Effect of Two Nonsurgical Periodontal Treatment Modalities in Type 2 Diabetes Mellitus Patients with Chronic Periodontitis: A Randomized Clinical Trial.

AIM AND OBJECTIVE: The current study aimed to investigate the effect of two nonsurgical periodontal treatment modalities on clinical periodontal parameters and glycemic control. MATERIALS AND METHODS: A randomized clinical trial was conducted with a sample of 64 type 2 diabetes mellitus (T2DM) patients with chronic periodontitis. Subjects were randomly assigned into two groups. Group I received oral hygiene instructions (OHI) at baseline and each recall visit. Group II received one-stage full-mouth scaling and root planning (SRP) combining OHI. At baseline, third month, and sixth month the plaque index (PlI), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and glycated hemoglobin (HbA1c) were recorded and analyzed. RESULTS: After treatment, two groups showed significant differences for all parameters at both assessed times (p <0.05). The OHI alone only demonstrated a slight reduction in GI in third month, with no significant changes for PlI and PPD indexes. However, Group I recorded the increased HbA1c and CAL values at 6-month follow-up (p <0.05). The combination of OHI and SRP exhibited a significant improvement in all periodontal values (p <0.05). Also, the HbA1C levels of Group II showed a significant reduction after treatment and were lower than those of Group I. CONCLUSIONS: Oral hygiene instructions only resulted in a better gingival condition of diabetic patients in the initial time. The nonsurgical periodontal therapy by combining SRP and OHI significantly improved both periodontal health and glycemic control. CLINICAL SIGNIFICANCE: Diabetic patients should be supplied with an effective OHI modality and a professional dental debridement.

Use of Septal Cartilage in Rhinoplasty to Correct Nasal Deformity After Unilateral Cleft Lip and Palate Surgery.

Background: The most common facial defect is the congenital cleft lip (CL), which can occur with or without a cleft palate (CP). Patients need primary plastic surgery for rehabilitation and esthetics; nevertheless, secondary abnormalities of the lip and nose may develop after primary surgery. These deformities are complex and involve all tissue layers, including the skeletal platform, inner lining, osseocartilaginous structure, and overlying skin. This study evaluated the results of nasal deformity rhinoplasty using septal cartilage in patients with nasal deformities after plastic surgery for unilateral CL and CP. Methods: This retrospective study was conducted on 21 patients with secondary unilateral CL nasal deformity between June 2015 and August 2016. All patients underwent rhinoplasty with the use of septal cartilage grafts. Pre- and post-operative nasal forms were measured. Results: The patients had cosmetic problems and impaired nasal airflow due to distorted anatomy. The postoperative nasal forms were improved in all patients. Rhinoplasty using septal cartilage effectively increased the height of the columella and nose and improved the balance of the base width and the length of both sides of the nose. Excellent results were achieved in 18 patients. Three patients showed good results. No patient showed a fair result. Conclusion: This study demonstrated an effective correction of esthetic deformities and significant improvement in airway patency. A long-term longitudinal study is still required to evaluate the influence of septal cartilage harvesting on face and nasal development until children reach their late teens.