A short term comparative evaluation of the efficacy of diode laser with desensitizing toothpastes and mouthwashes in the treatment of dentinal hypersensitivity.

Background: Treatment of dentinal hypersensitivity (DH) has always been challenging with a wide variety of therapeutic options, in-office and home care. The study objective was to compare the clinical efficacy of diode laser [DL] with four commercially available desensitizing agents (two toothpastes and two mouthwashes) in the treatment of DH. Material and Methods: This study involved 75 participants (25-45 years) who were categorized as Group 1 (n=15) treated with DL, and Groups 2, 3,4 and 5 (n=15 in each) who were prescribed 3% potassium nitrate mouth rinse, a herbal mouth rinse, potassium nitrate tooth paste and a herbal tooth paste, respectively. DH was assessed by air blast stimulation using air blast syringe, and evaluation of DH was done based on the patient's subjective response using the Visual Analog Scale (VAS) at baseline, 1 week and 1 month. Results: DL and the desensitizing agents showed significant reduction in DH at 1 month when compared with baseline, except potassium nitrate mouth wash. However, DL showed more percentage reduction in DH when compared with potassium nitrate tooth paste, herbal mouth wash and paste. Conclusions: The study implies that even though all five groups showed improvement in terms of DH reduction, DL showed the best results among all the groups. Key words:Dentinal Hypersensitivity, Diode Laser, Potassium Nitrate, Herbal, Visual analog scale.

Evaluation of Long-term Stability of Secondary Alveolar Bone Grafts in Cleft Palate Patients Using Multislice Computed Tomography and Three-Dimensional Printed Models: A Prospective Study.

AIM: Three-dimensional (3D) printed models are contemporary volumetric bone graft assessment technique for secondary alveolar bone grafting (SABG) in cleft lip and palate (CLP) patients. The study aimed at evaluation of long-term stability of iliac autograft in SABG using multislice computed tomography (CT) and 3D-printed model-based volumetric analysis. MATERIALS AND METHODS: Twenty-eight patients were included in this prospective clinical study. CT image (T1) was taken after orthodontic maxillary expansion, correlating with the presurgical image. Furthermore, 3D-printed model was prepared, and volumetric assessment of graft needed was ascertained with water displacement technique. SABG was carried on with the anterior iliac crest autografting procedure. After 1-year follow-up, postoperative CT analysis (T2) was followed upon. RESULTS: The stability of bone graft at the 1-year postoperative was found to be 43.74% with mean bone loss of 56.26% (95% confidence interval; P < 0.005). The moderate scale of CLP cases has shown statistically significant bone stability compared to that of severe and mild cases. Furthermore, the 3D-printed model has shown a significant difference to that of T1 CT imaging (P < 0.005). CONCLUSION: Within the limitations of the study, it seems appropriate to conclude that 3D-printed models serves as better reference than CT imaging in the context of planning and execution of precise bone grafting in SABG.

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.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic periodontitis before and after nonsurgical therapy.

BACKGROUND: Various biomarkers have been evaluated for understanding the systemic inflammatory response (SIR) to periodontitis. Hematological markers have been reported to be useful biomarkers in a variety of diseases, including periodontal diseases. The role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in periodontitis and their possible role in the SIR are not extensively documented. Therefore, this study assessed NLR and PLR in chronic periodontitis (CP) patients before and after periodontal treatment, which to the best of knowledge has not been reported in the literature. MATERIALS AND METHODS: Sixty participants were grouped as systemically and periodontally healthy (H) (n = 30) and with CP (n = 30). Plaque index, gingival index, probing pocket depth, clinical attachment loss, leukocyte counts, platelet (PLT) counts, NLR, and PLR were estimated at baseline and also after treatment in the CP group. NLR was calculated as total neutrophil count/absolute lymphocyte count, and PLR was calculated as total PLT count/absolute lymphocyte count. The data were statistically analyzed. RESULTS: Periodontal parameters differed significantly between groups H and CP at baseline and posttreatment. A pair-wise comparison of NLR and PLR between CP patients at baseline and posttreatment was significant. Correlation analyses were not remarkable. Receiver operating characteristics analyses provided significant NLR and PLR predictive cutoff values to differentiate between CP patients at baseline and posttreatment. CONCLUSION: NLR and PLR may serve as potential biomarkers of the SIR to CP to bridge the association between periodontal and systemic conditions.

