Journal of Indian Society of Periodontology最新文献

Periodontal treatment of teeth with furcation defects is challenging due to the complex anatomy of the area. Resective techniques, such as root resection, may be effective in managing teeth with this defect if appropriately indicated and can lead to satisfactory survival rates associated with a favorable prognosis. This report describes the treatment of a Class II furcation defect in an upper molar using root resection combined with regenerative procedures. The regenerative procedure involved the use of a lyophilized bone graft combined with the use of a collagen membrane and a connective tissue graft. The 24-month follow-up demonstrated the success of the therapy, with a gain in clinical attachment level, a reduction in probing pocket depth, and a tomographic image showing the formation of new lamina dura. A healthy and stable periodontium can be achieved through the correct application of more conservative techniques aimed at preserving the dental element.

Background: Heat shock proteins (HSPs) are a group of stress proteins that participate in physiological processes such as cellular folding, assembly, translocation of polypeptides across membranes, and protein repair after cell damage. HSP60 has been implicated in the pathogenesis of both chronic periodontitis (CP) and coronary heart disease (CHD).

Aim: The aim was to assess the possible link between CP and CHD by estimating and comparing the serum HSP60 levels in patients with CP with and without CHD.

Settings and design: Ninety patients in the age group of 30-60 years were involved in this study. The patients were categorized as CP (control group) and CP with CHD (case group).

Materials and methods: Gingival index (GI) and periodontal parameters such as probing pocket depth and clinical attachment levels were documented. Enzyme-linked immunosorbent assay was used to determine the HSP60 levels in serum samples obtained from the patients.

Statistical analysis: Results were statistically analyzed using the SPSS version 16.0 software to estimate the mean and standard deviation using independent t-test and Mann-Whitney U-test.

Results: The findings of the research indicated that patients with CP with CHD exhibited elevated serum HSP60 levels compared to CP without CHD (P < 0.05). In addition, a statistically significant rise in GI was noted in the case group. However, the periodontal measurements did not reveal any significant differences.

Conclusion: As a result, HSP60 levels were observed to be elevated in the case group compared to the control group. Consequently, there is a connection between periodontal disease and CHD that contributes to the overall inflammatory burden.

Context: Demineralized freeze-dried bone allograft (DFDBA) is a commonly used biomaterial in periodontal regeneration, while autogenous tooth graft (ATG) is a newer, nearly ideal biomaterial. In the literature, in vivo studies on ATG for managing periodontal infrabony defects are rare.

Aims: The aim of this study was to comparatively evaluate the efficacy of DFDBA and ATG in the management of periodontal infrabony defects clinically, radiologically, and biochemically.

Settings and design: In this randomized controlled clinical trial, 30 sites were selected based on the study criteria and randomly assigned to Group A (DFDBA) and Group B (ATG) by toss of a coin.

Materials and methods: Selected patients were evaluated 3-4 weeks after phase I therapy. Both the groups underwent open flap debridement: Group A sites were grafted with DFDBA and Group B with ATG. Clinico-radiological evaluation was performed at baseline, 3 months, and 6 months for pocket probing depth (PPD), clinical attachment level (CAL), and linear defect depth (LDD). Biochemical assessment was done using enzyme-linked immunosorbent assay for gingival crevicular fluid-alkaline phosphatase (GCF-ALP) at baseline and at 6 months.

Statistical analysis: Data obtained were subjected to parametric tests of significance (paired and unpaired t-test).

Results: In intragroup comparison, highly significant differences (P < 0.01) were observed in PPD reduction, CAL gain, LDD reduction, and GCF-ALP levels statistically from baseline to 6 months in both the groups. However, Group B showed greater PPD reduction, CAL gain, and LDD reduction as compared to Group A (3.667 > 2.933, 2.600 > 2.000, and 2.400 > 1.533 mm, respectively). Biochemically, Group B demonstrated higher GCF-ALP levels than Group A.

Conclusions: Within the limitations of the present study, highly significant changes were noticed in all the parameters statistically in both the groups, with ATG showing higher bone fill and ongoing bone healing at 6 months postoperatively in the management of periodontal infrabony defects.

Opportunistic infections are common in patients infected with human immunodeficiency virus (HIV) in acquired immunodeficiency syndrome. This case report demonstrates a clinical case of an individual with periodontitis, HIV/hepatitis C coinfection, and candidiasis, using different drugs and under irregular antiretroviral therapy. The combination of several local and systemic conditions highlights the importance of the case and the need for health professionals to know the management of these combined pathologies in the context of HIV infection. We can conclude that it is extremely important for dentists to be aware of periodontal diseases in HIV-infected patients, due to the pathogenic mechanisms associated with these pathologies.

