A double lateral pedicle graft technique for palatal recession coverage on dental implants.

Rough surfaces of dental implants, when exposed to the oral environment, are conducive to biofilm colonization and can predispose the affected implant to periimplantitis. Recession coverage using soft-tissue grafts is one of the treatment modalities used for the treatment of exposed implant threads. Recession coverage on the palatal aspect of maxillary implants is difficult due to the firm nature of the palatal mucosa and, consequently has not been widely documented in the literature. This case report documents a novel double-pedicle technique for palatal recession coverage on a dental implant. Two pedicle grafts were obtained from either side of the implant with the mucosal recession: a full-thickness lateral-pedicle graft from the distal aspect and a subepithelial connective tissue pedicle from the mesial aspect. The connective tissue pedicle was stabilized first on the area of mucosal recession and was then covered with the distal full-thickness lateral pedicle. Complete recession coverage was obtained, and the result was observed to be clinically stable after 18 months of follow-up. The technique demonstrated in this report can be a useful tool for the treatment of localized palatal recessions on dental implants.

Photobiomodulation of human gingival fibroblasts with diode laser - A systematic review.

Low-level laser therapy (LLLT) is being extensively studied in the field of periodontics as a noninvasive technique to achieve better results after nonsurgical and surgical therapy. However, there is a lack of definitive guidelines for the use of LLLT to promote gingival and periodontal wound healing. The primary objective of this systematic review was to critically analyze the studies evaluating the effect of low-level diode laser on human gingival fibroblasts in vitro and to develop wavelength-specific guidelines for photobiomodulation of human gingival fibroblasts. A thorough electronic and manual search was conducted for relevant articles published until December 2019. Nine studies were included in the review after the initial screening of 1334 articles. Our data analysis revealed that LLLT with diode laser stimulates human gingival fibroblasts as there was the increase in cell viability, proliferation, migration, and protein synthesis in irradiated cells. The diode lasers in the 600-700 nm spectrum were effective in the 10 mW to 30 mW power range. Lasers in the 700-800 nm range were effective in the 25-50 mW power range and diode lasers in the 800-900 nm range were effective at a power setting of 10 mW. It was possible to ascertain a suitable power setting for a particular wavelength spectrum, but no other parameters could be defined due to a lack of reporting of details. Hence, the authors have developed guidelines for comprehensive reporting of in-vitro studies to facilitate future research and overcome existing lacunae in knowledge.

Applications of diode laser in periodontal therapy ­ clinical guidelines and tips / Aplicações do laser de diodo na terapia periodontal ­ Orientações e dicas clínicas

Os lasers de diodo tornaram-se ferramentas clínicas populares devido ao seu tamanho compacto, acessibilidade, facilidade de uso e versatilidade. O objetivo deste artigo é apresentar as diversas aplicações de um laser de diodo na prática diária e destacar os aspectos técnicos do uso do laser de diodo para o mesmo. Esta série de casos relata o manejo de seis diferentes situações clínicas com laser de diodo: anquiloglossia, bolsa periodontal, zênites gengivais desiguais, mucocele, hipersensibilidade dentinária e gengiva hiperpigmentada. Os pacientes foram tratados com laser de diodo de 940 nm com potência de 0,5 W a 2 W dependendo do caso. A cicatrização pós-operatória transcorreu sem intercorrências na maioria dos casos e foram observados resultados favoráveis. O laser de diodo ofereceu vantagens cirúrgicas como ­ campo seco, desinfecção do sítio cirúrgico e cirurgia sem sutura. Além disso, os autores observaram melhor satisfação do paciente devido à mínima dor ou edema pós-operatório e alívio imediato em caso de hipersensibilidade dentinária. Este artigo apresenta as aplicações cirúrgicas e não cirúrgicas do laser de diodo juntamente com os aspectos técnicos. Embora a literatura disponível não forneça evidências substanciais para comparação direta do laser de diodo com as técnicas convencionais, é seguro concluir que o laser de diodo é uma ferramenta eficiente para uso rotineiro em odontologia.(AU)

