ISP good clinical practice recommendations for gum care.

Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to "Gum Care for All", is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.

Composite outcome measure (COM) and pocket closure as clinical endpoints following treatment of infra bony defects with Guided tissue regeneration and Open flap debridement.

Background: Clinical outcomes of regenerative periodontal therapy has been traditionally assessed using surrogate markers, primarily clinical attachment level (CAL) gain and probing pocket depth (PPD) reduction. This study tried to assess newer clinical endpoints namely pocket closure and composite outcome measure (COM) apart from CAL gain, PPD reduction and gingival recession in patients who underwent guided tissue regeneration (GTR) and compared the same with open flap debridement (OFD) six months post treatment. Materials and Methods: Records of 58 sites in 48 patients who had undergone GTR (28 sites) and OFD (30 sites) for infrabony defects were evaluated for CAL gain, PPD reduction, change in GR, FMBS, and FMPS at baseline and 6 months after surgery. Pocket closure and COM were used to assess the efficacy of both treatments. Results: Statistically significant improvements were seen in both the groups except GR from baseline to 6 months. GTR-treated sites showed better improvements with a statistically significant difference in CAL gain after 6 months. Pocket closure and percentage of treatment success and failure in both the groups assessed using a COM were similar and did not differ statistically. Conclusion: Treatment of infrabony defects with GTR combined with a xenograft offers better CAL gain after 6 months compared to OFD alone and also found that baseline PPD and FMBS were the factors determining pocket closure.

Evolution of Barrier Membranes in Periodontal Regeneration-"Are the third Generation Membranes really here?".

In the last decades, Guide Tissue Regeneration (GTR) technique has been applied for the treatment of various periodontal defects such as intrabony defects, furcation involvements and localized gingival recession defects. From early days of using membranes with the simple aim of minimizing toxic response in the host, membranes have come a long way. Third generation membranes not only act as barriers but also as delivery devices to release specific agents. Many clinical trials have focused on using membranes as delivery devices for antibiotics and growth factors. In this article we take a brief look at the evolution of barrier membranes and future avenues with regard to third generation membranes.