An In Vitro Evaluation of Antibacterial Efficacy of Various Concentration of Eucalyptus globulus Leaf Extract on Periodontal Pathogens.

AIM: The aim of the present study was to evaluate the antibacterial efficacy of various concentrations of Eucalyptus globulus leaf extract on periodontal pathogens. MATERIALS AND METHODS: Matured, healthy and disease-free leaves of Eucalyptus globulus were collected. The leaves were washed under tap water and finally dried in an oven at a temperature of 45°C for 48 hours. The dried plants were ground in an electric blender to make them into a powder. The powder was mixed with 100% ethanol and kept it inside a shaker overnight at 35°C. The mixture was centrifuged for 10 minutes at 2,500 rpm. Three different concentrations (10%, 50%, and 100% v/v) were used as antibacterial agents. Chlorhexidine (0.2%) was considered as positive control and dimethyl formamide was considered as negative control against P. gingivalis and A. actinomycetemcomitans. The disc diffusion method was used to determine the extract's antibacterial activity against the test organisms. A digital Vernier caliper was used to measure the diameter of antibacterial activity showing the zone of inhibition in millimeters. RESULTS: Eucalyptus globulus with 100% concentration showed a maximum zone of inhibition against A. actinomycetemcomitans and P. gingivalis (5.38 ± 0.32 mm, 4.82 ± 0.11 mm) followed by 50% and 10% accordingly. The negative control of dimethyl formamide showed a zone of inhibition of 0.48 ± 0.96 mm and 0.63 ± 0.20 mm against A. actinomycetemcomitans and P. gingivalis. The positive control of 0.2% chlorhexidine showed a zone of inhibition of 8.46 ± 1.02 mm and 7.18 ± 0.54 mm against A. actinomycetemcomitans and P. gingivalis. The ANOVA test showed a highly significant antibacterial efficacy in 0.2% chlorhexidine and 100% concentration Eucalyptus globulus. CONCLUSION: A significant maximum zone of inhibition against A. actinomycetemcomitans and P. gingivalis was showed by 100% concentration of Eucalyptus globulus. CLINICAL SIGNIFICANCE: Other than the systemic diseases treatment, Eucalyptus globulus also serves as an effective promising alternative to antibiotics in the prevention of oral infections because of the natural phytochemicals existing in them.

Antimicrobial Activity of Curcuma longa L. Extract on Periodontal Pathogens.

AIM: The aim of this study was to evaluate the antimicrobial activity of Curcuma longa L. extract (CLE) on periodontal pathogens. MATERIALS AND METHODS: Sixty patients were divided into three groups: Group I (n = 20) patients treated with scaling and root planning (SRP) only, Group II (n = 20) patients treated with SRP followed by subgingival irrigation with 1% CLE solution, and Group III (n = 20) patients treated with SRP followed by subgingival irrigation with 0.2% chlorhexidine (CHX) solution. The clinical parameters (plaque index [PI], gingival index [GI] scores, probing pocket depths) were recorded at baseline, 4 weeks, and 8 weeks. The antimicrobial efficacy of 1% CLE and 0.2% CHX solutions against Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans were evaluated by disk diffusion method. RESULTS: There was no significant difference in the mean values of zone of inhibition exhibited by both CLE and CHX solutions. All the groups showed significant improvement in the clinical parameters when compared to baseline values. The improvement in the PI and GI scores in the CLE group was lesser than that in CHX group by the end of the study period. CONCLUSION: CLE possess antimicrobial efficacy against the common periodontopathic bacteria. However, further large-scale studies evaluating the substantivity of C. longa are required to support its beneficial use in the treatment of periodontal diseases.

Clinical Assessment of Gingival Sulcus Width using Various Gingival Displacement Materials.

AIM: This study aims to compare the clinical efficacy of three different gingival retraction systems on gingival sulcus width. MATERIALS AND METHODS: Study was conducted on prepared right or left maxillary central incisor for 45 subjects. Totally, 15 patients were randomly allocated in three gingival displacement groups, i.e., group I (retraction cord impregnated with aluminum chloride), group II (magic foam), and group III (laser). The pre- and postdisplacement impressions were made with addition silicone material using two-stage double mix technique. RESULTS: There was no difference between the groups at baseline. Group III produced more displacement (mean value 0.48 ± 0.101 mm) than group II (mean value 0.31 ± 0.09 mm) and group I (mean value 0.44 ± 0.11 mm), and this was statistically significant. CONCLUSION: Laser gingival displacement system was found to be effective among the three retraction systems. Choice of gingival displacement system is based on clinical situation and choice of operator. CLINICAL SIGNIFICANCE: The retraction groups in the study created greater amount of gingival retraction than the least sulcus width required for the elastomeric impression material and so are clinically useful.

In vitro Antimicrobial Activity of Ocimum sanctum (Tulsi) Extract on Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis.

