Comparative Evaluation of Effectiveness of Omega-3 Fatty Acids as an Adjunct to SRP with Conventional SRP: A Randomized Clinical Trial.

AIM: This study aims to compare the effectiveness of "omega-3 fatty acids" as an auxiliary to "scaling and root planing (SRP)" with traditional "scaling and root planing" in periodontal treatment in humans. MATERIALS AND METHODS: This study is a randomized control trial and was carried out over a period of 3 months (registered on 02/07/2023). Thirty patients were singled out according to the inclusion criteria, each having periodontitis (Stage II Grade B), and were arbitrarily distributed into two groups (control and test). The test group was treated with "scaling and root planing" along with the adjunctive application of "omega-3 fatty acids" while the control group was treated with "scaling and root planing" alone. Monthly follow-up was carried out over 90 days. Clinical parameters such as pocket probing depth (PPD), gingival index (GI), bleeding index (BI), and plaque index (PI) were measured respectively at baseline and 3 months. The data was recorded and statistically analyzed. RESULTS: The soft tissue architecture remained stable. The mean full mouth plaque index (FMPI) score was statistically significant (p < 0.001) when the control group was compared to the test group with a mean difference of 0.12 ± 0.02. The mean full mouth papillary bleeding index (FMPBI) score decreased at 3 months and was statistically significant compared to baseline with a mean difference of 0.24 ± 0.04 (p < 0.001). When the test group was compared with the control group, the FMGI was not significant (p = 0.02), with a mean difference of 0.16 ± 0.19. The PPD was not significant (p =1) when comparing both the groups, with a mean difference of 0 ± 0.66. Although the clinical parameters were statistically significant at 3 months when compared to baseline in both the groups, the FMGI and PPD were not significant. CONCLUSION: The combined action of using omega-3 fatty acid as an auxiliary to conventional scaling and root planing improved the periodontal parameters including both the soft and hard tissue outcomes. CLINICAL SIGNIFICANCE: The present study indicated that supplementary usage of omega-3 fatty acids is more beneficial for treating chronic and mild periodontitis than scaling and root planing alone. Omega-3 fatty acids can be used as energy for our cells, reduce the risk of blood clotting, maintain bone health, regulate metabolism, and reduce inflammation. Host modulatory therapy (HMT) with omega-3 fatty acids aims at reducing inflammation. With HMT as an adjunct, a better result of periodontal therapy was expected. It enhanced the positive effects on periodontal parameters and both the soft and hard tissue outcomes. How to cite this article: Salian S, Dhadse PV, Patil R, et al. Comparative Evaluation of Effectiveness of Omega-3 Fatty Acids as an Adjunct to SRP with Conventional SRP: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(5):440-444.

Laser Excision of Buccal Mucosal Growth: A Case Report.

The mucosal tissues are prone to overgrowths as hyperplasia or hypertrophy, which present a spectrum of clinical challenges. These lesions are located at different sites and differ in size and pathology related to their origin. They present as solitary nodules of pink or red on the tongue, gingiva, buccal mucosa and other oral tissues. The most common methods for eliminating overgrowths are scalpel excision, electrosurgery, and laser surgery. Among them, lasers are beneficial to every patient as they do not require anesthetic shots. Even for periodontal surgery, laser surgery is preferred because of its quicker healing, higher rates of re-epithelialization, blood-free surgical site, and superior repair capabilities. A diode laser to remove overgrowth is a rapid, safe treatment with little discomfort or issues after the procedure. This case report describes how a laser is used to excise the mucosal growth with minimal postoperative complications.

Correlation Between ABO Blood Grouping and Erythrocyte Sedimentation Rate (ESR) in Periodontal Diseases.

This study investigates the relationship between erythrocyte sedimentation rate (ESR) and ABO blood grouping in the context of periodontal disorders. Periodontal diseases, chronic inflammatory conditions that damage the tissues supporting teeth, can lead to tooth loss if left untreated. ESR, a common hematological test indicating systemic inflammation, has been linked to the severity of periodontal disease. ABO blood grouping, a hereditary trait, is linked to a higher risk of various oral and systemic diseases. By synthesizing existing research, this study explores the potential of the connection between blood type ABO and ESR levels in individuals with periodontal disorders, examining studies that assess the distribution of ABO blood types and corresponding ESR values among periodontal patients.

