Comparative Evaluation of Autogenous Bone Graft and Autologous Platelet-Rich Fibrin with and Without 1.2 mg in situ Rosuvastatin Gel in the Surgical Treatment of Intrabony Defect in Chronic Periodontitis Patients.

Context: Rosuvastatin (RSV) is a new synthetic, hydrophilic statin with potent anti-inflammatory and osseodifferentiation actions. Autogenous bone graft (ABG) is still considered the gold standard in reconstructive bone surgery. Addition of platelet-rich fibrin (PRF) to ABG provides sustained release of various growth factors and facilitates survival of the graft. Aims: The study aims to clinically and radiographically compare the effectiveness of ABG and PRF with and without 1.2 mg RSV gel in the surgical treatment of intrabony defect in chronic Periodontitis patient. Settings and Design: This was a randomized controlled clinical trial. Subjects and Methods: Thirty-nine patients (one site per participant) with chronic periodontitis were randomly divided into three groups: Group 1 (open flap debridement [OFD] + placebo), Group 2 (OFD + ABG + PRF), and Group 3 (OFD + ABG + PRF + 1.2 mg RSV). Relative attachment level (RAL) and probing pocket depth (PPD) were recorded at baseline, 3, 6, and 9 months. Radiographic measurements such as defect height (A and B) and defect width (C) were calculated at baseline and 9 months. Statistical Analysis Used: Intergroup comparison was done using Kruskal-Wallis ANOVA. An intragroup comparison was done using Friedman test and Wilcoxon signed-rank test. Results: The mean PPD reduction and mean RAL gain were highly significant in Group 3 and Group 2 than Group 1. For Group 3, a significant reduction of defect height and width and a significant amount of bone fill were achieved than Group 2 and Group 1. Conclusions: Addition of 1.2 mg RSV gel, PRF, and ABG has synergistic effects, explaining their role as a regenerative material in the treatment of intrabony defects.

Clinical efficacy of amino bisphosphonate on periodontal disease status in postmenopausal women: Randomized double-blind placebo-controlled trial.

OBJECTIVES: Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women. MATERIALS AND METHODS: Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months. RESULTS: A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179). CONCLUSION: Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy.

Effect of commercially available nano-hydroxy apatite containing desensitizing mouthwash on dentinal tubular occlusion: an in vitro FESEM analysis.

BACKGROUND AND AIM: Dentinal hypersensitivity is a significant clinical problem encountered in daily dental practice. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments currently available. The treatment approaches can be either home care products or professionally applied desensitizing agents. The present in-vitro study was designed to investigate the dentinal tubule occluding ability of commercially available nano HA containing mouthwash using FESEM analysis. METHODS: In the present in vitro study, 15 human premolars and canines were taken and sectioned mesiodistally. A total of 30 dentinal samples were obtained. All the dentinal discs were etched with 6% citric acid for 2 minutes. The treated samples were washed thoroughly with distilled water for 30 seconds. Samples were divided in two groups of 15 each. The specimens in Group I were shaken vigorously in the Vitis Sensitive mouthwash for 2 min twice daily for 14 days. After this intervention samples were placed in distilled water. Group II specimens were immersed in distilled water. Samples were subjected to FESEM to analyze for tubular occlusion. RESULTS: In group I nearly complete dentinal surface occlusion was present on the 7th and 14th day and precipitates were seen covering a large part of the dentinal surface. In group II no dentinal tubular occlusion was observed. CONCLUSION: The results of the present study support the ability of nHA containing Vitis sensitive mouthwash to occlude the dentinal tubules and thus it may demonstrate a significant reduction in dentinal hypersensitivity when used clinically.

Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient.

A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India.

Effect of gallium-arsenic laser on photosensitized periodontopathic anaerobic organisms: An in vitro study.