The diode lasers have become popular clinical tools because of their compact size, affordability, ease of use and versatility. The aim of this paper is to put forth the various applications of a diode laser in day to day practice and highlight the technical aspects of diode laser use for the same. This case series reports management of six different clinical situations with diode laser namely ­ ankyloglossia, periodontal pocket, unequal gingival zeniths, mucocele, dentinal hypersensitivity and hyper-pigmented gingiva. The patients were treated with 940 nm diode laser with power settings from 0.5 W to 2 W depending on the case. The post-operative healing was uneventful in most cases and favourable outcomes were observed. The diode laser offered surgical advantages like ­ dry field, disinfection of surgical site and suture-less surgery. In addition, the authors observed better patient satisfaction owing to minimal post-operative pain or swelling and immediate relief in case of dentinal hypersensitivity. This paper presents both surgical and non-surgical applications of diode laser along with the technical aspects. Even though the available literature does not lend substantial evidence for direct comparison of diode laser with conventional techniques, it is safe to conclude that diode laser is an efficient tool for routine use in dentistry.(AU)

Estimation and correlation of salivary calcium, phosphorous, alkaline phosphatase, pH, white spot lesions, and oral hygiene status among orthodontic patients.

INTRODUCTION: The initial carious lesions are the so-called "white spot" lesions (WSLs), which implies that there is a subsurface area with most of the mineral loss beneath a relatively intact enamel surface. It is common in patients who are taking orthodontic treatment. Salivary reservoir of calcium and phosphorous counteracts the demineralization and encourages re-mineralization providing protection against caries challenge. This study was aimed to estimate and correlate the oral hygiene status, WSLs and salivary calcium, phosphorus, alkaline phosphatase (ALP), and pH in patients undergoing fixed orthodontic therapy. MATERIALS AND METHODS: All clinical and biochemical parameters were recorded in 27 patients before starting orthodontic treatment and at 6 months of orthodontic treatment. The salivary calcium, phosphorous, ALP, and pH were determined by Arsenazo III method, Molybdate - UV and the International Federation of Clinical Chemistry method, respectively. International caries detection and assessment system index for WSL, orthodontic plaque index, bleeding on probing, and gingival index were recorded. Shapiro-Wilk's test and Wilcoxon test were applied to the data collected for statistical analysis. RESULTS: There was a statistically significant increase with ALP levels, orthodontic plaque index score, gingival index score, and bleeding on probing index score. A statistically significant reduction was seen with respect to levels of calcium and pH. CONCLUSION: Maxillary canines and lateral incisors were the most affected teeth with WSLs (78.84%). There is a need for more stringent prevention programs and oral hygiene practices prior to initiation of orthodontic treatment and also during orthodontic treatment.

Serotypes of Aggregatibacter actinomycetemcomitans in relation to periodontal status and assessment of leukotoxin in periodontal disease: A clinico-microbiological study.

CONTEXT: Aggregatibacter actinomycetemcomitans (A.a) serotypes may add some important information of the pathogenetic background of periodontal infections. A.a leukotoxin is an important virulence factor in the pathogenesis of periodontal disease and its rate of progression. When compared to minimally leukotoxic strains, variants of A.a highly leukotoxic strains produce 10-20 times more leukotoxin. AIMS: The aim of the present study was to detect serotypes a, b, c, d, and e of A.a its leukotoxin and find its correlation with periodontal status. SETTINGS AND DESIGN: Microbiological analysis and cross-sectional study. MATERIALS AND METHODS: A total of 80 subjects (40 chronic periodontitis and 40 aggressive periodontitis) in the age range of 14-55 years were selected. Subgingival plaque samples were collected and checked for the presence of A.a. Following isolation of the organism, detection of the serotypes and leukotoxin assessment was done. STATISTICAL ANALYSIS USED: The proportions of A.a were calculated using descriptive statistics in terms of percentage. Chi-square test was used to find association between serotype, leukotoxin, and periodontal disease in individual group. RESULTS: Out of 80 plaque samples, 45% tested positive for A.a. serotype b was detected in 33.33%, whereas serotype e in 8.33% samples and serotype c in 2.77% samples. Serotypes a and d were not detected in any of the samples. A combination of serotypes was seen in 47.22% of the sites. Of these 76.47% showed a combination of 2 serotypes, while 23.52%showed a combination of 3 serotypes. 8.33% showed untypable serotype. All samples had low-toxic variants of A.a. CONCLUSIONS: Serotype b and serotype e were predominant in chronic periodontitis, and serotype b was predominant in aggressive periodontitis. An association could be present between serotype and periodontal disease.