Aim: The present study was conducted with an aim to assess the antimicrobial activity of Ocimum sanctum (tulsi) extract on Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis.Materials and methods: Tulsi extract with ethanol was prepared using cold extraction method in the present in vitro study. Various concentrations (2, 4, 6, and 8%) were then obtained by dilution with dimethylformamide. A 0.2% chlorhexidine served as the positive control, whereas the negative control was dimeth-ylformamide. Zones of inhibition were measured, each for A. actinomycetemcomitans and P. gingivalis. For comparison within the group and between the study groups, one-way analysis of variance (ANOVA) and Tukey's post hoc tests were used. A statistical significance level of p < 0.05 was established. Results: The 8% concentration of the tulsi extract showed maximum zone of inhibition against A. actinomycetemcomitans and P. gingivalis (40.10 ± 0.90, 33.79 ± 1.82 mm), followed by the 6, 4, and 2% concentrations. The 0.2% chlorhexidine, which was the positive control, had 39.80 ± 1.24 and 32.28 ± 1.28 mm zones of inhibition; dimethylformamide showed 13.55 ± 1.92 and 10.21 ± 2.16 mm zones of inhibition against both the microorganisms. The ANOVA showed highly statistically significant (p < 0.0001) results between and within the groups. The antimicrobial activity of tulsi extract at 6 and 8% concentrations, and 0.2% chlorhexidine against A. actinomycetemcomitans showed statistically significant differences between the groups. The concentration of tulsi extract at 8 and 0.2% chlorhexidine on P. gingivalis showed statistically significant differences between the groups. Conclusion: It was concluded that 8% concentration of O. sanctum (tulsi) extract showed the maximum antimicrobial activity against A. actinomycetemcomitans and P. gingivalis. It is thus recommended that this may be useful as an adjunc-tive to mechanical therapy in the prevention and treatment of periodontal diseases. Clinical significance:O. sanctum (tulsi) is a herb that is abundantly available, easily accessible, economically feasible, and culturally acceptable. Therefore, it is very useful in the management of oral diseases and also for overcoming many barriers that exist for the utilization of dental services, such as affordability, accessibility, availability, and acceptability. Keywords:Aggregatibacter actinomycetemcomitans, Antimicrobial, Ocimum sanctum, Porphyromonas gingivalis.

Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study.

BACKGROUND & OBJECTIVES: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment and alveolar bone around the affected tooth. Different modalities have been employed in the treatment and regeneration of periodontal defects which include the use of bone grafts, PRP and other growth factors.The purpose of this prospective, randomized controlled study was to compare the regenerative efficacy of PRP and bonegraft in intrabony periodontal defects. METHODOLOGY: This randomized control trial was carried out in the Department of Periodontics & Oral Implantology, Kalinga Institute of Dental Sciences and Hospital, KIIT University, Bhubaneswar. The study sample included 20 periodontal infrabony defects in 20 patients, 12 males and 8 females. The patients were aged between 25 -45 years(with mean age of 35 years). The 20 sites selected for the study were was randomly divided into 2 groups of 10 sites each. Group A: PRP alone, Group B: Bone Graft. STATISTICAL ANAYSIS & RESULTS STATISTICAL ANALYSIS WAS DONE USING SPSS VERSION 180: Statistical analysis was done usingpaired 't' tests and ANOVA that revealed a significant reduction ingingival index, plaque index, probing pocket depth and gain in clinical attachment level at various time intervalswithin both the groups. Radiographic evaluation revealed statistically significant defect fill (p<0.001) at the end of 6months within both the groups. However, there was astatistically significant difference seen in group B radiographically, when compared to group A. CONCLUSION: Both the groups showed promising results in enhancing periodontal regeneration; however the resultswith bonegraftwere comparatively better, although not statistically significant when compared to PRP alone.

Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design.

AIM: The aim of the present study was to evaluate the effectiveness of different bristle designs of toothbrushes and the periodontal status among patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: This randomized controlled trial (RCT) consisted of 45 adolescents (comprising 20 males and 25 females) undergoing fixed orthodontic treatment. The study participants were randomly allocated to three groups, each group being assigned a locally available toothbrush with a particular design of toothbrush bristle. In the first test phase, group I study participants were allocated to toothbrush with flat bristles, group II study subjects were allocated to toothbrush with zigzag bristles, and group III study participants were allocated to toothbrush with crisscross bristles. The study participants were recalled after 4 weeks to check the effectiveness of the allocated toothbrushes. A washout period of 1 week was maintained to ensure that there was no carryover effect of the different bristle designs. In the second test phase, each patient used the opposite toothbrush bristle design (group I: toothbrush with zigzag bristles, group II: toothbrush with crisscross bristles, and group III: toothbrush with flat bristles). Plaque scores were measured using Turesky-Gilmore-Glickman modification of Quigley-Hein plaque index (PI). RESULTS: In both phase 1 and 2 of this RCT, toothbrush with crisscross bristles exhibited maximum plaque reduction among the three different bristle design toothbrushes following 30 days (p = 0.312 ± 0.102 and 0.280 ± 0.110, respectively), which was statistically significant. CONCLUSION: It was concluded that all the three designs of toothbrushes were effective in removing plaque in patients with fixed orthodontic appliances. But among the three different toothbrushes, toothbrush with crisscross bristles showed the highest mean plaque reduction. CLINICAL SIGNIFICANCE: Plaque accumulation around the orthodontic brackets and gingival margins is quite common among the fixed orthodontic patients, who encounter difficulty in maintaining good oral hygiene. Specially designed toothbrushes are very essential for effective plaque removal among the patients undergoing fixed orthodontic treatment.