Serum sTWEAK levels in chronic periodontitis and type 2 diabetes mellitus.

AIM: The two-way relationship between diabetes mellitus and periodontitis has been extensively studied with various interconnected biomarkers sharing a link. Soluble Tumour Necrosis Factor-like Weak inducer of apoptosis (sTWEAK) is gaining attention as an important mediator in chronic inflammatory diseases. Thus, the aim of this study was to detect, estimate and compare the levels of sTWEAK in the serum of health, chronic periodontitis (CP), and CP with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Forty-five participants between 18 and 65 years were divided into groups of 15 each as Group 1: healthy, Group 2: CP, and Group 3: CP + T2DM. Clinical periodontal parameters and glycemic status were assessed. sTWEAK in serum was estimated using a commercially available ELISA kit. The data was statistically analyzed. RESULTS: sTWEAK was detected in all participants. Significant differences were observed between the groups for sTWEAK; highest in health, lower in CP and lowest in CP + T2DM. In the diseased groups, the clinical and glycemic parameters correlated positively with each other, whereas sTWEAK correlated negatively with each of the parameters. CONCLUSION: The literature reports lower concentrations of systemic sTWEAK in T2DM which may be comparable to our observations in CP + T2DM when compared to health and its negative correlation with all the parameters suggesting an association with both clinical periodontal parameters and glycemic levels. However, serum sTWEAK levels may not be necessarily elevated in periodontitis as previously reported, and hence has the potential to be studied extensively for clarification with its association with T2DM.

A randomised clinical trial on the efficacy of 5% fluorocalcium phosphosilicate-containing novel bioactive glass toothpaste.

Dentine hypersensitivity (DH) is a common and harrowing dental condition. A novel BioMin-F technology that contains 5% fluorocalcium phosphosilicate bioactive glass has been introduced. It forms fluorapatite, which is more stable towards acid erosion. There is a lack of literature with the utility of this toothpaste in treating DH. Therefore, the authors of this randomised clinical trial have aimed to compare and evaluate the efficacy of 5% fluorocalcium phosphosilicate with an 8% arginine and calcium carbonate and placebo toothpaste. A total of 75 patients clinically diagnosed with DH were randomly divided into three groups: Group A, 5% fluorocalcium phosphosilicate; Group B, 8% arginine and calcium carbonate; and Group C, placebo. The DH was evaluated by tactile and evaporative stimuli, and a visual analogue scale (VAS) was used for evaporative stimuli at pre-baseline, baseline (15 days) and post-baseline (1 month). The results showed symptoms of DH were reduced in all three groups. However, Group A showed a better reduction of DH than the other two groups. The toothpaste containing 5% fluorocalcium phosphosilicate was reported to be more efficacious than the other two toothpastes in managing DH. This novel development opens up a unique opportunity in the prevention and management of DH and may also be beneficial in preventing acid erosion of the tooth surface and in the maintenance of oral hygiene by reducing the effects of plaque accumulation and gingival inflammation.

Public awareness, knowledge, attitude and acceptance of dental implants as a treatment modality among patients visiting SDM College of Dental Sciences and Hospital, Dharwad.