Profiling of Aggregatibacter actinomycetemcomitans Serotypes B and C and the genotypes in periodontal health and disease.

BACKGROUND: A. actinomycetemcomitans is prevalent in periodontitis but is found in some periodontally healthy individuals as well. Certain serotypes of the organism have shown to determine severity of the disease. The distribution of serotype and genotype is affected by geographic and ethnic variation. Therefore, the present study was aimed to detect serotypes b & c of A. actinomycetemcomitans and the genotypes and find its correlation with periodontal status. MATERIALS AND METHODS: A total of 75 subjects (25 aggressive periodontitis, 25 chronic periodontitis and 25 periodontally healthy) in age range of 14-55 yrs were included. Subgingival plaque samples were collected and checked for the presence of A. actinomycetemcomitans. Following isolation of the organism, detection of the serotype b or c was done by multiplex PCR. Genotyping of A. actinomycetemcomitans was done by arbitrarily primed PCR(polymerase chain reaction). RESULTS: Out of 75 plaque samples, 35(46.66%) tested positive for A. actinomycetemcomitans. Serotype c was detected in 19/35 (54.28%), whereas serotype b alone was not detected in any of the samples. Two samples were positive for both the serotypes (b and c) (5.71%) and 14 (40%) were untypeable. 14 different arbitrarily primed PCR genotypes were obtained among 35 A. actinomycetemcomitans isolates. CONCLUSION: Serotype c was predominant in periodontally diseased as well as periodontally healthy individuals. An association could be present between genotype - serotype and genotype - periodontal status.

Resistin levels in gingival crevicular fluid of patients with chronic periodontitis and type 2 diabetes mellitus.

BACKGROUND: Resistin is associated with local and systemic inflammatory conditions with a direct correlation with type 2 diabetes mellitus (T2DM). The aim of this clinico-biochemical study is to estimate and compare the levels of resistin in the gingival crevicular fluid (GCF) in health, chronic periodontitis (CP), and T2DM. METHODS: Sixty patients (aged >35 years) who participated in this study were divided into four groups of 15 patients each: healthy individuals (group 1), patients with CP (group 2), patients with T2DM (group 3), and patients with T2DM and CP (group 4). The parameters assessed included plaque index (PI), gingival index (GI), probing depth (PD), periodontal index, body mass index, random blood sugar (RBS), and glycated hemoglobin (HbA1c). GCF (4 µL) was collected and analyzed for resistin levels using an enzyme-linked immunosorbent assay. RESULTS: Resistin was detected in the GCF of all patients. A significant difference was observed in GCF resistin concentrations from group 1 versus group 2 (P = 0.0093), group 3 (P = 0.0341), and group 4 (P = 0.0002); in group 2 versus group 4 (P = 0.0032); and in group 3 versus group 4 (P = 0.0008). When all the samples were analyzed together, GCF resistin levels positively correlated with GI, PD, PI, RBS, and HbA1c and were predictable with PD and HbA1c. CONCLUSIONS: Resistin levels are increased in CP and T2DM. Hence, GCF resistin levels may be considered as a potential inflammatory marker for periodontitis with T2DM.

