Microneedling and injectable platelet-rich fibrin (i-PRF) have been proposed as relatively less invasive alternatives to surgical procedures for augmentation of thin periodontal phenotype. The present study was conducted to evaluate the effect of microneedling and i-PRF alone on gingival thickness in thin periodontal phenotype individuals.
Pleomorphic adenoma is the most common salivary gland tumor which accounts for about 60% of all salivary neoplasms. It is also known as "mixed tumor because of its wide cytomorphologic diversity". Pleomorphic adenoma salivary glands mostly occurs on the palate, but the involvement of the upper lip is rare. The present report describes a case of a 62-year-old male with asymptomatic firm nodular swelling attached with upper lip which was later diagnosed as pleomorphic adenoma in the excisional biopsy.
Objective: As dryness is reported to be associated with inflammatory conditions in different body parts, incomplete coverage by upper lip may be responsible for gingival inflammation. The objective of the study was to assess status of gingival inflammation with reference to upper lip coverage.
Materials and methods: Patients with plaque-induced gingivitis consisting of 38 individuals with incomplete upper lip coverage (ILC) and 38 individuals with complete upper lip coverage (CLC) were enrolled. Plaque index (PI), gingival index (GI) and bleeding on probing (BOP) were recorded in whole dentition excluding third molars. Bleeding/plaque ratio was also calculated for different regions of dentition. Logistic regression analysis was applied to examine association between BOP at labial sites of maxillary anterior teeth and upper lip coverage.
Results: Significantly higher PI, GI, BOP scores and BOP/plaque ratio were noted at labial sites of maxillary anterior teeth in ILC group as compared to CLC group (p=.001, p=.011, p=.004 and p=.016 respectively). Significantly higher scores of BOP were found at labial sites than palatal sites of ILC group (p=.003). Regression analysis revealed that maxillary anterior labial sites in ILC group were 1.51 times more likely of having BOP (adjusted odds ratio 1.51, 95% confidence interval (CI) 1.13-2.03, p=.006).
Conclusion: Incomplete upper lip coverage of maxillary gingiva is associated with higher periodontal inflammatory parameters at labial sites of maxillary anterior teeth.
Depression leads to behavioral and systemic changes making individuals more susceptible to inflammatory diseases. This study was conducted to assess the periodontal status of patients with clinically diagnosed mild and moderate depression.This cross-sectional study included 135 participants. Test group 1 (n = 45) consisted of patients clinically diagnosed with mild depression, test group 2 (n = 45) included patients with moderate depression and the control group (n = 45) included non-depressive participants. Sociodemographic characteristics and periodontal parameters were recorded.Plaque levels and gingival inflammation were significantly (p < 0.05) higher in mild and moderate depression patients than in controls. Significant greater number of sites with bleeding on probing, increasing probing pocket depth (PPD), sites with PPD 4-5 mm, ≥6 mm, attachment loss 3-4 mm, and high prevalence with grade C periodontitis were observed in moderate depression patients, compared to patients with mild depression and healthy controls. On applying partial correlation, periodontal parameters were positively correlated with depression, while a negative correlation was found with income status. On regression analysis, bleeding on probing as a dependent variable was also associated with depression.Patients with moderate depression showed high periodontal destruction and inflammation as compared to those with mild depression. Further, deep pockets were associated with depressive patients. Periodontal care is required in such patients so that the progression of periodontal diseases can be prevented at the earliest.
Regeneration of intrabony defects is a challenging target of periodontal therapy. The biologic rationale for regeneration not only is based on incorporating the regenerative material, but also takes into consideration the defect's inherent healing capacity. The present study was carried out to evaluate the efficacy of decortication or intramarrow penetration performed with demineralized freeze-dried bone allograft (DFDBA) in the management of intrabony defects.Forty chronic periodontitis (stage II and III periodontitis) patients having 40 intrabony defects were randomly assigned into test group (intrabony defect filled with DFDBA after intramarrow penetration along with open flap debridement [OFD+IMP+ DFDBA]) and control group (DFDBA along with open flap debridement [OFD+DFDBA]). Primary outcome measures included probing pocket depth, clinical attachment level, and percentage bone fill (%BF). All parameters were recorded at baseline, 6 months, and 9 months postsurgical follow-up.Mean reduction in probing depth and gain in clinical attachment level was statistically significantly higher at the interdental defect site in the test group compared to the control group at 9 months follow-up (P = .02 and .04, respectively). In radiographic parameters, statistically significant improvements in defect depth and gain in defect area were found in the test group (P = .00 and .03, respectively). Statistically significant improvements in %BF and linear bone growth (P = .02 and .00, respectively) were also observed in the experimental group (39.47 ± 13.92% and 1.41 ± 0.54 mm) in comparison with the control group (19.29 ± 14.24%, 0.62 ± 0.49 mm).Addition of intramarrow penetration with DFDBA in surgical periodontal therapy may enhance the healing potential of periodontal intrabony defects, as observed by greater improvement in clinical and radiographic outcomes.