Labial Frenectomy Using Conventional Scalpel Technique: A Case Report.

Frenum morphology is of pivotal concern while treating patients who desire improved aesthetics and for treating patients with midline diastemas, as it may lead to failure or relapse of orthodontic treatment. Frenum, a thick band of muscle fiber, may present with abnormalities in the shape, size, form, number, and thickness, which may cause gingival recession along with poor oral health. Frenectomy is adopted as the plan of action while treating abnormal frenum cases by resecting the frenum attachment to provide closure of the spacing between the upper anterior teeth, as in the case of midline diastema. Various forms and techniques of frenectomy have been adopted according to the type of frenum attachment and aesthetic concerns of the patients. Amidst the various treatment options available, conventional frenectomy using a scalpel has emerged as a viable solution for treating patients. The surgeons value and praise its exceptional precision and ease of use, and the patients prefer it for its affordability; hence, a functional and aesthetic outcome is achieved via this treatment. This report provides a comprehensive overview of a case of conventional frenectomy with a one-week follow-up.

Laser Depigmentation: A Case Report.

The pigmented lesions of the oral cavity may be endogenous or exogenous. Among the options for depigmenting these areas, laser therapy stands out for being a minimally invasive procedure. This study aims to report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior maxillary region, for the ablation of the pigmented tissue to improve gingival aesthetics. The patient had an aesthetic complaint of the darkened aspect of the gingiva in the anterior maxillary portions. After local anesthesia, we started depigmentation with a high-power diode laser and performed ablation from the attached gingiva toward the free marginal gingiva. The patient returned after 30 and 180 days presenting healthy gingiva and absence of melanin repigmentation. Thus, we concluded that the diode laser was a good alternative for melanin depigmentation because it is a procedure with lower morbidity and satisfactory results.

Maxillary Labial Double Frenum Frenectomy Using a Diode Laser: A Case Report.

Maxillary labial frenectomy is a surgical procedure aimed at addressing midline diastema, where a strip of tissue creating a gap between two upper front teeth is removed. Typically, this strip extends from the vestibule of the gingivobuccal sulcus to the attached gingiva. The procedure is often performed using a diode laser, offering benefits including simplicity and safety for the patients. It can remarkably improve overall aesthetics and decrease the chances of gingival recession. This case report highlights the successful management of a female patient who arrived complaining of double frenum attachment leading to poor musculature support due to which she experiences poor aesthetics and hampered oral hygiene maintenance.

Role of Oxidative Stress in Periodontal Diseases.

Periodontal disease, a significant worldwide health burden, is characterized by chronic inflammation and destruction of periodontal tissues, including the cementum, periodontal ligament (PDL), alveolar bone, and gingival tissue. Recent research has linked the development and progression of periodontal disease to oxidative stress. This study provides comprehensive explanations of the mechanisms behind oxidative stress in periodontal disease, with a focus on the generation of reactive oxygen species (ROS) and their effects on periodontal tissues. Oxidative stress triggers a number of detrimental reactions, including lipid peroxidation, protein oxidation, and damage to deoxyribonucleic acid (DNA). Alveolar bone resorption, connective tissue degradation, and periodontal inflammation are further conditions exacerbated by these processes. In addition, the delicate balance between antioxidants and oxidants is upset by oxidative stress, which impairs antioxidant defense systems and exacerbates periodontal tissue damage. This review highlights the negative effects of oxidative stress and enhances periodontal health outcomes.

Laser-Assisted Lingual Frenectomy: A Case Report.

A lingual frenectomy is a surgical procedure aimed at addressing "tongue-tie" or ankyloglossia, where a strip of tissue restricting tongue movement is removed. Typically, this strip extends from the bottom of the mouth to the underside of the tongue. The procedure, often performed using a diode laser, offers several advantages including simplicity and safety for patients. It can significantly improve speech articulation and eating for individuals with ankyloglossia. This case report highlights the successful treatment of a female patient experiencing speech difficulties with diode laser therapy for tongue-tie.

Laser-Assisted Treatment for Maxillary Peripheral Odontogenic Fibroma: A Case Report.

