phosphate and calculus formation after using anticavity dentifrices containing Recaldent® and functionalized tri‑calcium phosphate
Ena Sharma, Ramesh Alampalli Vishwanathamurthy, Manjari Nadella, AN Savitha, Gayatri Gundannavar, M Ahad Hussain
October-December 2012, 16(4):504-507
DOI:10.4103/0972-124X.106885  PMID:23492843
Aims: The aim of this study was to estimate the pH of saliva, concentration of calcium and inorganic phosphate, and calculus formation before and after usage of Recaldent ® (GC Tooth Mousse Plus TM ), Functionalized Tricalcium Phosphate (3M ESPE ClinPro TM Tooth Crème) and standard dentifrice (Colgate dental cream). Settings and Design: Randomized double-blind study. Materials and Methods: A total of 50 subjects were recruited, the subjects were assessed at their first visit, on the 21 st day and on the 42 nd day. At the first visit, scaling was carried out and oral hygiene instructions were given. After 21 days, the subjects were given coded dentifrices where the operator and the subjects both were unaware of the type of dentifrice. Clinical parameters assessed were Plaque index, Gingival index, and Calculus index. Salivary samples were obtained to measure calcium, phosphate levels, and pH at 21 st day and 42 nd day. Statistical Analysis: ANOVA test, t-test, Mann-Whitney test, Kruskal-Wallis test. Results: The mean salivary calcium level and mean salivary phosphate level were higher in Group III (functionalized tricalcium phosphate (3M ESPE ClinPro TM Tooth Creme) as compared to Group II (Recaldent ® GC Tooth Mousse Plus TM ) and Group I (Colgate dental cream) on the 42 nd day after using dentifrices, which was statistically significant. This showed that the usage of remineralizing dentifrices led to an increase in the salivary calcium, phosphate, and pH but it did not reach the level of super saturation of the ions caused by elevated pH which could lead to calculus formation. Conclusions: Thought here was a statistically significant increase in salivary calcium and phosphate level in all three groups from baseline to 42 nd day, there was no calculus formation.
  - 2,988 427
Chairside quantitative immunochromatographic evaluation of salivary cotinine and its correlation with chronic periodontitis
Chamarthi Surya, Devulapally Narasimha Swamy, Swarna Chakrapani, Surapaneni Sunil Kumar
October-December 2012, 16(4):508-512
DOI:10.4103/0972-124X.106888  PMID:23492903
Background: Cigarette smoking is an established and modifiable risk factor for periodontitis. Periodontitis appears to be dose-dependent on smoking. The purpose of this study was to assess a reliable marker of tobacco smoke exposure (salivary cotinine) chairside and to confirm the quantitative association between smoking and chronic periodontitis. Materials and Methods: Saliva samples from 80 males, aged 30-60 years, with chronic periodontitis, were evaluated chairside using NicAlert cotinine test strips (NCTS). Patients were divided into two groups: A (cotinine negative) and B (cotinine positive). Plaque index (PI), Gingival index (GI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR) were compared between the two groups and among the subjects of group B. Results: Comparison showed that the severity of PPD (P<0.001), CAL (P<0.001), and GR (P<0.001) was more in group B than in group A. Severity of all periodontal parameters increased with increased salivary cotinine among the subjects in group B. Conclusion: Quantitative direct association can be established between salivary cotinine and the severity of periodontitis. Immunochromatography-based cotinine test strips are a relatively easy method for quantification of salivary cotinine chairside. Immediate and personalized feedback from a chairside test can improve compliance, quit rates, and ease reinforcing smoking cessation.
  - 2,612 326
Clinical and radiographic evaluation of human periodontal osseous defect (mandibular grade II furcation) treated with PepGen P‑15 and a bioresorbable membrane (Atrisorb)
Himanshu Khashu, KL Vandana
October-December 2012, 16(4):569-576
DOI:10.4103/0972-124X.106917  PMID:23493651
Background: The various treatment modalities available to treat furcation involvement either maintain the existing furcation or increases access to furcation or leads to elimination of furcation (root resection, bicuspidization etc). Newer treatment modalities include regenerative procedures like placement of bone graft and organic or synthetic membranes. In this study we have evaluated the use of a new xenograft based tissue engineered bone material which provides both the inorganic and organic component; individually and in conjunction with a synthetic bioresorbable material. Materials and Methods: 6 patients with 18 mandibular grade 2 furcations were selected after the completion of initial phase in all the patients. Selected sites were divided into control and experimental groups randomly and were treated by split mouth design. The control sites were treated with flap debridement and placement of ABM graft, whereas the experimental site received flap debridement, ABM graft and a synthetic bioresorbable membrane. Results: All the parameters recorded showed significant reduction from baseline to 9 months in both the experimental and control group. When compared in between the control and experimental group, all the parameters showed marginally better results in the control group, although none of them were clinically significant. Conclusion: The results of this study suggest that the use of ABM along with a bioresorbable membrane and without membrane is both beneficial for the treatment of grade 2 furcation. On the cost benefit basis, the bone graft alone seems to be a better choice for regenerative treatment of furcation involvement.