Evaluation of holy basil mouthwash as an adjunctive plaque control agent in a four day plaque regrowth model.

OBJECTIVES: Various antibacterial and antiplaque agents are used in chemical plaque control but none are without their shortcomings. Chlorhexidine considered a gold standard, also has an array of side effects. To overcome these, numerous herbal extracts have been tried and tested and one among them is holy basil. The present study evaluated the antibacterial efficacy of holy basil in vitro against some periodontopathogens and its antiplaque effect in vivo. STUDY DESIGN: Thirty periodontally healthy volunteers were randomly divided into three groups and refrained from all mechanical oral hygiene measures for 4 days and used one of the randomly assigned mouthwash (1- chlorhexidine; 2- holy basil; and 3- sterile water [placebo]) twice daily. The Plaque Index (PI) was assessed at days 0 and 5. Aqueous extract of holy basil was tested against Prevotella intermedia (P. intermedia) and Fusobacterium nucleatum (F.nucleatum). RESULTS: Holy basil extract showed inhibition of both the tested periodontopathogens (P.intermedia and F.nucleatum) at various concentrations. In all groups, the PI increased from baseline to day 5. There was a statistically significant difference (p < .05) between the chlorhexidine and placebo rinse and the holy basil and placebo rinse, but no statistically significant difference was found between the chlorhexidine and holy basil rinse with respect to PI. CONCLUSIONS: These results indicate that the holy basil mouthwash has an antiplaque effect and is efficacious against P. intermedia and F. nucleatum strains in vitro. Hence holy basil mouthwash may have potential as an antiplaque mouthwash with prophylactic benefits. Key words:Antibacterial agent, basil, Fusobacterium nucleatum, mouthwashes, Prevotella intermedia.

Understanding the advances in biology of orthodontic tooth movement for improved ortho-perio interdisciplinary approach.

This article provides an insight on detailed current advances in molecular understandings of periodontal ligament cells and the influence of orthodontic force on them in the light of recent advances in molecular and genetic sciences. It sequentially unfolds the cellular events beginning from the mechanical force initiated events of cellular responses to bone remodeling. It also highlights the risks and limitations of orthodontic treatment in certain periodontal conditions, the important areas of team work, orthodontic expectations from periodontal treatment and the possibility of much more future combined research to improve the best possible periodontal health and esthetic outcome of the patient.

Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

BACKGROUND: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. CASE DESCRIPTION: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. CLINICAL IMPLICATIONS: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

Comparative evaluation of diode laser, stannous fluoride gel, and potassium nitrate gel in the treatment of dentinal hypersensitivity.

The aim of the present study was to compare the efficacy of diode laser (DL) with stannous fluoride and potassium nitrate gels in the treatment of dentinal hypersensitivity (DH). Fifty-four subjects, ages 25-45, having 2 adjacent teeth sensitive to air blast stimulation were included. The subjects were divided randomly into 3 groups (n= 18): Group A, subjects treated with DL; Group B, subjects treated with 0.4% stannous fluoride gel; and Group C, subjects treated with 5% potassium nitrate gel. Each group was evaluated at baseline; at weekly intervals for 2 consecutive weeks; and at 1, 3, and 6 months. All 3 groups showed decreases in the DH scores between baseline and 6 months This was more pronounced in Group A at all time intervals. When the 3 groups were compared between baseline and Week 1, there was a statistically significant decrease across all 3 groups between (P = 0.0020). The greatest difference in the DH scores between baseline and Week 1 was in Group A, compared to Groups B and C. The 940 nm DL was not only efficacious, but also brought about improved immediate relief as compared to stannous fluoride and potassium nitrate gels in the reduction of DH.

Determination of thickness of palatal mucosa.