Although titanium is considered as the biocompatible material and widely used in medical and dental fields, the clinical application of this material is still a critical issue due to the possible adverse host response. Very few case reports related with titanium-based hypersensitivity reactions with dental implants proved the existence of titanium allergy. The present case report describes 56-year-old male showing allergic symptoms after 1 week of dental implant placement with no perioral or facial signs, but eczema was shown on the distant body parts, and the complete remission was attained after removing the dental implant.
This study was conducted to elucidate the link of site-specific, tooth-related, and patient-associated factors with bleeding on pocket probing (BOPP) and the impact of scaling and root planing over these factors.This cross-sectional study comprised of 50 untreated periodontitis patients and 50 periodontitis patients who had received scaling and root planing in the last 6 to 12 months and were on supportive periodontal therapy. Multilevel modeling was applied to data, with BOPP being the dichotomous outcome variable. Variables that revealed a significant association with BOPP in multilevel modeling were analyzed further to find the influence of the treatment group (untreated periodontitis and treated periodontitis) on the association between predictor variables and BOPP.Odds ratio (OR) for BOPP in untreated periodontitis versus treated periodontitis was 1.493, and in molars versus anterior teeth this was 1.439. Untreated periodontitis had an OR of 3.500 compared to treated periodontitis, in anterior teeth with Plaque Index 0. This was 2.795 and 7.734 in treated periodontitis and 5.106 and 12.762 in untreated periodontitis at Plaque Index 1 and 2, respectively. Bleeding on marginal probing had an OR of 6.984 for BOPP. Bleeding on marginal probing negative sites had higher OR in untreated periodontitis irrespective of the probing pocket depth.Plaque control is more effective in controlling periodontal inflammation after scaling and root planing. The probability of BOPP in the absence of bleeding on marginal probing is higher in untreated patients. The scope of influence of marginal inflammation on periodontal inflammation in shallow pockets is more in untreated periodontitis as compared to treated periodontitis; however, the trend reverses in deep pockets.
Introduction: Lateral window sinus augmentation is done to augment the vertical sinus height for implant placement. Putty alloplasts have been used due to their longer resorption time and provide resistance to implant insertion. Although, widely used, the stability and bone loss around implants placed simultaneously following sinus augmentation with putty bone graft has not been evaluated. Aim: To evaluate the effect of putty alloplastic bone substitute on implant stability. Materials and Methods: This prospective interventional study was conducted in the Outpatient Department (OPD) of Oral and Maxillofacial surgery at SGT Dental College and Research Institute, Gurugram, Haryana, India. The duration of the study was two years and 11 months, from December 2014-November 2016. A total of 15 implants were placed simultaneously after lateral window sinus augmentation. Primary implant stablity measurements were done using Resonance Frequency Analysis (RFA). Vertical Bone Height (VBH), Maximum Insertion Torque (MIT) and Crestal Bone Loss (CBL) were measured till six months of follow-up. The data was analysed using standard statistical analyses with Shapiro-Wilk-test, Wilcoxon signed-rank test and Spearman’s correlation co-efficient. Results: The mean age of the study participants was 58±3.04 years. A total of 15 implants were placed in 12 patients. Adequate primary stability was achieved with MIT >36 N/cm2 in 9/15 patients whereas, in 6/15 patients the MIT was ≤36 N/cm2 . The implants showed 100% survival rate. Postoperative bone gain obtained was in the range of 7.89 mm to 11.9 mm, with a mean of 9.92 mm. Acceptable levels of implant stability were obtained after six months. Conclusion: Within the limitations of the study, it can be concluded that, putty bone alloplast can serve as an adequate bone substitute in simultaneous implant placement after lateral window sinus augmentation and help in achieving stability.
The aim of the present study was to evaluate the effect on systemic inflammation of subgingival instrumentation (SI) with or without antibiotics. Moreover, systemic parameters were compared between periodontally healthy (PH) individuals and periodontitis patients.Patients with generalized periodontitis: stage III and PH individuals were recruited. Forty eight periodontitis patients were randomly allocated to each treatment group; systemic antibiotics for seven days after completion of SI (AB group), or SI alone (SI group). Periodontal parameters, serum high-sensitivity C-reactive protein (hsCRP), and hematological parameters were assessed at baseline and at week 8. Multivariate analysis was applied to analyze predictive effect of treatment allocated and improvement in periodontal parameters on change in systemic parameters.At baseline, hsCRP, total leukocyte count (TLC), neutrophil, and monocyte count were significantly higher in periodontitis patients. There was comparable reduction in neutrophil count in both treatment groups. At week 8, change in periodontal parameters was similar in treatment groups, except for probing pocket depth (PPD). Improvement in both PPD and clinical attachment level (CAL) and CAL alone was predictive of change in TLC and lymphocyte count, respectively.This study failed to demonstrate the significant benefit of systemic antibiotics as an adjuvant to SI on improvement in periodontal inflammation and systemic inflammatory parameters, despite significantly higher reduction in PPDs.
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