  - 3,346 488
Clinical evaluation of GEM 21S® and a collagen membrane with a coronally advanced flap as a root coverage procedure in the treatment of gingival recession defects: A comparative study
Preetinder Singh, DK Suresh
October-December 2012, 16(4):577-583
DOI:10.4103/0972-124X.106919  PMID:23493720
Aim: Clinical evaluation of efficacy of rhPDGF-BB plus beta tricalcium phosphate (GEM 21S ® ) along with a collagen membrane in root coverage using a coronally advanced flap. Materials and Methods: This human case series evaluated the clinical outcome of rhPDGF-BB with beta-tricalcium phosphate (GEM 21S®) and a collagen membrane in the treatment of recession defects using a coronally advanced flap. Patients were followed postoperatively, and healing was evaluated at 1, 3, and 6 months, with recession depth as the primary outcome measure. Results : This pioneer case series revealed a favorable tissue response to GEM 21S® and collagen membrane from both clinical and esthetic point of view in regenerative periodontal surgery.
  - 3,123 441
Prevalence of chronic periodontitis in Meerut: A cross‑sectional survey
Amrinder Singh, Vipin Agarwal, Avantika Tuli, Bhram Parkash Khattak
October-December 2012, 16(4):529-532
DOI:10.4103/0972-124X.106895  PMID:23493232
Background: Chronic periodontitis is seen in majority of population and is responsible for the high tooth morbidity as well as mortality. Materials and Methods: One thousand and twenty-six subjects were selected by multistage stratified randomized sampling technique. They were examined in free dental camps organized in preselected rural areas by using community periodontal index of treatment need. The impact of known risk factors for periodontal disease, e.g., oral hygiene habits, age, gender, smoking, and pan + tobacco chewing, was also observed. Results: Deep pockets were observed in 52.7% of the subjects and 17.8% of the sextants. Shallow pockets were observed in 37.4% of the subjects and 36.4% of the sextants. Calculus had the highest score in 9.8% of the subjects and 43.8% of the sextants. None of the subjects and negligible number of the sextants was found to be having bleeding or healthy periodontium as the highest score. Conclusion: Periodontal disease severity was found to be increased with increasing age. Severity was also more in smokers and in the subjects using finger and powder to maintain their oral hygiene.
  - 2,585 377
An evaluation of a periodontal plastic surgical procedure for the reconstruction of interdental papillae in maxillary anterior region: A clinical study
Madhuri Lokhande Sawai, RM Kohad
October-December 2012, 16(4):533-538
DOI:10.4103/0972-124X.106897  PMID:23493264
Background: In today's world, people are very much aware about their looks and personality. They are getting more concerned about the esthetics and thus are not ready to compromise the appearance of black holes, especially in the anterior region of the mouth. Various techniques like orthodontic correction, prosthetic veneers and various periodontal surgical methods have been used to cover these unaesthetic open embrasures. In the present study, a variant technique given by Beagle in 1992 was used to cover these open gingival embrasures. The technique uses a gingival flap from the labial aspect to close the open gingival embrasures thus solving the problem of black holes. Aims and Objectives: This clinical study was aimed to reconstruct the lost or blunted interdental papillae with gingival tissue for esthetic purpose and for maintaining oral health with the objective to determine the extent to which the procedure can revert the maxillary esthetics. Materials and Methods: The patients selected were those who were having a complaint of at least one black hole in the maxillary anterior region with grade '0' or '1' type of contour of interdental tissues. A total of 39 open embrasures were surgically closed using this technique. Various indices were taken pre-surgically and then again post surgically. Results: Plaque index and gingival index showed an initial increase in the scores at the end of 1 week. Later, there was a gradual fall till the end of the study. Bleeding index significantly increased at the end of 12 weeks ( P<0.001) but reduced to insignificant levels at the end of 24 weeks ( P<0.09). The sulcus depth increased by about 1.19 mm. There was improvement in the contour of interdental tissues in 51% of cases and in 38.46% the interdental papillae completely obliterated the open embrasures. Conclusion: The surgical technique used here for reconstruction of interdental papilla was fairly successful. However, use of bone grafts or soft tissue grafts would have improved the results further.
