Journal of Indian Society of Periodontology最新文献

Background: Furcation defects in periodontitis present treatment challenges due to complex anatomy. While guided tissue regeneration aids regeneration, periosteal isolation limits osteoblast contribution. The marginal periosteal membrane (MPM) serves as a biological barrier, potentially enhancing regeneration. Hence, the study aims to evaluate the application of a vascularized MPM in the treatment of mandibular Grade II furcation defects with and without bone graft in terms of defect depth reduction.

Materials and methods: A total of 60 patients, 30-50 years of age group having Stage III periodontitis with Grade II buccal furcation defect in a mandibular molar with vertical probing pocket depth (PPD) ≥5 mm at mid-furcation area were chosen. Control group (n = 30) was treated with MPM, and the test group (n = 30) with MPM with bone graft. Follow-up was done at the 3^rd and 12^th months following surgery for clinical parameters, i.e., mean plaque index (PI), modified sulcular bleeding index (mSBI), Visual Analog Scale score, healing index score, mean PPD, and relative clinical attachment level (RCAL) and 12 months for radiographic parameters such as horizontal defect depth and vertical defect depth with intraoral periapical radiograph and cone-beam computed tomography (CBCT), following which the statistical analysis was performed.

Results: Both groups improved significantly in PI, mSBI, PPD, and RCAL (P < 0.05). The test group showed better RCAL at 3 months (9.37 ± 1.10 mm vs 10.87 ± 0.68 mm) and 12 months (6.73 ± 1.40 mm vs. 8.77 ± 1.10 mm) (P < 0.05) while CBCT results revealed greater defect depth reduction (horizontal: 1.41 ± 0.25 mm vs. 1.55 ± 0.14 mm and vertical: 1.47 ± 0.23 mm vs. 1.62 ± 0.15 mm) (P < 0.05). No differences in wound healing score (P > 0.7) or pain perception (P > 0.68) were seen.

Conclusion: The study demonstrates that MPM significantly improves clinical and radiographic outcomes in Grade II furcation defects. MPM showed superior results when combined with bone graft, with greater RCAL gain and enhanced defect depth reduction. Hence, MPM with bone graft offers a more predictable regenerative approach for mandibular molar furcation defects.

Aim: This study evaluated the effectiveness of an innovative "oral hygiene robot" (OHR) compared to traditional audiovisual aids in motivating dental students to enhance their brushing skills.

Materials and methods: The study included thirty-two dental students, divided into two phases, which were further randomized into two groups: Group A and Group B. During the initial phase, no motivational methods were applied to both the groups. In the second phase, Group A received audiovisual education, while Group B utilized the OHR. Clinical parameters (gingival index and plaque index) for both the groups were recorded before oral prophylaxis (at day 0) and subsequently at the completion of the 1^st, 2^nd, 4^th, and 8^th weeks.

Results: The findings revealed that both the methods of motivation significantly improved plaque control compared to the absence of motivational tools. However, students who interacted with the OHR demonstrated superior results in maintaining oral hygiene as the mean gingival index reduced from 1.661 ± 0.404 to 0.836 ± 0.349 (P < 0.001) and the mean plaque index reduced from 3.203 ± 0.338 to 1.582 ± 0.283 (P < 0.001). The data were statistically analyzed using paired "t-" test for intragroup analysis and unpaired "t-" test for intergroup analysis. All statistical comparisons were conducted at the 0.05 level of significance.

Conclusion: The study highlights the potential of the OHR as an advanced educational tool for promoting better oral health practices. Its interactive and time-efficient design offers a more dynamic learning experience, making it a valuable addition to dental health education. This approach could pave the way for innovative strategies in oral hygiene training, ultimately enhancing patient care standards.

Introduction: Platelets are discoidal and anuclear structures which are formed in bone marrow from megakaryocytes. They play a major role in the release of growth factors at the site of injury to initiate wound healing. Platelet rich fibrin which belongs to second generation of platelet concentrates has an important role in hard and soft tissue regeneration.

Aim: This research aims to determine advanced PRF (A-PRF) as a medium for prolonged release of antibiotics locally and its effects on Porphyromonas gingivalis.