Background: Platelet-rich fibrin (PRF) serves as a natural fibrin-based biomaterial scaffold, facilitating cellular attachment. Low-level laser therapy (LLLT) may influence PRF properties through its stimulatory effects.

Aim: The study aimed to evaluate the effect of LLLT on PRF architectural changes and platelet concentrate values.

Materials and methods: Thirty-four samples from seventeen subjects were included in the study, with 20 mL of blood collected from each participant. Blood was distributed into two 10 mL vacutainer tubes: one served as a control for baseline platelet and leukocyte counts, whereas the other was used for PRF preparation. The PRF samples were vertically cut into two equal parts and divided into two groups: Group I (without laser treatment) and Group II (treated with LLLT). Histological preparations were performed for all samples. The mean and standard deviation of platelet and leukocyte counts in Groups I and II were analyzed using the Statistical Package for the Social Sciences (SPSS) version 17.1. Analysis of variance (ANOVA) and post hoc tests were employed for comparisons.

Results: Platelet and leukocyte values showed statistically significant differences, with greater cellular entrapment in Group II compared to Group I. The residual serum cell count in both groups was lower than the whole blood cell count. Microscopically, Group I displayed dense, thick fibrils with increased spacing distally, whereas Group II exhibited thinner fibrils with gradual density changes toward the distal end.

Conclusion: PRF obtained in both groups was similar in size. Laser irradiation altered the fibrin architecture and enhanced platelet and leukocyte entrapment in PRF.

Objectives: This study aimed to estimate and compare salivary sodium, potassium, and calcium levels in periodontal health and disease.

Materials and methods: A total of 150 patients were selected based on selection criteria. The selected patients underwent complete periodontal examination and were categorized into three groups - Group A, Group B, and Group C. Group A (control group) consisted of 50 patients with healthy subjects. Group B (gingivitis group) consists of 50 patients with gingivitis. Group C (periodontitis group) consists of 50 patients with Stage II/III periodontitis. Gingival index, probing pocket depth, and clinical attachment loss were measured and recorded. The unstimulated whole saliva was collected and sent for biochemical analysis using colorimetric and modified Arsenazo III method.

Results: A statistical comparison of salivary sodium, potassium, and calcium levels was analyzed among the three groups by a one-way Analysis of Variance test. Tukey Post hoc test was used for pair-wise statistical comparison among the groups. Salivary sodium, potassium, and calcium levels between the groups showed a statistically significant difference with P < 0.001. P value was statistically higher when Group A (healthy group) compared with Group C (periodontitis) than Group A (healthy group) compared with Group B (gingivitis).

Conclusion: Within the limitation of the current study, there was an increase in Group C (periodontitis group) concentration levels of salivary sodium, potassium, and calcium ions, which showed a statistically significant difference. However, additional studies are necessary to investigate these findings, and future periodontal research should include larger sample sizes with prospective and experimental study designs.

Clinical relevance: The assessment of these inorganic ions can be effectively utilized as a significant diagnostic marker of active disease in periodontal tissues. It would help the clinician identify the risk of developing periodontitis.

Background: Infection control is of paramount importance after any periodontal therapy to achieve proper wound healing and regeneration of periodontal tissues. Clinicians continuously strive to provide procedures and/or materials that allow for enhanced and rapid wound healing. The regenerative potential of platelet concentrates like platelet-rich fibrin (PRF) has been explored for their anti-inflammatory action and liberation of growth factors; however, research is lacking on the antibacterial properties of platelet-rich gels. The present in vitro study was done to assess the antimicrobial activity of PRF and titanium PRF (T-PRF) alone or with antibiotics on periodontal pathogens.

Materials and methods: Thirty-three individuals who were willing to donate blood (12 ml) were included in the study. Amoxicillin (AMOX) + metronidazole (METRO) combination or clindamycin (CLINDA) was incorporated into the blood drawn, and this blood was subjected to centrifugation so as to obtain T-PRF and PRF with antibiotics. The antibacterial activity of all the groups was tested on both bacteria that were cultured in their respective media for up to a 4-day period. The data were subjected to independent t-test, Tukey post hoc test, repeated analysis of variance (ANOVA), and ANOVA.