BACKGROUND: The mainstay of periodontal therapy is mechanical removal of subgingival plaque. There is considerable interest in supplementing it with the use of antibiotics and antiseptics. Many drawbacks are associated with these adjunctive pharmacological regimens such as development of resistance to antibiotics and disruption of microflora of the gastrointestinal tract. Hence, alternate means of killing subgingival bacteria are clearly desirable. One such method is the use of laser. AIM: This study aimed to investigate antibacterial capabilities of gallium-arsenic (Ga-As) laser on photosensitized periodontopathic organisms. The three bacteria selected for the study were Porphyromonas gingivalis, Fusobacterium nucleatum, and Prevotella intermedia. SETTINGS: The subjects for the study were selected from the patients visiting the Department of Periodontics, Karnataka Lingayat Education Society's Institute of Dental Sciences, Belgaum. DESIGN: In vitro study design. MATERIALS AND METHODS: Subgingival plaque samples collected from chronic periodontitis patients were cultured anaerobically for 72 h. Predetermined number of colonies of each bacterium was taken and was then divided into cases and control groups. Both groups were photosensitized using toluidine blue O (TBO) dye and the case groups were irradiated with Ga-As laser. Bacterial colonies were then serially diluted and were incubated for subculture. After incubation period, the number of viable bacterial count was performed. STATISTICAL ANALYSIS: Wilcoxon-signed rank test was carried out to determine significance of reduction on subsequent dilution within the bacterial group. Mann-Whitney U-test was performed to determine the significance of reduction between cases and control of particular bacterial group. RESULTS: The results revealed substantial reduction in the viable bacterial count. F. nucleatum was found to be most sensitive to killing by laser irradiation followed by P. intermedia and then P. gingivalis. Further, the TBO dye per se did not have any significant bactericidal effect. CONCLUSION: Photodynamic Therapy may prove to be a promising method for eradicating periodontopathic bacteria in near future.

Drug induced gingival overgrowth: a rare case report.

Gingival overgrowth is well documented side effect associated with three major classes of drugs viz, anticonvulsants, calcium channel blockers, and immunosuppressants. Despite our greater understanding of pathogenesis of Drug induced Gingival Overgrowth (DIGO), its treatment still remains a challenge for the periodontists and treatment is still largely limited to maintenance of improved level of oral hygiene and surgical removal of overgrown tissue. Dental Surgeons need to discuss this issue with their medical colleagues and to practice care while prescribing the drugs associated with gingival overgrowth. The aim of present article is to report a rare case where even after extraction of all teeth; the enlargement did not subsided for one month.

Efficacy and acceptability of 0.074% diclofenac-containing mouthwash after periodontal surgery: a clinical study.

BACKGROUND: The systemic use of non-steroidal anti-inflammatory drugs are associated with various side-effects like hepatotoxicity, blood dyscrasias, nephrotoxicity and gastric irritability. Among these, gastric irritability is the most common and the most important one, which should be taken care of. Therefore, it may be preferable to use a local formulation such as a mouthwash to treat the inflammatory conditions of the oral cavity. AIM: To determine the efficacy and acceptability of 0.074% diclofenac mouthwash in relieving pain and inflammation of post-periodontal surgery patients. MATERIALS AND METHODS: The study was designed as a double-blind, placebo-controlled clinical trial. Twenty chronic periodontitis patients who were scheduled for full-mouth periodontal flap surgery were randomized to receive either diclofenac mouthwash or placebo to rinse with 15 ml of solution daily for a period of 7 days. Modified gingival index (Lobene 1986) was used to verify gingival inflammation and visual analog scale was used to assess pain. After the baseline measurements for all the parameters were recorded, spontaneous pain and burning were evaluated daily while redness and edema were recorded on the 3 rd and 7 th day from the day of treatment. RESULTS: Data obtained were analyzed statistically using paired " t" test for intragroup comparison and unpaired " t"-test for intergroup comparison. Spontaneous pain was significantly reduced by diclofenac mouthwash. Other parameters, i.e. gingival inflammation and swelling, had not shown significant reduction in scores in either group, although the reduction was higher in the test group. CONCLUSION: The new 0.074% diclofenac mouthwash is an effective and tolerable medicinal product for post-surgical symptomatic relief.

Partial expression of Papillon-Lefèvre Syndrome.

Papillon- Lefèvre Syndrome (PLS) is a rare autosomal recessive trait, which is transmitted with an estimated frequency of one to four per million individuals. It is characterized by palmar plantar keratosis and severe early-onset periodontitis affecting both deciduous and permanent dentition. In this report, we present clinical, microbiological and leukocyte function test findings of a thirty-five year-old patient with symptoms typical of Papillon-Lefèvre Syndrome except for premature loss of deciduous and permanent dentition. The patient exhibited palmar plantar keratosis and an isolated, moderately deep periodontal pocket in the third quadrant. No anaerobic bacteria were isolated from the plaque culture. The neutrophil function test revealed defective chemotaxis and phagocytosis while intracellular killing and respiratory burst were normal.