BACKGROUND: The use of dental implants as a prosthetic treatment modality for partially edentulous or completely edentulous patients is increased more commonly ever since the concept of osseointegration has been accepted. OBJECTIVE: The objective of this study is to assess the awareness, knowledge, attitude, and acceptance of dental implants as a treatment modality among patients visiting SDM Dental College, Dharwad. MATERIALS AND METHODS: A cross-sectional survey was conducted among 500 patients visiting SDM College of Dental Sciences and Hospital (SDMCDSH), Dharwad, using a self-explanatory questionnaire. RESULTS: A total of 500 individuals participated in the survey. The results of this survey indicate that 93.4% of the patients knew about dental implants, and for majority of them, the major source of information was through their dentist followed by relatives and friends and electronic media. About 60.4% patients disapproved the removable prosthesis as an option for the replacement of missing teeth. 77.2% patients expressed that they could not afford for the dental implant treatment. The major deterioration for this treatment was related to the cost in 80.4% patients, surgical procedure in 11.6% patients, and a long treatment time in 5.6% patients. While 60.4% patients felt that dental implants being expensive, is the treatment option only for the rich. CONCLUSION: The results of this survey showed that majority of the patients visiting SDMCDSH, Dharwad, were aware about dental implants as a treatment modality for the replacement of missing teeth. Although the attitude was positive and they did accept dental implants as a treatment option, the treatment cost mainly was the major reason to take a back step.

Evaluation of the intensity of gingival melanin pigmentation at different age groups in the Indian population: An observational study.

BACKGROUND: The brownish-black pigmentation of the gingiva has been reported in several countries. However, the available literature pertaining to the Asian population suggests that this pigmentation is more predominant in individuals with dark complexion. Although there is available literature on the intensity of gingival pigmentation with different age groups in Japanese and Israel population, no such literature pertaining to age and intensity of melanin pigmentation is available in the Indian population. AIM: This study aims to observe the intensity of melanin pigmentation in different age groups in the Indian population. METHODS AND MATERIALS: Intensity of melanin pigmentation was observed by the gingival melanin pigmentation index as given by Ponnaiyan et al. in 250 individuals who were grouped under the age group of 0-5 years, 6-9 years, 10-12 years, 13-15 years, and 16-20 years. Each group comprised 25 individuals. RESULTS AND CONCLUSION: The results were subjected to statistical analysis so as to observe the intensity of melanin pigmentation at different age groups in the Indian population. It was concluded that with age, the intensity of gingival melanin pigmentation, as well as its distribution to the posterior gingiva was increased. As age increased, gingival pigmentation was more in the attached and interdental papilla, while in the younger age groups, it was confined either only to the interdental, marginal or attached gingival, or both depending on the skin color.

A novel clinical protocol for the greater palatine compression suture: A case report.

Bleeding from the palatal donor site is a worrisome complication of palatal soft tissue harvesting procedures and leads to considerable stress to both the patient and the surgeon. Several methods to control palatal hemorrhage have been suggested in literature, including a palatal suture, but a precise protocol has not been suggested. The present case report aims to suggest a protocol for the greater palatine compression suture (GPCS). Five patients who experienced profuse bleeding from the palatal free gingival graft donor site were treated with the GPCS. The palatal midline was used as a landmark and the location of the greater palatine foramen was estimated. The suture was placed anterior to the estimated location of the foramen and was passed deep into the palatal tissue with the aim of looping and compressing the vascular bundle. In all the patients, an immediate reduction and arrest of bleeding from the palatal wound was observed with blanching of the soft tissues around the suture. The proposed technique is a predictable method to control palatal hemorrhage and can be used if other less invasive techniques fail to stem the blood flow from an injured palatal vessel.

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.

Systemic Cytokines in Type 2 Diabetes Mellitus and Chronic Periodontitis.