Results: All individual parameters were compared for antimicrobial activity on both bacteria on all 4 days. A highly statistical difference (P = 0.0001) was observed in all the groups, with the highest inhibition zone produced by PRF-CLINDA, followed by T-PRF-CLINDA. Antimicrobial activity was evident for the observed 4-day period, which declined from day 1 to day 4.

Conclusion: T-PRF/PRF with and without antibiotics exhibited antimicrobial activity on Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis over the observed 4-day period.

Tooth resorption; both internal and external, occasionally occurs as an inflammatory response of the dentoalveolar apparatus to infection. Depending on the type of resorption, etiology, and the stage at which root resorption defect is detected, different treatment regimens have been proposed. This case report demonstrates the management of extensive inflammatory combined internal and external root resorption by nonsurgical endodontic therapy using a Bioceramic sealer (BioRoot RCS) and surgical reconstruction of resorptive defect using Biodentine. On follow-up at 1, 3, 6, and 12 months, clinical and radiographic evidence revealed signs of periapical healing, arrested root resorption, and periodontal reattachment. The inclusion of cone beam computed tomography plays a crucial role in diagnosis, decision-making, and treatment planning and thus successful management of such cases having Endodontic-Periodontal involvement. As supported by clinical and radiographic findings at 12-month follow-up, treatment of cases with extensive root resorption and associated involvement of periodontium can be successfully done using bioceramic materials.

Background: Implant placement in the posterior maxilla is challenging in the case of maxillary sinus pneumatization. Increasing the vertical dimension by grafting the sinus floor is a common surgical modality. Cone-beam computed tomography (CBCT) scans are used to assess the presurgical anatomic variations of the maxillary sinus and determine the difficulty that might be encountered while performing sinus elevation. The sinus membrane is elevated from both the lateral and mesial walls of the sinus. The location and angulation of the palatal-nasal recess (PNR) on the medial wall of the sinus could complicate the elevation of the sinus membrane in this region. This study aimed to assess the angulation of the PNR and its position with respect to the alveolar crest in dentulous and edentulous subjects in the 1^st molar region on CBCT scans.

Materials and methods: One hundred and fifty-two scans were selected from the department database. Sagittal sections including the 1^st molar region were selected and measurements made. The PNR height was measured from the alveolar crest in millimeters and angulation in degrees and compared between the dentulous and edentulous groups.

Results: The dentulous group showed a statistically significant greater distance (10.4 ± 2.8 mm) between the alveolar crest and PNR as compared to the edentulous group (8.08 ± 3.1 mm). The edentulous group showed a statistically significant greater PNR angle (139.6^o ± 13.6^o) as compared to the dentulous group (133.4^o ± 16.4^o).

Conclusion: Maxillary sinuses with acute-angled PNR and lesser distance from the alveolar crest should be carefully evaluated to avoid complications such as membrane perforation during their elevation from the bony wall of the sinus.

Introduction: Although a lot of commercially available guided tissue regeneration (GTR) membranes are used, none of them could actually ensure complete bone regeneration so far and they also have certain limitations. This study aims to explore further and develop a membrane that might overcome these limitations and aid in bone regeneration for the treatment of bony defects.

Materials and methods: Magnesium oxide nanoparticles (MgONPs) were prepared from magnesium nitrate prepared by calcination at different temperatures and dried using filter paper under specific temperature. Later, 0.3 ml of 0.2 M 1% acetic acid was added to water and placed in the stirrer for at least 1 h. Chitosan (CS) (2%) of two different concentrations containing 0.588 g and 0.576 g of CS, respectively, was prepared and added to the previous mixture. To these concentrations, the prepared MgONPs were added and stirred using a magnetic stirrer for 1 h. Later, it was cast in the mold and dried. The prepared membrane was immersed in 1 M sodium hydroxide to neutralize acetic acid. After preparation, they were subjected to scanning electron microscope (SEM) analysis, energy-dispersive X-ray (EDAX), Fourier transform infrared spectroscopy (FTIR), and contact angle test.

Results: In SEM analysis, spherical in size, uniformly dense, and porous agglomeration was noticed. EDAX and FTIR revealed the formation of MgONPs (magnesium oxide) in the membrane. The average contact angles of the CS with MgONPs and control membranes were 85.48° and 80.80°, respectively. Degradation analysis showed that test membrane showed a slower degradation rate than control collagen membrane at the end of the 28^th day.

Conclusion: On comparing membranes with pure CS, membranes with nanoparticles, and control collagen membranes, the membrane incorporated with nanoparticles showed more favorable positive outcomes.