Most odontogenic tumors are intraosseous growths. A peripheral odontogenic fibroma presents as a slow-growing and firm swelling on the gingiva. It develops more commonly on the mandibular than the maxillary region. It can be found on either the palatal or lingual and on the labial or buccal surface of the jaw. It usually does not ulcerate. The most common type is a peripheral odontogenic fibroma, which is a benign odontogenic neoplasm of the periodontal soft tissues. In this case report, a 53-year-old male patient with peripheral odontogenic fibroma was treated using a laser.

Conventional Scalpel Technique for Frenectomy During Orthodontic Treatment: A Case Report.

Frenum aberrations in the maxillary and mandibular regions are pivotal concerns, particularly regarding midline diastema and gingival health. The frenum is composed predominantly of collagenous and elastic fibers. There are various frenal attachment anomalies that may result in gingival recession. Amidst treatment options, conventional scalpel frenectomy emerges as a viable solution, showcasing its efficacy in addressing deviant frena. Ultimately, our findings underscore the imperative for personalized interventions to alleviate aesthetic apprehensions and uphold periodontal integrity in adult populations.

Surgical Excision of Localized Gingival Overgrowth Using Laser: A Case Report.

Gingival overgrowth, localized or generalized, is one of the leading causes of poor maintenance of oral hygiene. Excision of growth using laser should be the choice of treatment because laser helps maintain a blood-free surgical site during treatment and provides more patient comfort during and after the procedure. Lasers are commonly employed in many different applications, including scaling, root planning, cavity preparation, and excision of soft tissue growths in surgery. Laser therapy offers numerous benefits over traditional methods of treatment. These benefits have led to the growing use of lasers as dental treatment options in a variety of dental fields. In this case report, we are presenting a case of excision of localized gingival growth using a laser. Postoperative healing and maintenance of oral health were satisfied after laser surgery.

Radiographic Evaluation in Implant Patients: A Review.

Diagnostic imaging is crucial in assessing dental implant patients. The height, width, and shape of the bone are precisely depicted and measured by these tests, which help pinpoint the locations of significant anatomical structures adjacent to the implant placement sites. The type of implant to be utilized, the positioning of the remaining dentition, and the degree to which bone quality or quantity is in question all play a role in determining the radiologic approach that is most suited for a given patient. This review is an update on the current knowledge in the field of radiographic evaluation in implant placement. Considering the radiation exposure and the expense of each test, it is important to carefully determine whether pre-implant imaging is acceptable in each situation. Although multislice computed tomography is the gold standard from the authors' perspective, not every implant situation can justify such a test.

Laser-Assisted Gingival Depigmentation: A Case Report.

The gingiva's colour varies in different individuals and is assumed to be related to cutaneous pigmentation. The most frequent natural pigment causing endogenous gingival pigmentation is melanin, a brown pigment. Depigmentation is a therapy of choice when individuals are concerned about their appearance and demand it for their aesthetic satisfaction. It is not a clinical indication. This article demonstrates gingival depigmentation using a laser diode with a 90-day follow­up. A 23-year-old male patient visited the Periodontology Department, complaining of poor aesthetics owing to dark-coloured gums. Depigmentation with a laser diode was selected as the treatment plan for both the maxillary and mandibular arches, at an interval of a week. The choice of a procedure is largely influenced by the gingival thickness, the clinician's experience, the patient's preferences, and the rate of recurrence. According to reports, using lasers produces better aesthetic outcomes and has a low recurrence rate.

Investigator knowledge, awareness, and registrations of academic clinical trials with the Clinical Trial Registry of India: An observational study.

