Comparative Evaluation of Er: YAG Laser, Diode Laser, and Novamin Technology for Dentinal Tubule Occlusion: An In-Vitro Scanning Electron Microscope (SEM) and Energy Dispersive X-Ray Analysis (EDX) Study.

BACKGROUND: Dentinal hypersensitivity is a brief and painful oral condition that is characterized by an abrupt shooting sensation. Stimulation occurs when hot, cold, sweet, or sour food comes into contact with exposed dentinal tubules. The present study used a scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX) to investigate the efficacy of Er: YAG, 810 nm diode LASER, and NovaMin Technology in obstructing dentinal tubules. MATERIAL AND METHODS: We extracted the outer layers of 30 human teeth to expose the tubules and then treated the surfaces with 17% ethylenediaminetetraacetic acid (EDTA) to create an etched effect. Three cohorts were created from the portions. Group A was subjected to the application of Erbium:Yttrium-Aluminum-Garnet (Er: YAG) laser with a power output of 2W in the non-contact mode for 1 minute. Group B was subjected to the application of an 810nm diode laser with a power output of 1W in continuous mode for 30 seconds. Group C was subjected to the application of NovaMin paste, which contains a 927 ppm fluoride content. Following the therapy, occluded dentinal tubules were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) for both quantitative and qualitative examination. The data analysis was conducted using a one-way analysis of variance (ANOVA) and Tukey's test, with a significance threshold of 0.05. RESULTS: The average percentages of complete blockage of dentinal tubules in Groups A, B, and C were evaluated using the number of entirely unobstructed dentinal tubules at magnifications of 2000X (F = 3.05, p = 0.064), 5000X (F = 5.33, p = 0.011), and 10000X (F = 8.63, p = 0.001). The count of partially open dentinal tubules seen at magnifications of 2000X, 5000X, and 10000X was F = 10.15 (P < 0.001), F = 5.97 (p = 0.007), and F = 2.12 (p = 0.140) accordingly. CONCLUSION: NovaMin technology has demonstrated more effectiveness in blocking dentinal tubules compared to 810nm diodes and Er: YAG lasers.

Clinical management and histopathological analysis of composite type of gingival Stillman's cleft.

Gingival Stillman's cleft is one of the least-studied mucogingival defects that may jeopardize the periodontal health and esthetic of the affected teeth. The etiology behind this lesion is believed to be multifactorial, and the histopathology remains unclear. In this report, we present a case of composite gingival Stillman's cleft in anterior maxillary teeth that was clinically treated with a laterally moved coronally advanced flap. The cleft tissue was removed during root coverage surgery and then was harvested for histopathological analysis using hematoxylin and eosin, Masson's trichrome, and van Gieson's stain. In the cleft site, microscopic examination revealed variable degrees of epithelial bifurcations with elongated forking of rete ridges into the stroma. Endothelial-lined blood vessels and inflammatory cells, primarily lymphocytes and fibroblasts, were seen in the stroma. The Masson trichrome (blue) and Van Gieson (pink) revealed colored gingival tissue with prominent collagen fiber distribution at the cleft site, which is suggestive of gingival fibrous hyperplasia brought on by repeated damage from tooth brushing.

Evaluation of the efficacy of concentrated growth factor along with bovine-derived xenograft and collagen membrane in the treatment of Degree II mandibular molar furcation defect - A clinicoradiographic study.

Background: The ultimate goal of furcation defect therapy is furcation closure via periodontal regeneration. However, the process of periodontal regeneration is affected by the regenerative environment of signaling molecules and growth factors due to which consistent findings of complete furcation closure could not be attained. In this study, we have evaluated the use of concentrated growth factor (CGF) which provides sustained release growth factors in conjunction with bovine-derived xenograft anorganic bovine bone (ABB) in guided tissue regeneration (GTR) of Degree II mandibular molar furcation defect. Materials and Methods: Twenty patients with Degree II mandibular molar furcation defects were selected for the study. Each group consisted of 10 patients and a total of 10 sites were treated in each group. The control sites were treated with GTR and ABB, while the experimental sites received CGF mixed with ABB along with GTR. Clinical parameters recorded were Plaque Index, Gingival Index, vertical probing depth, and horizontal probing depth measured at baseline and 6 months. Radiographic parameters such as the vertical height of defect, horizontal depth of defect, and percentage of vertical and horizontal bone fill were recorded at baseline and 6 months. Results: All the parameters recorded showed a significant reduction from baseline to 6 months in both the groups. Significantly higher vertical and horizontal bone fill was observed in the experimental group as compared to the control group. Conclusion: The use of CGF showed a positive additive efficacy in enhancing the events of periodontal regeneration in the treatment of Degree II mandibular molar furcation defect.

Bacterial Identification and Monitoring Around Two-Piece Dental Implants by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS).

