Journal of Indian Society of Periodontology最新文献

This case report presents the case of a 34-year-old male with a chronic periradicular abscess, fractured prosthesis, and significant mandibular bone resorption. The goal was to restore function and esthetics through immediate implant placement (IIP) despite infection and bone loss. Examination revealed Grade III mobility of teeth #19 and #20, a draining sinus, and extensive bone resorption confirmed by the cone-beam computed tomography. Using the Simple, Advanced, Complex classification, the case was classified into "complex" due to its pathology and poor bone quality. IIP was chosen after careful debridement and bone grafting with xenogeneic material. The implants were placed with primary stability, and a customized healing abutment was prepared for optimal soft-tissue healing. This case shows that IIP is effective in challenging conditions with infection and bone resorption, given careful planning, infection control, and grafting. Treatment was successful with long-term outcomes. Bone healing and implant integration were confirmed at follow-up, providing functional and esthetic restorations.

Objective: This in vitro study aimed to evaluate the antimicrobial effects of high-molecular-weight hyaluronic acid (HA) against two key periodontal bacteria, Prevotella intermedia and Fusobacterium nucleatum. These organisms play an important role in biofilm formation and disease progression in periodontitis.

Materials and methods: Standard laboratory strains of P. intermedia (ATCC 25611) and F. nucleatum (ATCC 25568) were cultured in anaerobic conditions. HA with different molecular weights (141 kDa, 757 kDa, and 1,300 kDa) was tested at concentrations from 0.5 to 2.0 mg/ml. The minimum inhibitory concentration was determined through serial dilution in thioglycollate broth. Each test was performed in triplicate. Turbidity after 48-72 h of incubation served as an indicator of bacterial growth. Statistical significance was analyzed using G*Power with α = 0.05 and 80% power.

Results: HA showed concentration-dependent bacteriostatic effects. P. intermedia showed growth inhibition at 1 mg/ml, whereas F. nucleatum required 2 mg/ml for similar inhibition. Concentrations below these amounts did not inhibit growth. These findings suggest that HA may disrupt adhesion and nutrient uptake needed for bacterial growth and biofilm formation.

Conclusion: High-molecular-weight HA shows potential as a nonantibiotic support agent in periodontal therapy by selectively inhibiting key anaerobic bacteria involved in biofilm development. Its two actions, antimicrobial and immunomodulatory, highlight its importance by breaking down pathogenic cooperation and supporting periodontal healing. Further research with multispecies biofilms, clinical isolates, and host interaction models is necessary for clinical application.

Aim: The study compared the clinical effectiveness of Giomer and Zirconomer in patients with gingival recession (GR) associated with noncarious cervical lesions (NCCLs), and evaluated their outcomes when combined with coronally advanced flap (CAF).

Materials and methods: Nine subjects with bilateral Cairo et al. recession type 1 associated with NCCL suggestive of CAF with restorations underwent a split-mouth randomized clinical trial. Eighteen sites were randomly assigned to one of the two groups and restored using Zirconomer (Group A) or Giomer (Group B). CAF was performed after 2 weeks, and patients were followed up at 3 and 6 months. Plaque index (PI), gingival bleeding index (GBI), pocket depth (PD), relative GR (RGR), clinical attachment level (CAL), height of NCCL (NCCL-H), thickness (KTT), and width (KTW) of keratinized tissue and dentinal hypersensitivity (DH) were recorded at baseline, 3, and 6 months postsurgery.

Results: Both groups revealed excellent root coverage and CAL gain, although Group A significantly had higher KTW than Group B. After 6 months, the PI, PD, CAL, RGR, and KTW displayed statistically notable variations between the groups. At 6 months, Group A displayed better relief in DH as well as improved RGR and CAL.

Conclusion: Both Zirconomer and Giomer, coupled with CAF, achieved sufficient soft-tissue coverage after 6 months. The Zirconomer group, however, had marginally better outcomes in terms of PI, RGR, NCCL-H, KTW, and DH, while Giomer performed better in terms of PD and CAL.

Background: Salivary biomarkers have the potential to be used as diagnostic tools for periodontal disease. This study aimed to evaluate the role of semaphorin 4D (SEMA4D) in saliva among healthy and periodontitis subjects and its response to nonsurgical periodontal treatment.

Materials and methods: An interventional clinicobiochemical study was conducted on the study population. SEMA4D levels were evaluated and compared using enzyme-linked immunosorbent assay (ELISA). Individuals with periodontitis underwent nonsurgical treatment followed by ELISA.

Statistical analysis: Intergroup comparison was performed using one-way analysis of variance to assess significant differences between the groups, followed by post hoc Tukey's test. Intragroup comparison was performed using a paired t-test to assess significant differences. Pearson's correlation coefficient helped to determine the strength of association.

Results: Increased levels of SEMA4D were seen in subjects with Stage 1 Grade A periodontitis. Correlation of SEMA4D to the gingival index, clinical attachment loss, and probing pocket depth was not statistically significant.

Conclusion: SEMA4D can be a potential biomarker since there is a positive relation between SEMA4D and Stage 1 Grade A periodontitis.

Background: Maxillary sinus augmentation is a predictable procedure to increase bone height in atrophic posterior maxilla. Different protocols and procedures for sinus lift are available. Many biomaterials are employed in this technique; however, no biomaterial has been proven as the best.

