Increasing the width of attached gingiva by using modified apically repositioned flap - A case series.

Attached gingiva plays a promising role in maintaining periodontal health. An adequate width of attached gingiva prevents plaque formation and soft-tissue recession. Among various techniques for augmenting width of attached gingiva, modified apically repositioned flap (MARF) is a simple and easy procedure that does not require a second surgical site. It is less time-consuming. It provides better operative and postoperative comfort for the patient. In this case series, MARF technique was used for augmenting the width of attached gingiva.

Unveiling the Link between Prostatitis and Periodontitis.

BACKGROUND: One of the important tumor markers having critically important applications in every aspect of treating men with prostatic illness is prostate-specific antigen (PSA), formed by prostate acini's epithelial cells. Where prostate is affected by inflammation or malignancy, the PSA levels rise to/and above 4 ng/ml. This study analyzes the interlink between different severity of periodontitis and prostatitis by assessment of PSA antigen levels and periodontal clinical parameters. MATERIALS AND METHODS: In this study, 100 chronic prostatitis patients diagnosed to also have periodontal diseases were divided into four batches on the basis of the nature of prostatitis and levels of periodontal clinical attachment. The grouping was as: group 1A - clinical attachment level (CAL) <3 mm and mild prostatitis, Group 2A - CAL ≥3 mm and mild prostatitis, and Group 1B - CAL <3 mm and moderate-to-severe prostatitis, Group 2B - CAL ≥3 mm and moderate-to-severe prostatitis. Readings of CAL, probing pocket depth, bleeding on probing, plaque index, and gingival index (PI and GI) were recorded, followed by calculation and assessment of PSA values and correlation of periodontal parameters, respectively. RESULTS: An important and affirmative correlation (r = 0.5549, P < 0.05) was seen between PSA and CAL scores at significance level of 5%, and also between PSA and probing depths (PD) scores at 5% (r = 0.5315, P < 0.05), indicating that PSA and CAL scores, as also PSA and PD scores are mutually dependent. The similar positive correlation was seen between PSA with PI (r = 0.3231, P < 0.05) and GI (r = 0.3567, P < 0.05) scores, respectively, at 5% level of significance, which shows PSA is also mutually dependent on PI and GI scores. CONCLUSION: Patients with of grades, moderate-to-severe prostatitis as well as periodontitis were found having higher PSA levels. The clinical readings of periodontal parameters were significantly higher in patients with moderate-to-severe prostatitis which shows a pathological link between the above two.

Evaluation of Periodontal Risk in Adult Patients using Two Different Risk Assessment Models - A Pilot Study.

OBJECTIVE: The aim of the present study was to evaluate the periodontal risk of individuals using periodontal risk assessment (PRA) model and modified PRA model. MATERIALS AND METHODS: A total of 50 patients with chronic periodontitis, age 30-60 years were selected randomly and charting of the periodontal status was performed and those who met the inclusion criteria were enrolled in the study. Parameters recorded were- percentage of sites with bleeding on probing (BOP), number of sites with pocket depths (PD) ≥ 5mm, number of the teeth lost, bone loss (BL)/age ratio, Clinical attachment loss(CAL)/age ratio, diabetic and smoking status, dental status, systemic factors like diabetes were assessed. All the risk factors were plotted on the radar chart in (PRA) and (mPRA) models, using Microsoft excel and periodontal risk were categorized as low, moderate and high risk. RESULTS: Among 50 patients 31 were in low risk, 9 in moderate risk, and 10 in high risk identified by modified (PRA) model, whereas 28 patients were in low risk, 13 in moderate risk and 9 in high risk identified by (PRA). Statistical analysis demonstrated that there was no significant difference between the risk scores (X(2) = 0.932 with degree of freedom = 2, P = 0.627). CONCLUSION: Both the periodontal risk models are effective in evaluating the risk factors and can be useful tool for predicting proper diagnosis, disease progression and therapeutic strategies during the supportive periodontal therapy.