Context Early microbiological diagnosis and treatment of periodontal pathogens is important for successful retention of dental implants. Aims This study aimed to identify and monitor oral bacterial colonization after successful two-piece dental implants. Settings and Design In this study, 50 two-piece dental implant subjects were included and assessed clinically, radiographically, and microbiologically. Methods and Material All the parameters were recorded at various stages after prosthesis placement. In each stage, nonadherent (peri-implant sulcular fluid) and adherent (curetted inner threads) samples were collected. Semiquantitative anaerobic culture of the samples were done in Anoxomat system. Bacterial colonies were first identified by routine microbiological methods and then by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) method. Statistical Analysis All the results were analyzed by appropriate statistical methods (Chi-square, one factor analysis of variance, etc.). Results All the bacterial isolates were identified in the MALDI-TOF MS system with no failure. After implant placement for the nonadherent samples, the frequency (%) of Fusobacterium nucleatum, Prevotella melaninogenica, and Propionibacterium acnes decreased whereas frequency (%) of Escherichia coli, Staphylococcus epidermidis, and Streptococcus mitis increased. For adherent samples, the frequency (%) of E. coli, Enterococcus faecalis, Porphyromonas gingivalis, P. melaninogenica , and Veillonella parvula decreased, whereas frequency (%) of S. mitis and Streptococcus mutans increased. The postimplant mean nonadherent and adherent bacterial load increased with time but not significantly over the periods ( p = 0.302 and 0.123, respectively). Conclusion Combination of basic (semiquantitative culture method) and advanced microbiological method (MALDI-TOF MS) can be useful for accurate detection and monitoring of potential pathogens around two-piece dental implants.

Comparative in vitro SEM study of a novel root canal irrigant-MTAD and conventional root biomodifiers on periodontally involved human teeth.

BACKGROUND: Smear layer removal and collagen fiber exposure may improve regeneration which can be accomplished by use of root biomodifiers. These enhance the degree of connective tissue attachment to denuded roots. The objective of this in vitro study was to evaluate and compare novel root canal irrigant and other root biomodifiers for smear layer removal on periodontally involved human teeth. MATERIALS AND METHODS: Forty human teeth were collected and stored in saline. After scaling and root planing, two samples were obtained from each tooth. Thus, a total of 80 dentin blocks were randomly divided into four groups: Mixture of tetracycline, acid and detergent (MTAD), tetracycline hydrochloride (TTC HCl), citric acid (CA), and ethylenediaminetetraacetic acid (EDTA). The agents were applied for 3 min by active burnishing. Immediately following treatment, the specimens were rinsed, dehydrated, fixed and prepared for scanning electron microscope and were examined at × 3500 magnification. Sampaio's index was evaluated by the previously trained blind examiner using photomicrographs. Groups were compared using analysis of variance followed by Tukey's post-hoc test. RESULTS: Mixture of tetracycline, acid, and detergent is most efficacious in removing the smear layer and showed statistically significant dentinal tubules opening, followed by EDTA, TTC HCl, and CA. CONCLUSION: Mixture of tetracycline, acid and detergent and conventional root biomodifiers used in the study alters the dentin surface by smear layer removal and exposure of dentinal tubules. Hence, MTAD as a root biomodifier may have a significant role in periodontal regeneration.

Evaluation of the effect of nicotine and metabolites on the periodontal status and the mRNA expression of interleukin-1ß in smokers with chronic periodontitis.

BACKGROUND AND OBJECTIVE: Smoking is an important environmental risk factor involved in the causation and progression of periodontal disease. Smoking can impair various components of the host immune response and immune system. The virulence factors of periodontal pathogens stimulate inflammatory cytokine expression by mononuclear cells. IL-1ß is the key mediator involved in the pathogenesis and disease progression. Therefore, whole gingival biopsy samples are assessed for this increased expression of IL-1. MATERIALS AND METHODS: 29 male subjects' age and gender matched were divided into three groups based on the periodontal and smoking status (Group A:healthy, Group B: non-smokers suffering from chronic periodontitis, Group C: smokers suffering from chronic periodontitis). Periodontal parameters like plaque index, gingival index, probing pocket depth and clinical attachment level were recorded at baseline and post scaling. The mRNA expression of IL-1ß was determined by real time polymerase chain reaction and correlated with the periodontal and smoking status. RESULTS: The improvement in the periodontal parameters was statistically significant in the non- smokers (Group B) and there was a 2 fold increase in the mRNA expression in this group. The smokers (Group C) showed lesser improvement in the periodontal parameters and there was an 8 fold increase in the mRNA expression of IL-1ß. CONCLUSION: Association of smoking status with periodontal destruction can thus be correlated with the increased mRNA expression of IL-1ß in chronic periodontitis patients.

Periodontal disease and type I diabetes mellitus: Associations with glycemic control and complications.

OBJECTIVE: The aim of the study was to evaluate periodontal health status in patients diagnosed with type 1 diabetes mellitus (DM1) and to establish a correlation between metabolic control and periodontal health status. MATERIALS AND METHODS: Periodontal health parameters namely plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL) were recorded in 28 patients diagnosed with type 1 diabetes mellitus (DM1) and 20 healthy controls. Diabetes history was recorded based on the information provided by the physician and it included date of diagnosis, duration, age of diagnosis, latest values of glycosylated haemoglobin and existing diabetic complications. Statistical analysis was performed to evaluate the relationship between periodontal parameters and degree of metabolic control, the duration of the disease and the appearance of complications. RESULTS: The periodontal health in the diabetic group was compromised and they had greater bleeding index (P < 0.001), probing pocket depth (P < 0.001) and clinical attachment level (P = 0.001). Patients diagnosed for diabetes for shorter duration of time (4-7 years) showed bleeding index-disease severity correlation to be 1.760 ± 0.434. CONCLUSION: Periodontal disease was more evident in type 1 diabetes mellitus patients and periodontal inflammation is greatly increased in subjects with longer disease course, poor metabolic control and diabetic complications.