Use of Platelet Rich Plasma in the Management of Periodontal Intra-Osseous Defects: A Clinical Study.

BACKGROUND: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment, and alveolar bone around the affected tooth. Alveolar bone support and attachment apparatus regeneration has been achieved through various processes and have given elusive results. An expedient and cost-effective approach to obtain autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-ß is the use of platelet-rich plasma (PRP). PRP is obtained by sequestrating and concentrating platelets by gradient density centrifugation. AIMS: The current study was aimed at evaluating the regenerative potential of platelet-rich plasma in comparison with open flap debridement. SETTINGS AND DESIGNS: This study was a randomized controlled clinical trial conducted in the Department of Periodontics and Oral Implantology, KIDS, Bhubaneswar, Odisha. MATERIALS AND METHODS: Twenty periodontal infrabony defects in 10 patients; 6 males and 4 females of age between 25-45 years were included in this study and were followed up for a period of 6 months. STATISTICAL ANALYSIS: Both the groups showed a mean plaque index of 2.10 and 2.50 at baseline, 1.75 and 2.05 at 3 months, and 1.28 and 1.53 at the end of 6 months. The mean reduction of 0.35 and 0.45 at three months and 0.82 and 0.97 at six months was achieved, which was statistically significant. (P < 0.001). When comparison was done between the two groups it was not found to be statistically significant (P < 0.05). In each of the group there was definitive reduction in plaque score over a period of time. RESULTS AND CONCLUSION: There was no statistically significant difference in the treatment outcome between open flap debridement and PRP alone. Platelet-rich plasma application holds promise and needs further exploration.

An In-vitro Comparison of Nano Hydroxyapatite, Novamin and Proargin Desensitizing Toothpastes - A SEM Study.

INTRODUCTION: Dentinal Hypersensitivity (DH) is commonly encountered clinical condition in dental practice which affects 8-57% of the adult population presenting for dental treatment, but the treatment of the same remains doubtful. AIM: The purpose of this study was to evaluate and compare the effects of three different desensitizing agents (15% nano hydroxyapatite crystals; 5% novamin and 8% proargin) on dentinal permeability and tubule occlusion in-vitro. Scanning Electron Microscope (SEM) was used to evaluate the effect of these commercially available desensitizing toothpastes. MATERIALS AND METHODS: A total of 40 disc shaped dentin specimens were dissected from extracted premolars. Dentin discs of 1mm were obtained with the help of diamond discs. Ten specimens were randomly selected and allocated to the evaluation groups A (control group), B (Nano-hydroxyapatite), C (Novamin) and D (Proargin). Each treatment group dentine disc specimen was treated with the respective slurry for two minutes for a period of seven days. Each disc was subjected to a pre- and post-treatment SEM analysis to evaluate the changes occurring in the dentinal tubules. RESULTS: The qualitative analysis showed no occlusion of the dentinal tubules in Group A (control group) and Group B (nano-hydroxyapatite) showed 98.1% tubule occlusion. Group C (Novamin) and D (Proargin) showed 83.1% and 69.1% tubule occlusion respectively. Quantitative analysis showed a statistical significant difference between Group B and D (p< 0.005) and no statistical significant difference between group B and C (p= 0.235). Similarly, there was no significant difference between Group C and D as (p=0.235). CONCLUSION: It was concluded that all the three desensiting agents were effective in the dentine tubule occlusion. In addition efficacy of nano-hydroxyapatite toothpaste was greater compared to the other desensiting agents.

Cavernous hemangioma of the tongue.

Hemangioma is a benign tumor of dilated blood vessels. It is most commonly seen in the head and neck region and rarely in the oral cavity. Hemangiomas in the oral cavity are always of clinical importance and require appropriate treatment. We report here a case of a 34-year-old female patient with a swelling on the lateral surface of tongue which did not respond to the sclerosing agent and was finally confirmed as cavernous hemangioma on histological evaluation.