Comparison of coronally advanced and semilunar coronally repositioned flap for the treatment of gingival recession.

BACKGROUND: Gingival Recession (GR) occurs in population with low oral hygiene levels. Root coverage may be achieved by a number of surgical techniques, including pedicle gingival grafts, free grafts, connective tissue grafts, gtr may also be used. The objective of the present study is to compare the clinical outcomes of the Semilunar Coronally Repositioned Flap (SCRF) and Coronally Advanced Flap (CAF) procedure in the treatment of miller's class I gingival recession defects in maxillary teeth. MATERIALS AND METHODS: Twenty systemically healthy patients, with isolated miller's class 1 gingival recessions, were selected and allocated randomly into two groups, Group I and Group II with 10 patients in each. In Group I, the patients were treated with coronally advanced flap procedure with sling sutures, whereas in Group II, patients were treated with semilunar coronally repositioned flap without sutures. RESULTS: Descriptive statistical analysis has been carried out in the present study. RESULTS on continuous measurements are presented on Mean ± SD. Significance is assessed at 5 % level of significance. Student t-test (two tailed, dependent) has been used to find the significance of study parameters between baseline - 3 months and baseline - 6 months, 90% Confidence interval for mean has been computed. CONCLUSION: CAF provides consistently better results than SCRF With all other parameters, such as clinical attachment levels, percentage of root coverage and complete root coverage and esthetics were taken into account, caf was found to be superior. In contrary to this, there is significant increase in width of keratinized tissue in scrf group.

Neutrophil extracellular traps: Their role in periodontal disease.

Neutrophils are the first line of innate immune defense against infectious diseases. Since their discovery, they have always been considered tissue-destructive cells responsible for inflammatory tissue damage occurring during infections. Extensive research in the field of neutrophil cell biology and their role skewing the immune response in various infections or inflammatory disorders revealed their importance in the regulation of immune response. Neutrophils also release neutrophil extracellular traps (NETs) for the containment of infection and inflammation along with other antimicrobial molecules. Activated neutrophils provide signals for the activation and maturation of macrophages as well as dendritic cells. Neutrophils are also involved in the regulation of T-cell immune response against various pathogens and tumor antigens. Thus, the present review is intended to highlight the emerging role of neutrophil extracellular trap production in the regulation of immune response and its role in periodontal disease.

Evaluation of bioactive glass and demineralized freeze dried bone allograft in the treatment of periodontal intraosseous defects: A comparative clinico-radiographic study.

AIM: The purpose of this study was to evaluate the efficacy of demineralized freeze dried bone allograft (DFDBA) and bioactive glass by clinically and radiographically in periodontal intrabony defects for a period of 12 months. MATERIALS AND METHODS: Ten systemically healthy patients diagnosed with chronic periodontitis, with radiographic evidence of at least a pair of contralateral vertical osseous defects were included in this study. Defect on one-side is treated with DFDBA and the other side with bioactive glass. Clinical and radiographic measurements were made at baseline 6 month and 12 month after the surgery. RESULTS: Compared to baseline, the 12 month results indicated that both treatment modalities resulted in significant changes in all clinical parameters (gingival index, probing depth, clinical attachment level (CAL) and radiographic parameters (bone fill); P < 0.001*). However, sites treated with DFDBA exhibited statistically significantly more changes compared to the bioactive glass in probing depth reduction (2.5 ± 0.1 mm vs. 1.8 ± 0.1 mm) CAL gain 2.4 ± 0.1 mm versus 1.7 ± 0.2 mm; (P < 0.001*). At 12 months, sites treated with bioactive glass exhibited 56.99% bone fill and 64.76% bone fill for DFDBA sites, which is statistically significant (P < 0.05*). CONCLUSION: After 12 months, there was a significant difference between the two materials with sites grafted with DFDBA showing better reduction in probing pocket depth, gain in CAL and a greater percentage of bone fill when compared to that of bioactive glass.