Journal of Indian Society of Periodontology最新文献

Background: Periodontal disease is a chronic inflammatory condition that leads to the destruction of periodontal tissues, exacerbated by bacterial lipopolysaccharide (LPS). Current therapeutic approaches seek to reduce inflammation and promote regeneration. Curcumin, a natural polyphenol with anti-inflammatory and antioxidant properties, may offer a biocompatible alternative for periodontal regeneration by protecting human periodontal ligament cells (hPDLCs) from inflammatory damage.

Materials and methods: The present in vitro study examined the effects of curcumin on hPDLCs exposed to LPS (10 µg/mL) to simulate an inflammatory environment. hPDLCs were divided into four groups: control, curcumin-treated (2.5 µM and 5 µM), LPS-induced inflammation, and LPS with curcumin. Cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and morphological changes were evaluated via phase-contrast microscopy.

Results: Curcumin treatment did not significantly impact cell viability in hPDLCs under noninflammatory conditions, with viability rates exceeding 94%. In LPS-stimulated cells, curcumin at 2.5 µM and 5 µM significantly improved viability from 60.1% (LPS only) to 80.1% and 87.6%, respectively. Morphological assessment revealed that curcumin mitigated LPS-induced cellular damage, promoting normal cell structure and growth.

Conclusion: Curcumin demonstrates potential as a therapeutic agent for periodontal regeneration by enhancing cell viability and counteracting LPS-induced cytotoxicity in hPDLCs. This study supports curcumin's role in creating a microenvironment conducive to periodontal tissue repair and highlights its promise for future applications in periodontal therapy.

Insufficient dimension of alveolar bone and reduced width of keratinized gingiva may be the consequence of tooth loss accompanied by adaptive transformation. It creates a challenging situation for the clinician, especially in terms of implant-supported prosthetic rehabilitation. The present case of a 66-year-old female patient presented with an edentulous span of the right mandibular posterior edentulous site with Siebert class I defect. Literature recommended different bone augmentation procedures for such a clinical situation but are associated with a variety of risks and complications too. Adequate alveolar ridge dimensions are a prerequisite to achieve proper osseointegration; Khoury split bone block (KSBB) technique utilizing combination of thin split autogenous bone and bone particles is a popular intervention that is highly recommended in the literature and was executed in this case. Four months postoperatively Densah bur-assisted osteotomy preparation was done under osseodensification mode followed by implant fixture placement w.r.t tooth no. 45,46,47. Three months postimplant placement, insertion buccal site showed a lack of sufficient width of keratinized tissue. Therefore, free gingival grafting (FGG) was executed in order to maintain the peri-implant tissue health at the buccal aspect of tooth no. 45-47 region, followed by prosthetic rehabilitation at 12 months postoperatively. Clinically, peri-implant tissue was healthy, and no marginal bone loss was observed on radiovisual graph evaluation taken at 1.5 years, postoperatively. It was concluded that KSBB, osseodensification and FGG contributed in the excellent clinical and functional outcome of multiple implant-supported prosthetic rehabilitation at the mandibular posterior edentulous site with Siebert class I defect.

Langerhans cell histiocytosis (LCH) is a rare hematologic disorder characterized by the abnormal proliferation of Langerhans cells, resulting in a wide range of clinical manifestations and diagnostic challenges. A 36-year-old male presented with complaints of mobile teeth, gingival pain, and eczematous rashes on the toes. Clinical examination revealed advanced gingivitis, significant alveolar bone loss, and micronodular opacities in the chest on radiographic imaging. Histopathological and immunohistochemical analyses confirmed the diagnosis of LCH. This case underscores the diverse clinical spectrum of LCH and highlights the pivotal role of histopathology and immunohistochemistry in achieving a definitive diagnosis. Management strategies vary depending on the extent of disease involvement and may include surgical excision, corticosteroid therapy, or systemic chemotherapy. The case emphasizes the necessity of comprehensive evaluation and interdisciplinary collaboration in the diagnosis and treatment of rare disorders such as LCH.

Background: Elemental boron has a positive role in many functions in the human body, such as immune regulation, wound healing, bone health maintenance, etc. A boron-containing molecule (AN0128) has shown additional antimicrobial properties against virulent red-complex bacteria. However, there is a dearth of human trials evaluating the effectiveness of readily available boronic compounds in periodontitis patients.

