Journal of Indian Society of Periodontology最新文献

Objective: Significant association is exhibited between periodontal phenotypes and tooth crown morphology. The present study was planned to evaluate and correlate the facial and anterior teeth proportions among different facial types (FTs) based on gender in periodontally healthy patients.

Materials and methods: Two hundred patients within an age range of 20-40 years were assigned equally into two groups based on gender. The extraoral and intraoral parameters of facial height (FH), facial width (FW), crown width (CW), crown height (CH), and intercommissural width (ICOW) were recorded on digitized photographs. From these values, tooth type (TT), FT, and facial index (FI) were calculated.

Results: The mean values of FI, CH, CW, and ICOW were greater while FH and FW lesser in females than males. The predominant presence of average FI (55%), mesoprosopic FT (58%), and triangular TT (51%) was observed in males, whereas in females, it was average FI (51%), mesoprosopic FT (55%), and triangular TT (51%). A2 tailed significant positive correlation was exhibited at (0.745) and (0.799) between TT and FI and (0.772) and (0.808) between TT and FT for males and females, respectively. Both the correlations were statistically significant (P < 0.05).

Conclusion: The results suggest gender variability of the extraoral and intraoral parameters along with significant positive correlations between TT and FI and TT and FT. These extraoral and intraoral exhibits along with the periodontal phenotypes can be considered as critical aspects in smile designing procedures.

Introduction: Gingival melanin pigmentation is one of the most important factors for esthetically sensitive candidates. Literature reveals various depigmentation techniques which are predominantly utilized for clinical assessment only. The present randomized clinical study was planned to evaluate the efficacy of surgical stripping and diode laser-assisted gingival depigmentation techniques in terms of patient's perspective, clinical, and histological outcome.

Materials and methods: Twenty patients with bilateral labial physiological gingival melanin pigmentation extended from the distal aspect of #13-23, 33-43 were selected as for the study. Dummet Oral Pigmentation Index (DOPI) and Hedin Melanin Index (HMI) were recorded, and incisional biopsies were taken at baseline to evaluate the density of melanin pigmentation. Both arches were equally treated by surgical stripping assisted gingival depigmentation and diode laser-assisted gingival depigmentation (SSAGD and DLAGD). Patients were re-evaluated at 3 and 6 months postoperatively for DOPI and HMI and at 6 months for the density of melanin pigmentation. Visual Analog Scale (VAS) was evaluated during surgery, 1^st and 7^th-day postoperatively. Data obtained were statistically analyzed using Wilcoxon Signed Ranks, Mann-Whitney U, Chi-square, and Student's "t"- tests.

Results: DOPI and HMI were reported to be statistically significant (P < 0.05) at different intervals and density of melanin pigmentation at 0-6 months intervals in both the groups on intragroup comparison. HMI and DMP were reported to be statistically significant at 6 months postoperatively and VAS during and 1-day postsurgery on intergroup comparison.

Conclusion: SSAGD is best in terms of clinical and histological outcomes and induces less postoperative pain, and repigmentation is slow as compared to DLAGD.

Gingival recession in the esthetic zone is a frequent clinical challenge that can be effectively managed with an autogenous palatal connective tissue graft in combination with the tunnel technique. This case report presents a 30-year-old patient with Miller Class II gingival recession involving the labial surfaces of the mandibular incisors. The primary objective was to achieve predictable root coverage and improvement in the width of attached gingiva using a minimally invasive tunneling approach. The tunnel technique offers several advantages in the management of multiple gingival recessions. It preserves interdental papillae, enhances vascularization, and provides a tension-free adaptation of the graft. Palatal connective tissue grafts harvested for this purpose demonstrate increased survival due to the dual blood supply from the palatal connective tissue and the overlying marginal gingiva. This biological advantage not only improves graft stability but also enhances the predictability of clinical outcomes. In this case, satisfactory root coverage, increased gingival width, and adequate vestibular depth were observed at the recipient site. The procedure met both functional and esthetic expectations, with the patient expressing high satisfaction with the overall results. The findings highlight the effectiveness of the tunnel technique with autogenous connective tissue grafts in achieving predictable outcomes for recession coverage.

Langerhans cell histiocytosis (LCH) is an uncommon disease characterized by the clonal proliferation of Langerhans cells, which are specialized dendritic cells that play a role in the body's immune response. The hallmark of LCH is an aberrant proliferation of Langerhans cells, which can affect almost every part of the body. Oral symptoms may be the earliest indicator of the disease, and when it comes to adult patients, its location in the periodontal tissues can be readily confused with that of other, more prevalent conditions such as necrotizing ulcerative periodontitis, aggressive periodontitis, and chronic periodontitis. It can present itself as unifocal or multifocal with local and systemic manifestations, which involve various internal organs and mucosal tissues. The clinical course varies among individuals, ranging from spontaneous resolution to life-threatening conditions with multisystem involvement. The need to take LCH into account when making differential diagnoses of atypical periodontal disease is highlighted by our report of a rare instance of bilateral maxillary and mandibular involvement in an adult patient with LCH who first presented with periodontal symptoms.

Background: Root coverage following gingival recession is often performed for cosmetic reasons to reduce root sensitivity or to treat root caries and cervical abrasions. The subepithelial connective tissue graft is considered the gold standard for esthetically correcting gingival recession.

Aim: This study aimed to evaluate the clinical efficacy of coronally advanced flaps in the treatment of localized gingival recession, both as a standalone procedure and in combination with periosteal pedicle grafts.

