Clinical Effects of Subgingivally Delivered Achyranthes Aspera Gel in Chronic Periodontitis: A Clinical and Microbiological Study.

Introduction: Periodontitis is an inflammatory disease of microbial origin. Local drug delivery agents help reduce subgingival microflora. Achyranthes aspera is a medicinal herb with antimicrobial, antioxidant, anti-inflammatory, and wound-healing properties. Materials and Methods: A split-mouth study was conducted, in which 60 sites were included. Clinical parameters included measurements of probing depth (PD), gingival index, and clinical attachment level (CAL). Gingival crevicular fluid (GCF) samples were collected, followed by microbiological analysis of Porphyromonas Gingivalis. Clinical and microbiological parameters were recorded at baseline and after 3 months. Statistical analysis was done using the Statistical Package of Social Science (SPSS Version 22; Chicago Inc., USA). Result: At 3 months, Group A resulted in greater mean reductions in clinical parameters: PD (3.77) as compared to Group B (5.23), and also greater mean CAL gain (3.18) in group A as compared to Group B (5.16). Group A also showed a significant reduction in the number of sites harboring periodontopathogens as compared to Group B. Conclusion: A. aspera gel can be used as a nonsurgical local drug delivery agent in patients with chronic periodontitis as an effective adjunct to SRP.

Clinical effectiveness of indocyanine green mediated antimicrobial photodynamic therapy as an adjunct to scaling root planing in treatment of chronic periodontitis- A randomized controlled clinical trial.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) along with scaling and root planing has been studied for treatment of periodontitis. Various photosensitizers have been utilized for the same. The present study was conducted to assess the clinical efficacy of indocyanine green (ICG), a photosensitizer with better tissue absorption and low toxicity, as an aPDT adjuvant to scaling and root planing (SRP). METHOD: In the present split-mouth clinical study 29 patients suffering from chronic generalized periodontitis were enrolled. The test and control quadrant were randomly allocated, control quadrant was treated with scaling and root planing alone, while the test group received an adjunctive therapy in the form of ICG, mediated aPDT along with SRP. Clinical parameters such a plaque index (PI), modified sulcular bleeding index (mSBI), periodontal probing depth (PPD) and clinical attachment level(CAL)were recorded at baseline and 3 months. RESULT: It was observed that there was a significant reduction in PI and mSBI from baseline to 3 months in both the groups, although, the intergroup comparison for both parameters yielded a non-significant result. Whereas a significant improvement in PPD and CAL in ICG group were recorded during the intergroup comparison between test and control group from baseline to 3 months CONCLUSION: Within the limits of the present study it can be concluded that ICG mediated PDT when used as an adjunct improved the effectiveness of SRP.

Clinical assessment of interdental papilla competency parameters in the esthetic zone.

BACKGROUND: Interdental papilla occupies the space between two adjacent teeth. Its contour and health are regarded with utmost importance in esthetic dental therapy. The loss of papillary height can result in open gingival embrasures, phonetic problems, food impaction, and esthetic concerns: therefore in order to prevent its loss and to better understand the challenges of regenerating the lost gingival papillae, it is crucial to recognize the factors that influence papilla form. AIM: The purpose of this study is to evaluate various factors associated with the fill of interdental spaces by gingival papillae MATERIAL AND METHODS: 150 interdental papillae in 30 patients were assessed with clinical and study models. Papilla score (PS), tooth form/shape, gingival thickness, crest bone height, facio lingual thickness and gingival angle were recorded. RESULTS: In the study it was observed that complete papilla fill was associated with bone crest-contact point distance ≤ 5 mm and crown width: length ≥0.88 while interproximal gingival tissue thickness and gingival angle were significantly higher in competent as compared to incompetent papilla group. CONCLUSION: Interdental papillae appearance was associated significantly with tooth form/shape (CW/CL), crestal bone height, gingival thickness and gingival angle. CLINICAL SIGNIFICANCE: Presence of appropriately positioned interdental papillae in the anterior dentition is essential. Its deficiency leads to complex esthetic and functional problems while its reconstruction poses a formidable challenge. Thus a prior understanding of the various factors that affect its integrity in the anterior region allows for better management of the papillae leading to a more predictable outcome.

Clinical and radiographic evaluation of human periodontal osseous defect (mandibular grade II furcation) treated with PepGen P-15 and a bioresorbable membrane (Atrisorb).

BACKGROUND: The various treatment modalities available to treat furcation involvement either maintain the existing furcation or increases access to furcation or leads to elimination of furcation (root resection, bicuspidization etc). Newer treatment modalities include regenerative procedures like placement of bone graft and organic or synthetic membranes. In this study we have evaluated the use of a new xenograft based tissue engineered bone material which provides both the inorganic and organic component; individually and in conjunction with a synthetic bioresorbable material. MATERIALS AND METHODS: 6 patients with 18 mandibular grade 2 furcations were selected after the completion of initial phase in all the patients. Selected sites were divided into control and experimental groups randomly and were treated by split mouth design. The control sites were treated with flap debridement and placement of ABM graft, whereas the experimental site received flap debridement, ABM graft and a synthetic bioresorbable membrane. RESULTS: All the parameters recorded showed significant reduction from baseline to 9 months in both the experimental and control group. When compared in between the control and experimental group, all the parameters showed marginally better results in the control group, although none of them were clinically significant. CONCLUSION: The results of this study suggest that the use of ABM along with a bioresorbable membrane and without membrane is both beneficial for the treatment of grade 2 furcation. On the cost benefit basis, the bone graft alone seems to be a better choice for regenerative treatment of furcation involvement.