Materials and methods: Thirty-six patients with generalized periodontitis were included in this double-blind, placebo-controlled randomized clinical trial. Following scaling and root planing at baseline, each designated test site in the 18 treatment group subjects received subgingival 0.75% boric acid, whereas the remaining 18 subjects received placebo irrigation at the control site. At the 6^th week recall, test/control irrigations were repeated as per the group assigned. Clinical parameters were recorded at baseline, 6^th week and 12^th week, whereas chairside microbial assessment using benzoyl-DL-arginine-2-napthylamide (BANA) was done at baseline and 12^th week.

Results: Comparatively, the test group demonstrated significant improvements (P < 0.05) in terms of the gingival index, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) at the 12^th week. Improved mean BOP, PPD, and CAL differences were highly significant (P < 0.005) for the test group at the 6^th week. Microbial assessment using the BANA test did not observe a significant intergroup difference following therapy.

Conclusion: Outcomes of the present trial demonstrated boron's significant role in clinical improvements. Adjunctive subgingival boric acid irrigation can be effective in healing following phase-I therapy.

Background: The study aimed to enhance the efficacy of periodontal treatment through the development of dual drug-loaded nanoparticles (NPs) of metronidazole (MET) and green tea extract (GTE).

Materials and methods: The NPs were prepared by solvent displacement, optimized by central composite rotatable design. The particle size, polydispersity index (PDI), and entrapment efficiency were assessed. The cell viability was assessed using the L929 mouse fibroblast cell lines. In addition, texture analysis, flux, and permeability coefficient of MET and GTE gel were measured. Minimum inhibitory concentration (MIC) was assessed on isolates obtained from periodontal patients. Hen's egg test-chorioallantoic membrane (HET-CAM) study was conducted to assess the irritability and tolerability of NPs.

Results: The optimized NPs had a mean particle size of 171.0 ± 49.34 nm, a mean PDI of 0.383 ± 0.907, and a high entrapment efficacy of 89% ± 0:25%. Cell viability assay demonstrated 93.8% viability on mouse fibroblast cell lines. Texture analysis of NP-loaded gel showed high cohesiveness, less firmness, and consistency. The flux and permeability coefficient of MET and GTE was found to be 9.084 µg/h/cm², 7.8005 µg/h/cm², 0.0036 cm/h, and 0.0039 cm/h. The confocal study showed an increase in the depth of NPs due to their nanosized particles. The MIC values were 400 µg/mL for MET and 500 µg/mL for GTE against periodontal isolates. HET-CAM study illustrates that the NPs are secure, nonirritating, and well tolerated for periodontal disease.

Conclusions: Dual-drug-loaded NPs exhibited significant antimicrobial activity against periodontal pathogens and demonstrated promising potential to enhance the clinical outcomes of periodontal therapy.

Exquisite esthetics for implant-supported restorations in the anterior esthetic zone is a challenging task. Recreating the gingival profile with proper integration of hard and soft tissues is a prime requisite to overcome the clinical challenge. Abutment selection, impression technique, and emergence profile of the final restoration play an important role in providing a distinct appearance to the final prosthesis. Through two case reports, this paper describes the step-by-step procedures involved in customizing the emergence profile and gingival profile using laser-assisted surgery and provisional restorations.

Background: Early diagnosis of peri-implant bone loss is vital for the successful management of peri-implantitis. Among the various diagnostic tools available, cone-beam computed tomography (CBCT) is the most commonly used method. However, CBCT has own limitations, which have led to the development of new diagnostic technologies. Of these, ultrasonography (US) appears to be the most promising. The aim of the current study was to compare and evaluate the efficacy of US with CBCT and direct measurement (DM) using a periodontal probe (PP) in assessing peri-implant bone defects created in a cadaveric goat mandible.

Materials and methods: Fifteen cadaveric goat mandibles were procured from a local slaughterhouse, and 15 endosseous implants (3.5 mm × 13 mm) were placed using a standard surgical protocol. Critical defects measuring 7 mm × 3 mm × 3 mm were created around the implants using a piezosurgical unit. These defects were evaluated using a PP for DM in Group I (GI), CBCT in Group II (GII), and ultrasonography (US) in Group III (GIII). The collected data were statistically analyzed.

Results: The mean height of the peri-implant osseous defect measured in GI, GII, and GIII was 6.05 ± 0.08 mm, 5.55 ± 0.40 mm, and 6.05 ± 0.30 mm, respectively. The measurements in GIII were comparable to those of GI and more precise than those of GII.

Conclusion: Within the limitations of the current study, US is more effective than CBCT and equally effective as DM using a PP in measuring critical peri-implant bone defects in cadaveric goat mandible. Therefore, ultrasonography can be considered a reliable diagnostic tool for routine implant follow-up.