Introduction: In 2019, the Central Drugs Standard Control Organization (CDSCO) introduced the New Drugs and Clinical Trials Rules 2019 (NDCTR), which separated the research guidelines for "Clinical Trials" and "Biomedical and Health Research." As a result, guidelines issued by Indian Council of Medical Research were stated to apply to academic clinical trials (ACTs). This change is important because academic studies are crucial for scientific advancement and repurposing of approved drugs in health-care industry. However, conducting an ACT can pose challenges. We assessed the level of awareness, knowledge, and challenges faced by investigators. Our aim is to overcome some of these challenges and encourage more academic studies for the betterment of healthcare and scientific knowledge in India. Methodology: The study was conducted in two phases after obtaining approval from the Institutional Ethics Committee (EC) of three tertiary care hospitals in Mumbai. In the first phase, the number of ACTs was assessed from the clinical trial registry India website, while the number of registered and re-registered ECs were assessed from the CDSCO website. The second phase involved assessing investigator awareness and knowledge about ACTs using a prevalidated questionnaire with a content validity index score of 0.93. Results: In 2020, the highest numbers of studies were registered, with the highest numbers of registered and re-registered ECs from Maharashtra. All participants completed the questionnaire and were aware of the need to follow guidelines for clinical trials. Sixty-seven percent of participants knew that the guidelines for ACTs differed from those of sponsored clinical trials, but only 58% were aware of the exact definition of an ACT as per NDCTR, 2019. Eighty-five percent of participants knew who could initiate an ACT, but only 27% knew about the applicability of results of an ACT and 33% had in-depth knowledge about the required approvals, while only 10% knew the archival period. Although 71% of participants had knowledge about serious adverse event reporting, few answered in-depth questions correctly. Only 31 participants reported facing varied challenges. Conclusion: To conduct ACTs effectively and contribute to healthcare and scientific advancement, it is crucial to enhance investigators' existing knowledge about ACTs.

Effect of non-surgical periodontal therapy on the salivary levels of omentin-1, a novel adipokine biomarker in periodontitis: A clinico-biochemical study.

BACKGROUND: Biomarkers are emerging, advanced diagnostic tools for the assessment of periodontal disease progression. Omentin-1 is an anti-inflammatory adipocytokine, which has been observed and studied in the saliva of periodontitis patients. Non-surgical periodontal therapy (NSPT) is considered a vital part of periodontal disease treatment. OBJECTIVES: The study aimed to evaluate the interventional effect of NSPT on the levels of salivary omentin1 in healthy (H) and chronic periodontitis (CP) patients. MATERIAL AND METHODS: A total of 60 participants were selected and equally divided into 2 groups (group A: H participants, group B: CP patients). After obtaining verbal and written consent, whole unstimulated saliva was collected from all participants and analyzed for omentin-1 levels using enzyme-linked immunosorbent assay (ELISA). RESULTS: Mean salivary omentin-1 levels were elevated and found to be significantly higher in group A (95.80 ±26.65) compared to group B (61.97 ±24.53). In group B, there was a substantial rise in omentin1 levels from baseline to the 6th week of follow-up (p < 0.001). Thus, NSPT had a positive influence on salivary omentin-1 levels in the treatment group. CONCLUSIONS: Salivary omentin-1 levels may serve as diagnostic and prognostic indicators of periodontal disease progression, and may be used to assess therapeutic outcomes in periodontitis patients.

Antimicrobial efficacy of grape seed extract in terminating the ramifications of plaque microorganisms: a randomized control study.

Background: Grape seed extract contains Proanthocyanin, which reduces collagen degradation by inhibiting interstitial and extracellular collagenase, thus having the potential to reduce the progression of periodontitis. Here we compare and evaluate the aerobic and anaerobic microorganism's CFUs (colony forming units) in plaque samples of Group A, Group B, Group C and severity of periodontal disease on day 0 and 7. Methods: Forty-five subjects in age range 18-30 years were selected among undergraduate students and randomly divided into Group A: 15, 2% grape seed extract mouthwash (GSE), Group B: 15, 0.2% chlorhexidine mouthwash (CHX) and Group C: 15, distilled water (control). The supragingival plaque was collected into transport media. Kruskal Wallis test followed by Mann Whitney test was used to compare the mean CFUs (×103) of microorganisms and severity of periodontal disease was compared, by clinical parameters among all groups on day 0 and 7. Results: There was a significant difference concerning mean scores of all clinical parameters (P<0.001) and mean CFUs of microorganisms between 3 study groups (P=0.005) at 7 days post-intervention period. Intragroup comparison, mean scores were significantly reduced on day 7 as compared to day 0 at (P<0.001) in Group A and B, but no significant difference was noted with Group C. Conclusion: Intervention with GSE mouthwash showed a positive effect on reducing CFUs in the plaque when compared with the control group. GSE group also showed similar results in reducing CFUs in plaque when compared to CHX group, thereby demonstrating the agent's antimicrobial efficacy, therapeutic effect and its potential usefulness in controlling plaque and periodontal diseases.