Materials and methods: A split-mouth design was employed involving 10 patients with bilateral, nearly identical Miller's class I or II facial recession defects of 2 mm on anterior or premolar teeth. Clinical parameters, including plaque index, gingival index, probing pocket depth, and clinical attachment level, were recorded at baseline, 3-month, and 6-month posttreatment.

Results: Both groups showed significant clinical improvements in all measured parameters. Although Group I (periosteal pedicle graft combined with coronally advanced flap) demonstrated somewhat better results than Group II (coronally advanced flap alone), the differences were not statistically significant.

Conclusion: Within the limitations of this study, the periosteal pedicle graft combined with the coronally advanced flap technique provided greater root coverage compared to the coronally advanced flap alone, but this difference was not statistically significant.

The emerging concept of tribocorrosion including metal ion release and wear at the implant-abutment interface remains a challenge. This systematic review aims to investigate the differences in metal ion release at implant abutment interface when titanium/titanium alloy implants are coupled with dissimilar abutment materials as compared to titanium/titanium alloy abutments. A comprehensive search relevant to the predefined key terms was conducted across five databases (PubMed, Scopus, Web of Science, Embase, and Google Scholar) up to March, 2024 using the PECO framework. Inclusion criteria focused on in vitro studies on metal ion release at the implant-abutment interface. The eligibility and risk of bias of study was assessed using the QUIN tool. The data were extracted and based on the observed heterogeneity; only qualitative synthesis was performed. A total of 17 studies (477 specimens) were included for data analysis. The findings revealed significant variations in ion release depending on material combinations. Titanium implants paired with dissimilar abutment materials showed increased ion release over time, especially from days 43 to 84 as compared to Ti/Ti alloy abutment. Greater wear was also observed with dissimilar materials as compared to similar abutment material. Within the limitations of the analysis, metal ion release was substantially variable for Ti/Ti alloy abutments compared to other metal abutment materials coupled with Ti/Ti alloy implant and was found to be increased over time. Further clinical studies are needed to standardize metal ion detection and wear measurement methods and extend implant longevity.

Introduction: Subepithelial connective tissue grafts (CTGs) represent the gold standard of treatment for gingival recession; however, the method is associated with some limitations, stemming from necessity of a donor site and the inherent complexity of the harvesting technique. The present study utilizes Mucoderm^® (porcine-derived collagen matrix) and amnion membrane (allograft), as a substitute approach for root coverage.

Objectives: The purpose of the study is to evaluate the efficaciousness of the root coverage outcomes when employing Mucoderm^® and amniotic membrane (AM) versus CTG.

Materials and method: A randomized clinical trial was conducted comparing coronally advanced flap with Mucoderm^®, AM and CTG was conducted involving 15 patients subdivided into groups of five. The periodontal pocket depth, clinical attachment level, recession depth, and keratinized tissue width were measured preoperatively and at 1 and 3 months postoperatively.

Results: Statistical analysis showed that Mucoderm^® showed statistically significant results compared to CTG with regard to clinical parameters and complete coverage, whereas AM showed poorer results in terms of thickness of the gingiva.

Conclusion: The study results indicated that Mucoderm® and AM could serve as viable alternatives CTGs in root coverage procedures.

Background: The aim of this study was to assess and compare the efficacy of curcuminoid gel as an adjuvant to scaling and root planing (SRP) in chronic periodontitis patients.

Materials and methods: Thirty subjects participated in this randomized controlled study. The control sites received SRP alone, while the experimental sites received curcuminoid gel as a local drug delivery in addition to SRP. Clinical parameters such as the Gingival Index, Oral Hygiene Index-Simplified, probing pocket depth, and clinical attachment level were assessed at baseline and 3-month posttreatment. In both control and test sites, prostaglandin E2 (PGE2) levels in gingival crevicular fluid (GCF) were assessed at baseline and 45 days posttreatment.

Results: Parametric tests of significance were used for statistical analysis. Results revealed a statistically significant difference between the groups in both clinical and biochemical parameters.

Conclusion: In treating moderate chronic periodontitis, the adjunctive use of curcuminoid gel significantly improved clinical outcomes compared to SRP alone. Following the procedure, the PGE2 level in GCF was substantially lower in the test sites than in the control sites. Controlled release mechanisms lessen inflammation and prevent recolonization for an extended period. Given the limitations of the study, curcuminoid gel may be utilized in addition to nonsurgical periodontal treatment.

Background: Vestibular deepening procedure is a surgical intervention, intended to correct the insufficient vestibular depth (VD) and keratinized gingiva, both of which can compromise gingival health and hinder the maintenance of oral hygiene. The aim of this study is to assess and compare the gained VD, patient perception, and healing outcome in periosteal fenestration, Kazanjian, and free gingival grafting (FGG) techniques of vestibular deepening for a period of 6 months.

Materials and methods: Thirty patients presenting with a shallow vestibule in the anterior mandibular region, requiring improved VD or increased width of attached gingiva for effective oral hygiene maintenance, were included in the study. Clinical parameters like plaque index, gingival index, VD, and keratinized tissue width (KTW) were recorded at baseline and postoperatively at 1, 3, and 6 months. Healing outcomes and patient perception of pain were recorded by Landry et al., using healing index and Visual Analog Scale (VAS) score, respectively.

Results: All the three techniques resulted in a statistically significant improvement in VD at all time intervals (P < 0.05). Patients treated with the periosteal fenestration approach had less pain and better healing outcome than patients treated with the other two approaches. Free gingival graft resulted in better gain in VD and keratinized tissue.

Conclusion: The results of our clinical study showed that the periosteal fenestration group had better healing outcomes and less pain perception, while the FGG group had more improvement in VD and keratinized tissue.