  - 10,000 1,005
Estimation of matrix metalloproteinase‑3 levels in gingival crevicular fluid in periodontal disease, health and after scaling and root planing
N Ravindra Reddy, D Roopa, DS Madhu Babu, P Mohan Kumar, C Mahendra Raju, N Sarath Kumar
October-December 2012, 16(4):549-552
DOI:10.4103/0972-124X.106907  PMID:23493467
Background: Initial research has shown a positive correlation between the severity of periodontal disease and matrix metalloproteinase-3 (MMP-3) concentrations in gingival crevicular fluid (GCF). However, there are no enough reports to correlate the MMP-3 concentrations in GCF in periodontal health, disease and after treatment. Hence, the present study is to estimate the levels of MMP-3 in GCF in periodontal health, disease and to evaluate the effect of periodontal therapy on MMP-3 concentrations in GCF. Materials and Methods: Periodontal examination and collection of GCF by extracrevicular method was performed in 30 subjects selected randomly and categorized into three groups. Group I (Healthy, n=10), group II (Chronic periodontitis, n=20) and group III (After treatment group, n=20). Scaling and root planing (SRP) was performed and GCF was collected after 8 weeks of treatment. MMP-3 levels were estimated in GCF samples using enzyme linked immunosorbent assay (ELISA). Results: MMP-3 was detected in all samples. Highest mean MMP-3 concentrations in GCF were obtained for group II (7.490 ng/ml), while the lowest concentrations were seen in group I (0.344 ng/ml) and group III (2.129 ng/ml). This suggests that MMP-3 levels in GCF increases proportionally with the progression of periodontal disease and decreases after treatment. Conclusion: There is a substantial increase in the concentrations of MMP-3 as periodontal disease progresses. Since MMP-3 levels in GCF are positively correlated with gingival index, probing pocket depth and clinical attachment level, MMP-3 may be considered as a "novel biomarker" in periodontal disease progression. However, controlled, longitudinal studies are needed to confirm this possibility.
  - 2,262 282
Effectiveness of a controlled release chlorhexidine chip (PerioColTM‑CG) as an adjunctive to scaling and root planing when compared to scaling and root planing alone in the treatment of chronic periodontitis: A comparative study
Kameswari Kondreddy, N Ambalavanan, T Ramakrishna, R Saravana Kumar
October-December 2012, 16(4):553-557
DOI:10.4103/0972-124X.106909  PMID:23493496
Aims and objectives: The aim of this study is to evaluate the effectiveness of a controlled-release chlorhexidine chip as an adjunctive therapy to scaling and root planing when compared with scaling and root planing alone in the treatment of chronic periodontitis. Materials and Methods: 20 patients with a total number of 40 posterior sites were selected. These sites were divided into two groups in a split mouth design,: Group A (control site) had 20 sites treated with scaling and root planing alone and Group B (test site) had 20 sites treated with scaling and root planing and PerioCol TM -CG. The clinical parameters (Plaque index, bleeding on probing, probing pocket depth, clinical attachment level) were recorded at baseline, 90 th and 180 th day for both the groups. Results: When both groups were compared the change in Plaque index was significantly higher in Group B when compared to Group A on the 90 th day and 180 th day. However, there was no statistically significant difference in the mean percentage of gingival bleeding sites between the two groups on the 90 th day, though Group B showed a statistically higher reduction in the mean percentage of gingival bleeding sites at the end of 180 th day. There was no statistically significant difference in probing pocket depth between the two groups on both 90 th and 180 th day. Gain in clinical attachment level was significantly higher in Group B when compared to Group A on the 90 th and 180 th day. Conclusion: From the results observed in this study, it can be concluded that the adjunctive use of PerioCol TM -CG was safe and provided significant improvement in both Plaque index and gingival bleeding index. It was also more favorable than scaling and root planing alone for gain in clinical attachment level.
  - 3,560 501
Influence of moderate to severe chronic periodontitis on dental pulp
K Fatemi, R Disfani, R Zare, A Moeintaghavi, Saadat A Ali, HR Boostani
October-December 2012, 16(4):558-561
DOI:10.4103/0972-124X.106911  PMID:23493524
Background: The relationship between periodontal disease and dental pulp changes is controversial and has been debated for many years. This human study was performed to evaluate the possible effects of moderate to advanced periodontal disease on the different aspect of dental pulp structure. Materials and Methods: Twenty hopeless permanent teeth were extracted from systemically healthy adults because of moderate to advanced chronic periodontitis, with a bone loss of >6 mm and a mobility of grade 2 or 3. Upon extraction, the apical 2 to 3 mm of the roots were immediately sectioned. Four to five sections were mounted on each slide, and every third slide was stained with hematoxylin and eosin. The specimens were histologically processed and examined by an oral pathologist. Results: Non-inflamed pulp, with partial or complete necrosis in some sections and several non-necrotic sections, was found in only 6.3% of teeth. Most teeth (58.3%) displayed edematous pulps. Slightly fibrotic pulps were seen in 52.1% of sections. Odontoblastic integrity was seen in 31.3% of teeth. Most teeth (77.1%) displayed no pulp stones. In 43.8% of teeth, the pulp vessels displayed dilatation. Conclusions: Moderate to advanced periodontal disease can affect the dental pulp. Careful consideration of diagnostic and treatment planing in patients with endodontic-periodontal involvement is therefore recommended.
  - 3,450 406
Time to take fresh guard
Santhosh Sreedhar
October-December 2012, 16(4):485-485
  - 1,156 82
Notice of Retraction

October-December 2012, 16(4):0-0
  - 1,141 160
Newer goals!!!
Balaji Manohar
October-December 2012, 16(4):486-486
DOI:10.4103/0972-124X.106876  PMID:23495283
  - 1,401 88