BACKGROUND: The palatal masticatory mucosa is widely used as a donor material in periodontal plastic surgery. The thickness of graft tissue is an important factor for the graft survival. The purpose of this study was to determine the thickness of palatal mucosa by a bone sounding technique. The association of age and gender with the thickness of palatal mucosa was also examined. MATERIALS AND METHODS: Twenty four healthy subjects had participated in the study. The younger age group of 16-30 years consisted of 12 subjects of 7 females and 5 males, and the older age group of 31-54 years consisted of 12 subjects, of 5 females and 7 males. A bone sounding method using a periodontal probe was done to assess the thickness of palatal mucosa at 15 measurement sites defined according to the gingival margin and palatal line. Mann-Whitney test was used to determine the difference in mucosal thickness between both the groups. RESULTS: The younger age group had thinner mucosa ranged from 2 to 3.1 mm in thickness than the older age group which ranged from 3.2 to 3.7 mm. In the same age group, females had thinner mucosa than males in the same age group. The mean thickness of palatal masticatory mucosa ranged from 2.5 to 3.7 mm. CONCLUSION: The younger subjects had thinner mucosa than older subjects. The canine and premolar areas appeared to be the most appropriate donor site for grafting procedures.

A comparative evaluation of the antibacterial efficacy of honey in vitro and antiplaque efficacy in a 4-day plaque regrowth model in vivo: preliminary results.

BACKGROUND: Honey has a potent broad-spectrum antibacterial action that may make it suitable for "anti-infective" treatment of periodontal disease. The aims of this study are as follows: 1) to evaluate the antibacterial efficacy of honey against oral bacteria and compare the same with 0.2% chlorhexidine; and 2) to compare antiplaque efficacy in vivo with chlorhexidine. METHODS: The study was conducted in two parts. In the in vitro part, the inhibitory effects of three test agents, 0.2% chlorhexidine gluconate, honey mouthwash, and saline, against six oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256, and 512 µg/mL were tested in duplicate. The minimum inhibitory concentration (MIC) was set as the lowest concentration of the agent that completely inhibited the growth of the test species. The in vivo part consisted of a double-masked parallel clinical trial based on a 4-day plaque regrowth model. Sixty-six volunteers, 20 to 24 years of age, participated in the study, and the plaque scores were compared at baseline and at the end of 4 days. The Kruskal-Wallis test was used for significance, and the Mann-Whitney U test was used for pairwise comparison of the groups. The mean plaque scores were 1.77 ± 0.86, 1.64 ± 0.90, and 3.27 ± 0.83 for groups 1, 2, and 3, respectively. RESULTS: The honey mouthrinse effectively inhibited the six tested microorganisms. The chlorhexidine gluconate rinse had the lowest MICs compared with honey and saline rinses for all test species examined. The in vivo results revealed that plaque formation was inhibited/reduced by chlorhexidine and honey rinses. CONCLUSION: Honey has antibacterial action against tested oral microorganisms and also has antiplaque action.

Efficacy of locally-delivered doxycycline microspheres in chronic localized periodontitis and on Porphyromonas gingivalis.

AIM: This study aimed to assess the efficacy and effect of locally-delivered doxycycline microspheres with scaling and root planing in periodontal pocket therapy and on Porphyromonas gingivalis, respectively. METHODS: Twenty sites with a probing pocket depth of 4-6 mm were divided into two groups: a control group consisting of scaling and root planing, with one application of doxycycline microspheres only at baseline, and a test group consisting of scaling and root planing, with an application of doxycycline microspheres at baseline and 1 and 3 months. Clinical readings included the plaque index, gingival index, probing pocket depth, and relative attachment level. Rapid polymerase chain reaction method was used for the detection of P. gingivalis. RESULTS: A statistically-significant reduction in probing pocket depth and attachment gain was found in both groups; the test group showed a significant reduction in probing pocket depth and attachment gain compared with the control at 3 and 6 months. P. gingivalis cell count in the test group was significantly reduced at all the time periods, except from 1 to 3 months. CONCLUSION: Local drug delivery of doxycycline microspheres significantly improved the treatment outcomes in periodontal pocket therapy and reduced P. gingivalis in the periodontal pocket.

