Laser light: Illuminating the path to enhanced periodontal care.

The utilisation of laser technology in the realm of periodontal care represents a significant advancement in clinical practice. This article delves into the historical context of laser therapy in medicine, from its inception in 1960 to its evolution into low-level laser therapy (LLLT). LLLT, often referred to as photobiomodulation (PBM), has garnered attention due to its potential to enhance periodontal treatment outcomes. The article thoroughly examines the mechanisms of action of photobiomodulation therapy PBM(T), covering its impact on cellular and tissue levels. The authors explore the evidence-based recommendations for the use of PBM(T) in periodontal care, shedding light on its potential to improve periodontal conditions, especially when applied as an adjunct to conventional treatments. They investigate the role of PBM(T) in individuals and its possible contribution to periodontal health. Additionally, the article delves into its application in periodontal regenerative procedures and its ability to expedite soft tissue wound healing and the effects of PBM(T) in reducing periodontal inflammation and mitigating post-periodontal surgery discomfort. In conclusion, the article calls for enhanced clinical research to streamline laser procedures, develop antimicrobial photodynamic therapy, and conduct well-designed randomised controlled trials (RCTs). It also emphasises the importance of understanding the impact of laser therapy on therapeutic and biological goals, the potential to reduce invasive procedures, and the necessity of adequate research funding.

Effect of platelet-rich fibrin membrane on gingival crevicular fluid alkaline phosphatase levels in patients undergoing periodontally accelerated osteogenic orthodontics.

Background: The present study is aimed to compare the osteoblastic activity in periodontally accelerated osteogenic orthodontics (PAOO) with and without the platelet-rich fibrin (PRF) membrane by evaluating the gingival crevicular fluid (GCF), alkaline phosphate (ALP) levels and also to explore the efficiency of PRF membrane in terms of healing. Methods: A split-mouth randomized controlled trial, which comprised 16 sites, was randomly treated with PAOO + PRF membrane and PAOO alone. The primary outcome was to analyze the GCF ALP levels at baseline, 3rd, week, 5th week (2 weeks after surgery, 1 h before and after activation), 7th week (4 weeks after surgery), and 9th week (6 weeks after surgery). The clinical parameters (plaque index [PI], gingival index [GI], bleeding index [BI]) were assessed at baseline, 3rd week, 15th week, and 27th week. Healing index was recorded at 4th week (1 week after surgery), 5th week (2 weeks after surgery), and 7th week (4 weeks after surgery). Results: There was a statistically significant increase in GCF ALP levels (p < 0.05) in the test site (PAOO with PRF membrane) 2 weeks post-surgically compared to the control site. Improvement in the clinical measures (PI, GI, BI) was statistically significant at all time intervals. Adjunctive use of PRF resulted in statistically significant early healing in the first postoperative week compared to the control site (p < 0.05). Conclusions: Within the limitations of this split-mouth study, PRF membrane showed significant osteoblastic activity in the 5th week (2 weeks after PAOO) with the increased GCF ALP levels and accelerated healing in the 1st week after PAOO. They also maintained post-orthodontic stability until 18 months.

Evaluation of injectable platelet-rich fibrin effect on the rate of canine retraction and alkaline phosphatase levels: An in-vivo study.

INTRODUCTION: With time, the treatment protocol has changed, and currently, there is a new school of treatment called accelerated orthodontics, wherein the goal is to shorten the time. In this study, a liquid formulation of platelet-rich fibrin such as injectable platelet-rich fibrin (i-PRF), was used, and its effect on the rate of canine retraction and the crevicular alkaline phosphatase (ALP) levels were studied. METHODS: Thirteen patients were recruited for this study with a mean age of 20.6 ± 3.2 years. A split-mouth type of study design was used in which the maxillary arch of each subject was divided into an experimental and control group. I-PRF was injected in the labial and lingual attached gingiva of the canine in the experimental group. The gingival crevicular fluid collection was done from the distal aspect of the canine before canine retraction, 24 hours after retraction, and 28 days after retraction from both sites (ie, control and experimental sites). ALP activity was analyzed using a semiautomated analyzer, and the rate of canine retraction was measured on stone casts with the help of a digital vernier caliper. RESULTS: The individual canine retraction was 1.8-fold faster in the i-PRF group than in the control group. The ALP activity was significantly greater at 24 hrs and 28 days after retraction in the experimental group. CONCLUSIONS: These results suggest that i-PRF is an innovative, noninvasive approach to accelerating tooth movement. ALP activity in gingival crevicular fluid reflects the biological changes in the periodontium, and the steep increase in the activity indicates increased bone remodeling within the experimental group.

Malodor reductions and improved oral hygiene by toothbrushing and mouthrinsing.