BACKGROUND: Cytokine dysregulation plays an important role in Type 2 Diabetes Mellitus (T2DM) and Chronic Periodontitis (CP) with a commonality in pathogenic mechanisms. CP is considered the sixth complication of diabetes and may have an increased influence on systemic levels of cytokines in individuals with T2DM. OBJECTIVE: This study investigated two pro-, and two presumed anti-inflammatory cytokines and their ratios in the serum of healthy individuals, in chronic periodontitis with and without T2DM with, and without CP and in CP alone aimed at evaluating the systemic inflammatory burden of a local oral infection. METHODS: Eighty participants were divided equally into four groups as healthy volunteers (H) and patients having T2DM with, and without CP (T2DM+CP, and T2DM) and only CP (CP). Serum samples were collected to measure glycated hemoglobin (HbA1c), Random Blood Sugar (RBS) and also Tumor Necrosis Factor (TNF)-α, Interleukin (IL)-4, -6 - 10 were assessed using commercially available ELISA kits. RESULTS: The cytokines were detected in all groups. Significant differences were observed between groups for all the clinical, biochemical parameters and cytokines. Cytokine levels and the ratios showed significant correlations. The ratios of the cytokines differed significantly amongst groups, were highest in T2DM+CP. CONCLUSION: In this study, the cytokine ratios provided a qualitative profile along with the absolute levels in T2DM with periodontitis, indicative of an intensified systemic inflammatory state.

Perception by Osseointegrated Dental Implants Supporting a Fixed Prosthesis: A Prospective Study.

PURPOSE: Osseointegrated implants have been shown to transmit a certain sensibility termed as osseoperception. The purpose of this study was to determine the perception by implants over a period of 6 months after loading in comparison to the natural dentition. MATERIALS AND METHODS: Twenty subjects (ages 40 to 50 years) were included in this split-mouth clinical trial. The subjects were divided into two groups (n = 10) as follows: group 1-subjects with recently cemented implant-supported fixed prosthesis opposing natural teeth; group 2-subjects with recently cemented implant-supported fixed prosthesis in both arches. The implant-supported prostheses were considered as the test sites, whereas natural teeth on the contralateral side were considered as the control. Articulating papers of varied thickness were placed interocclusally in the posterior region in a predetermined random order of true and false insertions. The subjects' ability to perceive the presence/absence of the test papers was recorded for every insertion. The evaluation was performed immediately after cementation and at 1 week, 3 months, and 6 months after cementation. The minimum interocclusal thickness detected by the subjects at the test and control sites at different time intervals was used for further analysis. RESULTS: All subjects with implant-supported prostheses perceived a certain thickness of articulating paper. The minimum interocclusal thickness detected by the implant-supported prosthesis decreased postloading; however, the difference was not statistically significant (P > .008). At the end of the follow-up period, the minimum interocclusal thickness detected by the implants in group 1 was similar to the controls, whereas it was significantly higher than the controls in group 2 (P < .05). CONCLUSION: There was progressive improvement in the perception by implant-supported prostheses during the follow-up period, and it was nearing the perception by natural teeth in subjects with implants opposing natural teeth.

Efficacy of Milk as a Desensitizing Agent for the Treatment of Sensitivity Following Scaling and Root Planing.

BACKGROUND: Dentine hypersensitivity (DH) is the most common problem encountered by most of the dentists in their day-to-day clinical practice. It is characterized by a sharp pain or discomfort arising as a response to thermal, chemical, or osmotic stimuli and is caused due to exposure of dentine after the enamel or cementum at the root surface has been lost by the treatment, underlying dental and gingival diseases or physiologic wear and tear of the teeth. This further complicates preventive oral hygiene procedures by the patients, which jeopardize periodontal treatment or may as well aid in periodontal treatment failure. AIM AND OBJECTIVE: To evaluate the efficacy of commercially available milk as a desensitizing agent for the treatment of sensitivity following scaling and root planing. MATERIALS AND METHODS: Patients were selected randomly for scaling and then assessed for sensitivity. Those patients having DH were divided into two groups, wherein the Group A (test) patients were advised to rinse with commercially available milk at room temperature and those in Group B (control) with a commercially available mouthwash (Sentosil-SF). A four-point verbal rating scale was designed to record the numerical value of DH and were recalled for follow-up on 4th, 7th, and 10th day posttreatment. RESULTS: The study demonstrated that there was a considerable reduction in hypersensitivity in both the groups on the 7th and 10th day. In the milk group, eight patients showed a complete reduction in hypersensitivity on 7th day and 13 patients on 10th day, while in the mouthwash group, five patients showed the same on 7th day and ten patients on the 10th day, thus suggesting that more individuals in the milk group were benefited. However, there was no statistically significant difference between the groups in every visit. CONCLUSION: Although there is a vast literature available which suggests the efficacy of commercially available mouthwash in reducing hypersensitivity, this study is the first of its kind which evaluates the efficacy of commercially available milk in reducing sensitivity which is induced postscaling. Considering that milk rinse is cheap and easily available at home, it can be used as a desensitizing agent, and rinsing with milk for few days is effective and stable in quick reduction of hypersensitivity induced by scaling.