Materials and methods: This in vitro study consisted of four groups, where for each group 10 ml of blood was collected from healthy volunteers after obtaining informed consent. Before centrifugation, to each of the tubes, one among the three antibiotics, such as 0.5 ml amoxicillin, 0.5 ml of metronidazole, and 0.5 ml of azithromycin was added. The fourth tube had 0.5 ml of saline solution, which served as the control. Tubes were centrifuged at 1500 rpm for 14 min at room temperature. A-PRF membrane containing different antibiotics and control was placed on the blood agar plates containing four wells. These plates were then transferred to the anaerobic chamber at 37°C for 7 days. Antimicrobial activity of the A-PRF was assessed at 24 h, 48 h, 72 h, and 96 h.

Results: This study compared the antibacterial action of A-PRF against P. gingivalis at the 24 h, 48 h, 72 h, and 96 h. A-PRF with amoxicillin at 24 h showed less anti-P. gingivalis activity, whereas maximum activity was noted at 72 h and 96 h.

Conclusion: Results showed that among antibiotic solutions with A-PRF, metronidazole had more antimicrobial efficacy compared to amoxicillin and azithromycin against P. gingivalis.

Background: Periodontitis is a chronic immune-inflammatory disease influenced by multiple factors. LL-37, an antimicrobial peptide, contributes to host defense, immune regulation, and tissue repair. Its subgingival expression following nonsurgical periodontal therapy remains underexplored. This study evaluates LL-37 gene expression as a potential biomarker for response to scaling and root planing (SRP).

Materials and methods: Thirty systemically healthy patients (17 males and 13 females; aged 30-50 years) with Stage II or III periodontitis were included. Clinical parameters - probing pocket depth (PPD), clinical attachment level (CAL), and modified sulcular bleeding index (mSBI) - were recorded at baseline and 1 month post-SRP. Subgingival epithelial tissue samples were collected at both time points for quantitative real-time polymerase chain reaction analysis of LL-37 gene expression. Data were statistically analyzed.

Results: All clinical parameters improved significantly posttherapy. In Stage II, PPD reduced from 4.26 ± 0.53 to 3.25 ± 0.49 mm; CAL from 4.63 ± 0.32 to 3.60 ± 0.62 mm; and mSBI from 2.88 ± 0.55 to 1.45 ± 0.57. In Stage III, PPD decreased from 6.29 ± 1.24 to 4.40 ± 0.87 mm; CAL from 7.85 ± 1.11 to 5.81 ± 0.73 mm; and mSBI from 3.63 ± 0.37 to 3.22 ± 0.41 (all P < 0.05). LL-37 expression increased significantly in both groups (Stage II: 3.46 ± 0.35 to 15.1 ± 0.02 and Stage III: 3.88 ± 0.01 to 19.85 ± 0.70; P < 0.001), though correlation with clinical parameters was weak.

Conclusion: SRP significantly improved clinical outcomes and upregulated LL-37 expression, supporting its potential as a biomarker for early periodontal healing.

The present case report describes the use of radiographic techniques to assess the quality and quantity of the bone surrounding the dental implants treated with concentrated growth factor (CGF). Intraoral examination revealed a cracked, root canal-treated anterior tooth (#12). After discussing the surgical protocol, including its advantages and limitations, socket shielding was performed, implant osteotomy was prepared, and CGF was placed. Assessment of crestal bone levels, volume, and density was conducted at baseline and at the 9-month follow-up after implantation. Soft-tissue parameters were also evaluated at 3 and 9 months postimplantation. At recall, both bone quality and quantity had increased, and crestal bone levels remained stable. No changes were observed in soft-tissue parameters between the pre- and postimplantation phases. These findings suggest that CGF can promote the regeneration of both hard and soft tissues by enhancing bone quality and quantity and by improving the peri-implant soft-tissue environment.

Chlorhexidine (CHX) is a highly effective antiseptic agent. Allergic reactions on use of CHX are rare, but an increase in the percentage of cases is witnessed due to rapid increase in CHX-containing products in recent times. CHX forms an indispensable part of dentistry. The present case report showcases allergic reaction seen as a result of the use of CHX mouthwash, where in patient develops redness and inflammation on gingiva as well as urticarial rash on the skin of the back. The case report warns us for a cautious use of CHX products.

Background: Treating deep isolated mandibular recession defects, especially Miller Class III cases, remains a significant challenge due to factors such as shallow vestibules, muscle pull, reduced keratinized tissue width (KTW), and tooth malposition. Although various techniques have been explored, predictable outcomes with complete root coverage (RC) in such cases are rarely documented in the literature.