Comparison of radiovisiography and digital volume tomography to direct surgical measurements in the detection of infrabony defects.

OBJECTIVES: To compare the linear measurements of Radiovisiography (RVG) and Digital volume tomography (DVT) to direct surgical measurements in the detection of periodontal infrabony defects. STUDY DESIGN: RVG and DVT images were taken prior to periodontal surgery for 28 infrabony periodontal defects. After defect debridement, direct bony defect measurements were made from the cemento enamel junction (CEJ) to the base of the defect (CEJ-BD) and to the alveolar crest (CEJ-AC) with a periodontal probe. These same measurements were made on the RVG and DVT images and then compared to the direct surgical values. RESULTS: DVT correlated strongly with surgical measurements, whereas RVG correlated less favorably (P=0.0109, P=0.0193 respectively).No significant difference for CEJ-AC (P=0.0599) was seen between DVT and surgical measurements; however, there was a significant difference for the distance CEJ-BD (P=0.0105). CONCLUSION: DVT technique is significantly more accurate than RVG in the detection of infrabony periodontal defects. Key words:Tomography, volume computed, dental radiovisiography, periodontal diseases.

Oily calcium hydroxide suspension in the treatment of infrabony periodontal defects: a randomized controlled clinical trial.

OBJECTIVE: To evaluate the efficacy of oily calcium hydroxide suspension (OCHS) in the of treatment of infrabony defects. METHOD AND MATERIALS: Thirty patients with advanced chronic periodontitis, with one deep infrabony defect, were randomly treated with open flap debridement (OFD) (control) or OFD + OCHS (test). Clinical measurements were performed at baseline and 9 months after treatment. Surgical reentry was performed after 9 months. The primary outcome variables were reduction in probing pocket depth (PPD) and gain in relative attachment level (RAL). The secondary outcome was the reduction in depth of defect (DOD) measured intrasurgically. RESULTS: A statistically significant reduction in PPD was observed at the end of 9 months, with the control group showing a mean reduction of 2.06 ± 0.59 mm from baseline to 9 months and the test 1.06 ± 1.22 mm (P ≥ .05). There was no statistically significant gain in RAL at the end of 9 months, with a mean of 0.60 ± 0.50 mm in the control group and 0.60 ± 0.91 mm in the test (P ≥ .05). No statistically significant difference was observed in DOD at 9 months, with a mean difference of 0.80 ± 0.77 mm in the control group and 0.66 ± 0.97 mm in the test (P ≥ .05). CONCLUSION: Within the limitations of the study, OCHS failed to demonstrate any superior clinical outcomes in comparison with OFD.

Randomized, controlled, single-masked, clinical study to compare and evaluate the efficacy of microspheres and gel in periodontal pocket therapy.

BACKGROUND: The aim of this randomized, split-mouth, single-masked study is to compare the efficacy of a gel and microspheres as drug-delivery systems in the treatment of periodontal disease. METHODS: Microspheres were prepared, the release patterns of the microspheres and gel formulations were analyzed using an ultraviolet spectrophotometer, and particle shapes were studied under a scanning electron microscope. A split-mouth design was followed in which 30 potential sites were identified and divided into three groups: one control group and two groups in which microspheres or a gel was placed. Patients were recalled at 1, 3, 6, and 9 months. Clinical recordings included plaque index (PI), gingival index (GI), probing depth (PD), and relative attachment level (RAL) measurements; subgingival plaque was also obtained for microbiologic examination prior to and after therapy. RESULTS: Microspheres had a more sustained release and a high initial drug concentration. There was a significant improvement in the PI and GI in the initial 3 months. The results were statistically significant at P = 0.01. The mean PD scores among scores for the three groups at baseline and follow-up visits showed a reduction of 0.4 to 1 mm. The microbiologic parameters were also statistically significant. CONCLUSION: These data suggest that the type of delivery system could significantly influence the outcome of therapy.