Applications of a modified palatal roll flap in peri-implant soft-tissue augmentation - A case series.

Abrams's palatal roll technique has been used extensively to augment peri-implant soft tissues in the maxillary esthetic zone and has seen numerous modifications. An adaptation of the palatal roll technique is described here and its simplicity of application in three different scenarios is demonstrated. At second-stage implant surgery, a partial thickness initial incision followed by a palatal subepithelial dissection at the site of implant was done and a connective tissue graft with a buccal pedicle was obtained. The graft was rolled under the buccal flap and allowed to heal with the support of a healing abutment. The graft healed uneventfully and provided excellent contours of tissues around the implant. The procedure demonstrated good results for augmentation of a buccal ridge deficiency, for covering exposed and unsightly implant fixtures and was also done with a papilla preservation incision. In addition, a second surgical site to obtain the connective tissue graft was avoided.

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.

Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus.

AIM: Chronic periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic periodontitis. MATERIALS & METHODS: Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic periodontitis, and type 2 diabetes with, and without chronic periodontitis. RESULTS AND CONCLUSIONS: Cytokine ratios showed significant differences in type 2 diabetes and chronic periodontitis, were highest in participants having both type 2 diabetes and chronic periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic.

Interlinking Periodontitis and Type 2 Diabetes Mellitus by Assessment of Crevicular Visfatin Levels in Health and in Disease Before and After Initial Periodontal Therapy.

INTRODUCTION: Visfatin is a new adipocytokine associated with both chronic periodontitis and type 2 diabetes mellitus independently. AIM: We aimed to estimate and compare the changes in the levels of visfatin in the Gingival Crevicular Fluid (GCF) of healthy subjects and in subjects with periodontitis with or without controlled Type 2 Diabetes Mellitus (T2DM) after administration of non-surgical periodontal therapy. MATERIALS AND METHODS: Forty two subjects were equally divided into Group 1 (healthy), Group 2 (systemically healthy with chronic periodontitis), Group 3 (subjects with chronic periodontitis having controlled T2DM). Defined clinical parameters were recorded at baseline and at one month follow-up period. Visfatin was assessed using enzyme linked immunosorbent assay. One way ANOVA and Tukey's multiple post hoc procedures were used. Pearson's correlation coefficient was used for correlation. RESULTS: Significant increase in the visfatin levels was seen with the highest values observed in diabetes with periodontal disease. Visfatin responded to non-surgical periodontal therapy as observed by significant decrease in levels after one month but even at this period diabetics showed the highest levels. CONCLUSION: Visfatin levels are highest in individuals with both periodontal disease and diabetes even after periodontal therapy. Individuals with T2DM may be at higher risk of developing periodontal disease.

Crown lengthening procedure following intentional endodontic therapy for correction of supra-erupted posterior teeth: Case series with long-term follow-up.