Materials and methods: A single-center, prospective, interventional, single-arm study was done for evaluation of the efficacy of biphasic calcium phosphate mixed in a 1:1 ratio with autogenous bone graft. Patients with ≤5 mm of subantral bone height were recruited. Sinus membrane was elevated using piezosurgical tips and sinus elevators, and a graft was placed to achieve the desired bone height. Lateral window was covered by platelet-rich fibrin membrane, and suturing was done. After 6 months, bone biopsy specimens were harvested, and histomorphometric analysis was performed. Subantral bone height was measured on cone-beam computed tomography at baseline and at 6 months to get the bone height gain.

Results: (1) The mean gain of bone height was 8.53 ± 1.07 which was statistically significant. (2) On histologic evaluation, new bone% was 48.08% ± 2.41%, soft tissue% was 27.25% ± 3.18%, and residual graft% was 24.36% ± 2.91%. (3) The density and distribution of cells were favorable. (4) All patients had pain and swelling in mild range. (5) No major intra- or postoperative complications were noted.

Conclusion: The described surgical technique using a combination of hydroxyapatite + beta-tricalcium phosphate 30/70 along with autogenous bone in a 1:1 ratio offers a predictable and practical treatment choice in direct sinus augmentation. It provided significant bone height gain, new bone formation, and good implant stability in grafted sites.

Excessive gingival display, commonly referred to as a "gummy smile," is defined as more than 3 mm of gingival exposure during smiling and is often perceived as unesthetic, potentially leading to psychological and social concerns for affected individuals. Over the past five decades, significant progress has been made in understanding the etiology, diagnosis, and treatment of this condition. Initially regarded as a functional or developmental issue, the gummy smile has evolved into a major esthetic concern, reflected in the exponential growth of related scientific literature. Early treatment approaches (1975-2000) focused on surgical interventions such as orthognathic surgery, lip repositioning, and gingival reduction procedures, alongside foundational diagnostic classifications. In the last two decades (2001-2025), advancements have included refinements in surgical techniques, incorporation of digital workflows, and introduction of minimally invasive and nonsurgical options. Recent research emphasizes patient-reported outcomes, esthetic assessments, and algorithm-based treatment planning, while emerging technologies promise further improvements in diagnosis and personalized care. Continued innovation and interdisciplinary collaboration are essential to optimize treatment strategies and enhance patient satisfaction.

Introduction: Dental anxiety is a prevalent concern, significantly impacting patient experience and treatment outcomes, particularly in periodontal flap surgery. Binaural beats, an auditory brainwave entrainment technique with demonstrated anxiolytic effects in medical contexts, have emerged as a promising nonpharmacological approach but remain underexplored in dental surgery. This study evaluates the efficacy of binaural beats in alleviating anxiety among patients undergoing periodontal flap surgery.

Materials and methods: Fifty chronic periodontitis patients requiring periodontal flap surgery with moderate-to-high preoperative anxiety scores were randomly allocated to a test group (binaural beat exposure) or a control group (no auditory intervention). The test group listened to binaural beats for 30 min (10 min preoperatively + 20 min intraoperatively) using stereo headphones. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), and physiological stress markers such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded in both groups at the preoperative and postoperative stages.

Results: Binaural beat exposure significantly reduced anxiety and physiological stress markers (P < 0.0001). Mean STAI scores decreased from 49 ± 6.93 to 38.7 ± 9.46. SBP and DBP declined from 132.0 ± 7.79 to 124.6 ± 8.40 mmHg and from 87.2 ± 4.61 to 79.8 ± 6.91 mmHg. HR reduced from 93.4 ± 8.17 to 83.2 ± 7.15 bpm, whereas the control group demonstrated postoperative elevations in anxiety and stress markers.

Conclusion: Binaural beats effectively reduced anxiety and physiological stress responses during periodontal flap surgery, offering a cost-effective, noninvasive alternative for anxiety management.

Background: This study aims to formulate and evaluate the staining effect of three different types of mouthwash containing nanoparticles (NPs) and compare them with chlorhexidine (CHX) mouthwash on dental enamel.

Materials and methods: Twenty intact premolars were randomly assigned to four groups. The specimens were then immersed in CHX mouthwash (Group I), colloidal solutions containing cerium oxide NPs (Group II), Glycyrrhiza glabra NPs (Group III), and a cerium oxide NP and G. glabra NP composite (Group IV). The baseline color determination was made (T1) using a digital spectrophotometer. After 24 h, the shade of the samples was recorded (T2). The third color assessment was accomplished on the 15^th day (T3) and 30^th day (T4).

Results: The Kolmogorov-Smirnov test for normality was performed on four groups. One-way ANOVA revealed no significant differences in the ∆ E between groups at various time intervals. On the 1^st day, the highest staining was found in Group IV, and the least staining was found in Group I. On the 15^th day, the highest staining was found in Group III, and the least staining was found in Group II. On the 30^th day, the highest staining was found in Group III, and the least staining was found in Group II. P > 0.05, indicating that the results show no significant difference.

Conclusion: Cerium oxide NPs containing mouthwash produced equal enamel discoloration as compared with CHX, which can be used as an alternative to CHX.