Materials and methods: Thirty-two systemically healthy patients (22 males and 12 females) aged 22-36 years, with isolated mandibular recessions measuring 6-11 mm, were treated using the lateral overlap technique (LOT) combined with coronal flap displacement and subepithelial connective tissue grafts. Clinical parameters, including gingival recession depth (GRD), KTW, and probing depth, were evaluated over a 1-year follow-up.

Results: Significant improvements were observed: GRD reduced from 5.55 ± 0.89 mm to 0.17 ± 0.16 mm, KTW increased by 3.26 ± 0.37 mm, and the mean percentage of RC was 96.81 ± 2.83.

Conclusion: LOT with connective tissue grafting is a reliable and effective approach for managing deep isolated mandibular Miller Class II and III gingival recessions, achieving excellent clinical outcomes.

Aim and background: Contemporary minimally invasive periodontal approaches focus on conserving tissues and minimizing postoperative discomfort. Microneedling (MN), a technique that induces controlled collagen synthesis, has shown potential in stimulating soft-tissue regeneration and improving tissue volume. When used in addition to injectable platelet-rich fibrin (I-PRF), a biologically rich blood concentrate, the regenerative outcome may be further enhanced. In patients with chronic periodontitis, the current study sought to compare the clinical results of MN with I-PRF versus I-PRF alone after nonsurgical periodontal therapy.

Materials and methods: A randomized split-mouth clinical design was adopted, including 120 periodontal sites with Stage II periodontitis. Following initial therapy, the test sites (n = 60) underwent MN followed by I-PRF administration, while contralateral control sites (n = 60) received only I-PRF injections. Clinical parameters - probing pocket depth (PPD), gingival thickness (GT), keratinized tissue width (KTW), and relative attachment level (RAL) - were assessed at baseline, 1 month, and 3 months after treatment.

Results: All recorded metrics showed a considerable improvement with both treatment regimens (P < 0.001). In the test and control groups, the mean PPD decreased to 3.38 ± 0.42 mm and 3.65 ± 0.57 mm, respectively. Correspondingly, the mean RAL in the test group showed a reduction from 4.91 ± 0.77 mm at baseline to 3.66 ± 0.65 mm after treatment, while the control group exhibited an improvement to 3.87 ± 0.69 mm. After 3 months, the test group demonstrated a mean gain in GT of 0.60 ± 0.31 mm and an increase in KTW of 0.80 ± 0.14 mm, indicating a larger enhancement in periodontal phenotype (P < 0.001).

Conclusion: MN used adjunctively with I-PRF demonstrated superior outcomes in soft-tissue healing, phenotype improvement, and clinical attachment gain, highlighting its promise as a minimally invasive regenerative modality in nonsurgical periodontal therapy.

Objectives: The primary objective was to assess the effect of periodontitis and its treatment on glycemic status, as measured by glycated hemoglobin (HbA1c), fasting blood sugar (FBS), and systemic inflammation employing C-reactive protein (CRP) in nondiabetic individuals with a family history of type 2 diabetes mellitus (T2DM). The secondary objective was to assess the relationship between periodontal parameters, glycemic status, and systemic inflammation.

Materials and methods: Sixty nondiabetic subjects with a family history of T2DM were recruited. They were grouped as those with periodontitis (Group 1) and those without periodontitis (Group 2). Biochemical parameters such as HbA1c, FBS, and CRP were assessed at baseline and at the 3-month follow-up in both groups. Both groups were given oral hygiene instructions. Group 1 received nonsurgical periodontal therapy (NSPT) consisting of supra- and subgingival professional mechanical plaque removal and oral azithromycin 500 mg for 3 days. Periodontal parameters such as full-mouth plaque score, full-mouth bleeding score, probing pocket depth, and clinical attachment loss were assessed at baseline and at 3-month follow-up in Group 1.

Results: There were significant differences in HbA1c, FBS, and CRP between both groups at baseline. A significant difference was noted between baseline and 3-month follow-up values of HbA1c, FBS, and CRP in the periodontitis group. Periodontal parameters also showed improvement from baseline values after NSPT in 3 months.

Conclusion: In patients with periodontitis, the HbA1c, FBS, and CRP levels were higher than those in periodontally healthy subjects, and the values reduced after NSPT. Hence, controlling periodontal inflammation may positively influence the future development of T2DM in prediabetic patients and the conversion of nondiabetics to prediabetes.