CONTEXT: The crown lengthening procedure (CLP) is routinely carried out to correct gingival levels and achieve esthetic contours and adequate crown lengths for restorative purposes. Though the short-term outcomes have been found to be stable, long-term results are not much reported. AIMS: To evaluate the long-term stability of the marginal bone levels, gingival levels, and the status of the teeth, which underwent endodontic therapy, followed by CLP and final restorations. SETTINGS AND DESIGN: Institutional setting, long-term case series. MATERIALS AND METHODS: Case records of the patients who underwent CLP and endodontic therapy for corrections of the supra-erupted teeth to regain the lost interocclusal spaces were retrieved, and the cases with complete set of the clinical and radiographs were taken. All the cases were recalled and bone levels on the radiographs, bleeding on probing, probing pocket depths, and changes in the soft tissue margins were evaluated. STATISTICAL ANALYSIS USED: Descriptive analysis. RESULTS: A total of 25 teeth had undergone CLP and endodontic therapy and final restorations for a minimum of 24 months. The mean post-restorative duration was 50.8 ± 22.48 months (range 24-96 months). All the teeth were functional and asymptomatic with 100% survival. Interdental bone loss of 1 mm, probing pockets of 5 mm, and 1 mm buccal recession were observed in 16% of the sites. The amount of interocclusal space regained was adequate to restore the missing teeth in the opposing arch. CONCLUSIONS: The CLP is a predictive procedure for correction of supra-erupted teeth. The survival of the teeth that underwent the procedure in the present study was 100% over 24-96 months.

Tumor necrosis factor-α, interleukin-4 and -6 in the serum of health, chronic periodontitis, and type 2 diabetes mellitus.

BACKGROUND: Cytokines are significant in the development and progression of chronic periodontitis (ChP) and type 2 diabetes mellitus (DT2). Insufficient information is available regarding the pro- versus anti-inflammatory cytokines in ChP's influence on systemic levels of cytokines on DT2. This study investigated the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-4 and IL-6 in the serum of patients with ChP, DT2, and with both ChP and DT2, as compared to health. MATERIALS AND METHODS: A total of eighty participants were grouped equally groups as healthy (NH), ChP with, and without DT2 (ChP and ChP + DT2) and only type 2 diabetes (DT2). Plaque and gingival indices, bleeding on probing, pocket probing depths, clinical attachment loss, were evaluated. Serum samples were collected to measure glycated hemoglobin, random blood sugar. TNF-α, IL-4 and -6 was assessed by ELISA. RESULTS: The selected cytokines were detected in all the participants. TNF-α and IL-6 were highest in ChP + DT2 group, whereas IL-4 was highest in health. Significant differences and correlation were observed between the cytokines, periodontal, and glycemic parameters and among the four groups. CONCLUSION: TNF-α and IL-6 appear to heighten the inflammatory state in patients with both type 2 diabetes and periodontitis, but IL-4, though considered an anti-inflammatory mediator was not convincing in such a role in this study. The cytokine behavior needs to be studied further in larger studies.

Palatal approach of anterior superior alveolar injection technique may not be potentially useful in periodontal procedures.

BACKGROUND: The palatal approach of anterior superior alveolar (P-ASA) using WAND injection was reported to effectively provide a profound bilateral maxillary anesthesia of the soft tissue of anterior one-third of the palate and facial gingivae extending from canine to canine which lasted for more than an hour thus making it ideal for scaling root planing and minor periodontal procedures in the anterior maxilla. Our study suggests that the conventional P-ASA injection is of very short duration and the extent of anesthesia was not profound and consistent. This has not been reported earlier in the literature. MATERIALS AND METHODS: Thirty-five cases (20 males and 15 females), who underwent scaling, root planing and minor periodontal surgical procedures such as abscess drainage, gingivectomy, and frenectomy in the maxillary anterior region in the age range of 19-45 years was assessed for the efficacy of the P-ASA injection. After the administration of the P-ASA injection, the subjective and the objective symptoms were used to evaluate the extent and duration of the anesthesia at 10, 15, and 20 min. RESULTS: This study suggests that the conventional P-ASA injection technique does not provide anesthesia for more than 20 min. Wilcoxon matched pairs test was used to compare the effect of anesthesia at the different time intervals and the results were found to be statistically significant (P < 0.05). CONCLUSIONS: The conventional P-ASA injection technique is of very short duration and does not demonstrate effectiveness in periodontal surgery of the anterior maxilla.