OBJECTIVE: This clinical study compared the effects of an antibacterial regimen, comprising a triclosan toothpaste and a 0.075% cetylpyridinium chloride (CPC) mouthrinse, on malodor, self-reported malodor, and oral hygiene measures such as dental plaque, gingivitis, and bleeding relative to brushing with a fluoride toothpaste. MATERIALS AND METHODS: At baseline, 36 subjects were evaluated for malodor (9-point organoleptic scale [OLT]), dental plaque (Turesky modification of Quigley-Hein; PI), gingivitis (Lφe-Silness; GI) and bleeding (Ainamo and Bay; BI) and randomized to (1) tooth brushing with fluoride toothpaste, or (2) a regimen comprising tooth brushing with a triclosan toothpaste and mouth rinsing with CPC mouthrinse. After the first use of assigned treatments, subjects were evaluated for malodor 2 h after breakfast (OLT-2 h) and used provided treatments for the next 14 days. On the 7 th and 14 th days, subjects refrained from oral hygiene for 12 h before evaluations (OLT, PI, GI, and BI) and then performed oral hygiene at the dental clinic. Subjects were evaluated for malodor 2 h after breakfast (OLT-2 h) and self-assessed their malodor on a 100 mm visual analog scale (VAS). RESULTS: Treatment groups demonstrated no significant differences in OLT, PI, GI, BI at baseline (P > 0.05). OLT-2 h scores after the first use of regimen and after tooth brushing alone were 5.94 and 6.21, respectively, and were statistically significantly different (P < 0.05). Correspondingly, the regimen demonstrated progressive reductions in OLT and OLT-2 h on the 7 th and 14 th day evaluations (5.81, 4.88, and 5.09, 4.20, respectively) and were significantly lower than after tooth brushing alone (6.49, 6.18, and 6.35, 5.99, respectively) (P < 0.05). From the 7 th to 14 th days, the regimen also demonstrated progressively lower PI, GI, BI, and self-reported malodor (VAS scores) which were significantly lower than tooth brushing alone (P < 0.05). CONCLUSIONS: Results from this study demonstrated that a regimen comprising a triclosan toothpaste and CPC mouthrinse demonstrated significant malodor reductions 2 h after the first use and progressively increasing reductions in malodor, dental plaque, gingivitis, bleeding and self-reported malodor from the 7 th to 14 th days than tooth brushing alone.

Going green with eco-friendly dentistry.

Eco-friendly dentistry is currently transforming the medical and dental field to decrease its affect on our natural environment and reduce the amount of waste being produced. Eco-friendly dentistry uses a sustainable approach to encourage dentists to implement new strategies to try and reduce the energy being consumed and the large amount of waste being produced by the industry. Many reasonable, practical and easy alternatives do exist which would reduce the environmental footprint of a dental office were it to follow the 'green' recommendations. Dentist should take a leading role in the society by implementing 'green' initiatives to lessen their impact on the environment. This article provides a series of 'green' recommendations that dentists around the world can implement to become a leading Stewards of the environment.

Development, in vitro and in vivo evaluation of novel injectable smart gels of azithromycin for chronic periodontitis.

Periodontitis is an inflammatory condition affecting teeth resulting in progressive destruction of periodontal ligaments, resorption of alveolar bone and loss of teeth. Treatment of periodontitis includes surgical and non surgical management. Systemic antibiotics are also used for the treatment of periodontitis. The aim of this research was to formulate smart gel system of azithromycin (AZT) and to evaluate in vitro and in vivo for non-surgical treatment of chronic periodontitis. Azithromycin dihydrate, used systemically in the treatment of periodontitis, was formulated into smart gels using biodegradable, thermosensitive polymer Pluronic® F-127 (PF-127) and Hydroxy Ethyl Cellulose (HEC) as copolymer. The prepared smart gels were evaluated for sterility, content uniformity, gelation temperature and time, syringeability, rheological behavior, in vitro diffusion and in vivo efficacy in human patients. The prepared smart gels were clear and transparent, sterile, thermoresponsive and injectable. Viscosity of gels increased with increase in concentration of polymer/co-polymer and also with temperature. They gelled in short response time below the body temperature. In vitro release studies showed controlled drug release which was influenced significantly by the properties and concentration of PF-127 and HEC. In vivo efficacy studies showed a significant improvement (p <0.001) in clinical parameters such as gingival index, probing pocket depth, clinical attachment level, bleeding index and plaque index. The developed azithromycin smart gel system is a novel approach for the treatment of chronic periodontitis since it reduces the dose and side effects, bypasses the usual surgical procedures and improves patient compliance.

Gold nanorods embedded discotic nanoribbons.

It is shown that gold nanorods (GNRs) can be easily inserted into the supramolecular order of discotic liquid crystals (DLCs) along the director without disturbing their mesomorphism. GNRs embedded discotic nanoribbons, useful for constructing devices like thin film transistors, sensors, etc., are prepared by simple solution processing of GNR-DLC nanocomposites.

A modified double pedicle graft technique and other mucogingival interceptive surgeries for the management of impacted teeth: a case series.

Maxillary canine is one of the most common teeth that are impacted. This accounts for 1-2% of all patients who attend orthodontic treatment. The key to achieve maximal eruption of these teeth is their surgical exposure and the role of periodontist in such situations is to provide a functional and satisfactory width of attached gingiva on the labial surface. There are different techniques to surgically expose the impacted teeth, namely--gingivectomy technique, apically positioned flap, closed eruption technique, modified apically positioned flap, double pedicle flap and free gingival graft. Selection of the procedure is dependent on the positioning of the tooth in relation to mucogingival junction and attached gingiva. In the present case series we describe three different techniques for uncovering of impacted teeth, which are apically positioned flap, closed eruption technique and a modified double pedicle graft specially planned for the situation. These procedures when selected diligently using sound selection criteria will create adequate width of attached gingiva which minimizes or eliminates the future mucogingival problems.