Fibrosarcoma of the gingiva: A rare entity.

Fibrosarcoma is a rare malignancy of fibroblasts that seldom occurs in the oral cavity. Although rare, fibrosarcoma is an aggressive lesion associated with a poor survival rate. The occurrence of such a highly aggressive lesion on the gingiva is a diagnostic challenge for the clinician. This is because the gingiva is a common site for various inflammatory and nonspecific enlargements, which are commonly benign and the chances to overlook aggressive lesions are high. This case report describes an atypical case of fibrosarcoma of gingiva in a middle-aged individual that mimicked a nonspecific gingival enlargement.

Proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and on oral antidiabetic therapy.

BACKGROUND: Treatment of diabetes includes oral antidiabetic drugs (OAD), insulin, or their combinations. Insulin can achieve faster glycemic control and have anabolic action on bone. This study was undertaken to assess the prevalence and severity of periodontitis, and to estimate the proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin (HbA1c) level in patients with type 2 diabetes (T2DM) on OAD therapy and on insulin therapy. METHODS: This cross-sectional study comprised 130 patients with T2DM on OAD therapy (OAD group) and 130 patients with T2DM on insulin therapy (INSULIN group). All patients were assessed for sociodemographic, behavioral characteristics, clinical history, periodontal parameters (bleeding on probing, probing depth, clinical attachment loss [Clinical AL], Oral Hygiene Index-simplified, plaque index, and periodontal inflamed surface area [PISA]), and biochemical variables (HbA1c, fasting plasma glucose, postprandial plasma glucose). RESULTS: Prevalence, extent, and severity of periodontitis and PISA were lower in the INSULIN group as compared with the OAD group. A proportional relationship was observed between HbA1c and PISA and between HbA1c and Clinical AL. A unit increase in HbA1c is associated with an increase in PISA of 130.47 mm2 and an increase in Clinical AL of 0.182 mm. CONCLUSION: A proportional relationship was observed between PISA, clinical attachment loss, and HbA1c level in patients with type 2 diabetes mellitus on insulin therapy and OAD therapy. Despite comparable oral hygiene status and glycemic control between the two groups, the periodontal parameters were lesser in the INSULIN group as compared with the OAD group.

Simvastatin in polymer bioscaffold for bone regeneration. An in vitro and in vivo analysis.

OBJECTIVE: The study aimed to fabricate and test the biocompatibility of a polylactic-co-glycolic acid (PLGA) based guided tissue regeneration membrane impregnated with 'simvastatin' to promote sustained drug delivery near osseous defects and evaluate the regenerative potential of the membrane histologically. MATERIALS AND METHODS: We tested the mechanical properties and cytotoxicity of an indigenously fabricated PLGA membrane incorporated with simvastatin (1 mg/cm2). An animal study evaluated the regenerative potential of the membrane. Twenty-four adult Wistar rats, approximately 175 g in weight, were used in this study. The rats were divided randomly into four groups based on the postoperative healing periods into ten days, 1, 3, and 6 months. Within each time group, six rats were divided into three subgroups: Subgroup A - sham surgery controls; Subgroup B - PLGA without Simvastatin; Subgroup C - PLGA with simvastatin tests. The radiographic examination intervals were ten days, 1 and 3 months, while the histological assessment was around 1, 3, and 6 months. RESULTS: Simvastatin content was distributed uniformly in all the prepared membranes and was equivalent to 1 mg/cm2. 100 mg PLGA membrane with simvastatin demonstrated uniform drug release over time, excellent mechanical properties, and biocompatibility. The rat models in Subgroup C had better bone tissue formation radiographically and histologically. CONCLUSION: The study suggested that 'PLGA with Simvastatin' has the requisite properties to serve as a third-generation barrier membrane with the potential for local drug delivery.