Comparative efficacy of two treatment modalities for dentinal hypersensitivity: a clinical trial.

BACKGROUND: Dentin hypersensitivity is a recurrent condition causing discomfort and sometimes pain to the patient, which also deters him from maintaining adequate oral hygiene. Home care and office measures are used for treatment of this malady. AIM: To evaluate and compare the efficacy of 2 treatment modalities for dentinal hypersensitivity, iontophoresis with acidulated phosphate gel (APF) gel, and dentin-bonding agent application. MATERIALS AND METHODS: This split mouth randomized clinical study recruited subjects with a history of hypersensitivity with at least 2 teeth, verified by a light stroke with a dental explorer along the cervical third of the teeth. The patients were subjected to a 1-s air blast and cold water stimuli and their responses were recorded on a verbal rating scale. A total of 30 sites from 15 patients were divided into Group A-1.23% APF gel iontophoresis; and Group B-aqueous solution of hydroxyl-ethyl-methacrylate and glutaraldehyde. The teeth were evaluated immediately after the treatment and at the end of 2 weeks. In case of failure, the tooth was retreated with the same agent as before. RESULTS: The results were statistically analyzed using Kruskal-Wallis analysis of variance and Mann-Whitney U tests. There was no statistically significant difference between the groups at the end of 2 weeks. However, Group A was more effective clinically, with fewer number of failures compared with Group B. CONCLUSION: Both the agents showed a statistically significant reduction in sensitivity compared with baseline; however, APF gel iontophoresis was more effective in reducing hypersensitivity over a longer time period.

Efficacy of a chairside diagnostic test kit for estimation of C-reactive protein levels in periodontal disease.

BACKGROUND: C-reactive protein [CRP] levels increase to hundreds of mg/mL within hours following infection. Studies have shown that serum CRP levels were elevated in periodontal disease. However, in all the previous studies, CRP levels were measured by using high-sensitivity CRP assay kits with minimal detection limits of 0.1 to 3 mg/L, which was much below the normal value of 10 mg/L. These high-sensitivity CRP assays need a proper laboratory setup, and these methods cannot be used as a routine chair-side test in the dental office. AIM: The purpose of this study was to investigate the serum CRP levels in subjects with periodontal disease by using a rapid chair-side diagnostic test kit with a lower detection limit of 6 mg/L and to compare the CRP levels before and after periodontal therapy. MATERIALS AND METHODS: A total of 45 systemically healthy subjects were selected for the study. Subjects were divided into three groups: group A: healthy controls, group B: gingivitis, group C: periodontitis. Serum levels of CRP were determined by using a latex slide agglutination method with commercially available kit with lower detection limit of 6 mg/L. RESULTS: CRP was negative in all the 15 subjects in groups A and B at baseline, 7th and 30th day. CRP was positive only in 2 subjects in Group C at baseline and 7th day. CONCLUSION: Estimation of serum CRP by using a rapid chair-side diagnostic test kit is not of any significance in subjects with periodontitis.

Viability of bacteria in dental calculus - A microbiological study.

AIM: The aim of this study was (1) To investigate the viability of bacteria within supragingival and subgingival calculus, (2) To examine motility of bacteria, and (3) To identify bacterial morphotypes in calculus. MATERIALS AND METHODS: Supra and subgingival calculus were harvested from 30 subjects having clinical evidence of chronic inflammatory periodontal disease and were divided into two groups. Samples from both groups were immediately transported to the Department of Microbiology for gram staining, acridine orange staining, bacterial culture and to the Department of Oral Pathology for dark field microscopy. RESULTS: Gram staining revealed presence of bacteria within the samples.Dark field microscopic examination revealed presence of filamentous organisms, spirochetes, and motile short bacilli. Acridine orange fluorescent stain showed that the viable bacteria appeared apple green. Bacterial culture revealed presence of a variety of aerobic organisms. CONCLUSION: From the results, it appeared that viable bacteria were present within calculus especially within internal channels and lacunae.