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OBJECTIVES: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. MATERIALS AND METHODS: Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P <0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. RESULTS: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P <0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). CONCLUSION: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.
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BACKGROUND AND AIM: Reconstruction of interdental papillae (IDP) is among the most difficult periodontal therapy. Papillary recession is multifactorial, and several surgical, nonsurgical, and minimally invasive techniques have been suggested. The purpose of this study was to evaluate the clinical application of injectable hyaluronic acid (HA) gel for the reconstruction of IDP in Nordland and Tarnow's Class I and II papillary recession cases. MATERIALS AND METHODS: In the present in vivo clinical trial, 7 patients (2 males, 5 females) with 25 defects were selected. A volume of 0.2 ml HA gel was injected at the respective areas and massaged for 2-3 min. Photographs were obtained, and the assessment of the data was performed clinically (CP-GM, interproximal width [IPW]) and by Image analysis software (black triangle height [BTH], black triangle width [BTW]). Comparison of mean values was performed using the analysis of variance, followed by Post hoc Bonferroni test. Value of P ≤ 0.05 was considered statistically significant. RESULTS: Application of HA gel for the reconstruction of IDP was successful in 6 months. CP-GM, BTH, IPW, and BTW showed a statistically significant difference from baseline to 3 and 6 months interval (P = 0.01). Post hoc Bonferroni test for CP-GM, BTH, BTW, and IPW revealed a statistically significant difference from baseline to 3 months (P ≤ 0.05) and 6 months (P ≤ 0.05) and a nonsignificant difference at 3-6 months (P ≥ 0.05). CONCLUSION: Injectable HA gel is a promising minimally invasive therapy for enhancing papillary esthetics.
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CONTEXT: Major limitations of conventional radiography are overlapping and lack of 3D information. Surgical exposure, though being able to provide accurate information, provides very little time to plan-out the type of periodontal regeneration required during surgery. Cone Beam Computed Tomography (CBCT) has emerged as a feasible tool and found to be accurate. Unfortunately, in-vivo studies are still scarce. AIM: Aim of the present study was to assess the efficacy of CBCT in the detection of periodontal bony defects while determining its quantitative precision in the measurement of alveolar bone height as against the open flap debridement (OFD) procedure which is set as the gold standard. SETTING AND DESIGN: Present study is a cross-sectional study. MATERIALS AND METHODS: The present study includes patients with Chronic Periodontitis indicated for periodontal surgeries. Bone defects were measured with the help of CBCT and with William's periodontal probe during surgical intervention and compared. STATISTICAL ANALYSIS: Measurements were compared with Student's t-test; unpaired t-test & correlation were tested with Pearson's correlation coefficient test. P < 0.05 was considered statistically significant. RESULTS: The mean CBCT & surgical value of palatal/lingual & distal sites of anterior teeth showed statistically significant difference (P = 0.001). All the values for posterior teeth were statistically non-significant. CONCLUSION: Statistically CBCT & clinical measurement with OFD have similar potential of accuracy to access the bony topography but CBCT provides good accessibility to visualize the sites which are difficult to access during surgical interventions like palatal sites & the distal sites of the posterior teeth.
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INTRODUCTION: Present study was undertaken to determine the prevalence of periodontal disease in an adult population and to further characterize the extent and severity of the disease. MATERIALS AND METHODS: The study population consisted of 700 randomly selected individuals reporting to out patient department of dental college and hospital. Demographic details and lifestyle characteristics of the all the subjects were recorded and a thorough oral examination was performed. In order to evaluate the periodontal status of subjects, five indices (CAL, PD, OHI, PI and GI) were assessed and subjects having at least one site with clinical attachment loss (CAL) ≥3mm were diagnosed as having periodontitis. Further, to analyse the extent of disease, subjects having periodontitis were divided into two groups as having at least one site with CAL ≥5mm and having at least three sites with CAL ≥5mm. RESULTS: RESULTS showed that there was a high prevalence of periodontitis amongst population with almost 72% of the individuals having at least one site with CAL ≥3mm. A trend was noted in which periodontal status worsened as the age increased. Analysing the extent and severity of disease amongst the population, results revealed that almost 41% of population had at least one site with CAL ≥5mm whereas almost 21% of individuals had at least three sites with CAL ≥5mm. CONCLUSION: Present study provides with evidence of high prevalence of periodontal disease amongst the population. Importantly, this study also unveils the lack of awareness for dental health amidst the population.
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BACKGROUND: The aim of this study was to compare the effect of adrenaline on blood glucose concentration in patients with diabetes undergoing tooth extraction under local anesthesia and also to find out whether blood glucose concentration differs if local anesthetics are injected in clinical doses with and without adrenaline. METHODS: Patients included had a tooth in need of extraction, were in the 25-55 years age group, had a random blood sugar level ≤140 mg/dL and were on oral antidiabetic drugs. The 25 patients in Group A were injected with 2 mL of lignocaine hydrochloride without adrenaline (xylocaine 2%) and the other 25 patients (Group B) were injected with 2 mL lignocaine hydrochloride along with adrenaline 1:80,000. Serial blood glucose estimations were made at regular intervals of 10 min before local anesthesia and subsequently 10 and 20 min after local anesthesia. RESULTS: A statistically significant difference of the mean blood glucose concentration was noticed at three different time intervals between the two groups. CONCLUSIONS: Dental local anesthetic solutions containing adrenaline may safely be used in patients with diabetes who had taken their hypoglycemic medications preoperatively.