Boric acid gel as local drug delivery in the treatment of class II furcation defects in chronic periodontitis: a randomized, controlled clinical trial.

AIM: Boric acid (BA) exhibits antibacterial, anti-inflammatory, as well as osteoblastic, activity. The aim of the present study was to explore the efficacy of 0.75% BA gel as a local drug-delivery system in adjunct to scaling and root planing (SRP) for the treatment of class II furcation defects in comparison with placebo gel. METHODS: A total of 48 mandibular class II furcation defects were randomized and treated with either 0.75% BA gel or placebo gel. Clinical parameters were recorded at baseline, 3 months, and 6 months, while radiographic parameters were recorded at baseline and 6 months. RESULTS: Greater mean probing depth reduction and mean relative vertical and horizontal clinical attachment level gain were shown to be greater in group 1 than in group 2 at 3 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in group 1 (16.98%±1.03%) than in the placebo (2.86%±0.92%) at 6 months. CONCLUSION: The .75% BA group showed significant improvement in clinical parameters compared to placebo gel as an adjunct to SRP. This implies an alternative for treatment of class II furcation.

Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers.

OBJECTIVE: Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. MATERIAL AND METHODS: 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. RESULTS: Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). CONCLUSIONS: The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers

Abstract Objective Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. Material and Methods 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Results Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). Conclusions The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

Levels of lipocalin-2 in crevicular fluid and tear fluid in chronic periodontitis and obesity subjects.

AIM: Lipocalin-2, a 25 kDa secretory glycoprotein, was first found in the neutrophilic granules of humans and in mouse kidney cells. It has been shown to have an important role in inflammation. The aim of this study was to determine the levels of lipocalin-2 in gingival crevicular fluid and tear fluid in patients with obesity and chronic periodontitis. METHODS: A total of 40 subjects in the age group 25-40 years were divided into four groups based on probing depth, gingival index, clinical attachment level, body mass index, and radiographic evidence of bone loss. The groups were: nonobese healthy group; obese healthy group; nonobese chronic periodontitis group; obese chronic periodontitis group Gingival crevicular fluid and tear fluid samples were collected on the subsequent day. RESULTS: There was an increase in lipocalin-2 levels from group 1 to group 4 (with the nonobese healthy group showing the least levels and obese chronic periodontitis group showing the highest levels) in both gingival crevicular fluid and tear fluid. CONCLUSION: Lipocalin-2 may be an important inflammatory marker that may help link obesity and chronic periodontitis.

Vaspin: a new adipokine correlating the levels of crevicular fluid and tear fluid in periodontitis and obesity.

AIM: In the present study, we investigated the levels of vaspin in gingival crevicular fluid (GCF) and tear fluid in obese patients with chronic periodontitis (CP), and sought to find an association, if any. METHODS: Forty patients (20 males and 20 females) with moderate-severe CP were selected based on their clinical parameters of gingival index, probing depth (PD), clinical attachment level (CAL), bleeding on probing, body mass index (BMI), and waist circumference, and divided into four groups (n = 10/group): group 1 (healthy non-obese), group 2 (healthy obese), group 3 (non-obese with CP), and group 4 (obese with CP). GCF and tear fluid vaspin levels were estimated by enzyme-linked immunosorbent assay. RESULTS: The mean vaspin concentration both in GCF and tear fluid was greater for group 4 (1.84 ± 0.03) and (1.98 ± 0.08), followed by groups 3 (1.35 ± 0.03 and 1.50 ± 0.06), 2 (0.95 ± 0.26 and 1.27 ± 0.51), and then 1 (0.65 ± 0.02 and 0.75 ± 0.02), respectively. Mean vaspin levels correlated with BMI, CAL, and PD. The association between GCF and tear fluid vaspin concentration was also statistically significant (P < 0.001). CONCLUSION: Vaspin can be a novel biomarker connecting inflammatory marker for the systemic inflammatory response in obesity and CP.

Primary tuberculous gingival enlargement: a rare entity.

With the advent of effective drug therapy, tuberculous lesions of the oral cavity have become so rare that they are frequently forgotten. Primary gingival tuberculosis is extremely rare and usually manifests as ulcer. We report the first case of primary tuberculosis manifesting as gingival enlargement, which was the only presenting sign of tuberculosis. Diagnosis was based on histopathology (hematoxin and eosin staining), complete blood count, polymerase chain reaction assay and immunologic investigation with the detection of antibodies against Mycobacterium tuberculosis. The possibility of gingival enlargement due to drugs, leukemia, fungus and sarcoidosis was ruled out. Antituberculous therapy over 6 months was followed by surgical excision of the residual enlargement under local anesthesia. After 1-year follow-up there was no recurrence of the disease. This case emphasizes the need for dentists to include tuberculosis in the differential diagnosis of gingival enlargement so that they may play a role in its early detection.