Evaluation of serum concentrations of hs-CRP and Hb in varying severities of chronic periodontitis.

CONTEXT: Chronic periodontitis patients exhibit elevations in serum concentrations of c-reactive protein (CRP). Also, periodontitis can potentially contribute to reduced haemoglobin (Hb) levels leading to anaemia of chronic disease (ACD). OBJECTIVE: To determine whether disease severity affect CRP and Hb levels in patients with chronic periodontitis. MATERIAL AND METHODS: Based on periodontitis severity, three groups of 50 subjects each were selected, who underwent screening for gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). Blood samples were taken to estimate the number of erythrocytes, mean corpuscular volume (MCV), packed cell volume (PCV), Hb concentration, mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), and high sensitivity C-reactive protein (hs-CRP). RESULTS: Mean hs-CRP levels of 0.796, 2.238, 2.886 were found in mild, moderate, and severe periodontitis groups respectively with significant intergroup differences. The differences in haematological parameters other than MCV were not significant between groups. CONCLUSION: The possible systemic effects of periodontitis might be influenced by its severity, as evidenced by a corresponding change in the levels of systemic inflammatory markers like CRP.

A rare case of plasma cell mucositis in a young patient.

Plasma cell mucositis (PCM) is a rare benign proliferative disorder affecting various mucosal surfaces usually seen in elderly patients. In the present case, a 13-year-old young boy reported with the complaint of swollen upper lip and enlarged gums in relation to upper front teeth. The diagnosis of plasma cell mucositis is complex and frequently requires histopathological examination and immunohistochemistry. Management included conventional gingivectomy and intralesional steroid. Regular follow-up of PCM is essential based on the possibility of recurrence, the potential involvement of other mucosal surfaces and unknown potential for malignant transformation.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study.

INTRODUCTION: The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. AIM: To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. STUDY AND DESIGN: Department of Periodontics. Randomized clinical trial with split mouth design. MATERIALS AND METHODS: Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. STATISTICAL ANALYSIS: Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. RESULTS: Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. CONCLUSION: Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis.

Management of Chronic Periodontitis Using Subgingival Irrigation of Ozonized Water: A Clinical and Microbiological Study.

INTRODUCTION: Adjunctive use of professional subgingival irrigation with scaling and root planing (SRP) has been found to be beneficial in eradicating the residual microorganisms in the pocket. OBJECTIVE: To evaluate the effect of ozonized water subgingival irrigation on microbiologic parameters and clinical parameters namely Gingival index, probing pocket depth, and clinical attachment level. MATERIALS AND METHODS: Thirty chronic periodontitis patients with probing pocket depth ≥6mm on at least one tooth on contra lateral sides of opposite arches were included in the study. The test sites were subjected to ozonized water subgingival irrigation with subgingival irrigation device fitted with a modified subgingival tip. Control sites were subjected to scaling and root planing only. The following clinical parameters were recorded initially and after 4 weeks at the test sites and control sites. Plaque Index, Gingival Index, probing pocket depth, clinical attachment level. Microbiologic sampling was done for the test at the baseline, after scaling, immediately after ozonized water subgingival irrigation and after 4 weeks. In control sites microbiologic sampling was done at the baseline, after scaling and after 4 weeks. The following observations were made after 4 weeks. The results were statistically analysed using independent t-test and paired t-test. RESULT: Test sites showed a greater reduction in pocket depth and gain in clinical attachment compared to control sites. The total anaerobic counts were significantly reduced by ozonized water subgingival irrigation along with SRP compared to SRP alone. CONCLUSION: Ozonized water subgingival irrigation can improve the clinical and microbiological parameters in patients with chronic periodontitis when used as an adjunct to scaling and root planing.

Comparative evaluation of subgingival plaque microflora in pregnant and non-pregnant women: A clinical and microbiologic study.

CONTEXT: Gingival changes in pregnancy have been attributed to changes in the subgingival biofilm related to hormonal variations. AIMS: To evaluate the subgingival plaque microflora in pregnant and nonpregnant women to determine if pregnancy induces any alterations in the subgingival plaque and to associate these changes with changes in periodontal status. SETTINGS AND DESIGN: Thirty pregnant and 10 nonpregnant women within the age group of 20-35 years having a probing pocket depth (PPD) of 3-4 mm were included in the study. The pregnant women were equally divided into 3 groups of 10, each belonging to I, II, and III trimester. MATERIALS AND METHODS: Plaque index, gingival index, PPD, and microbiologic evaluation for specific bacterial counts for Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, and Fusobacterium nucleatum were carried out for all subjects. STATISTICAL ANALYSIS: Mann-Whitney U test. RESULTS: Increase in gingival inflammation was observed in II and III trimester as compared with I trimester and control. Plaque scores did not show any significant difference between pregnant and nonpregnant women. Specific bacterial examination revealed an increase in proportion of P. intermedia in pregnant women of both II and III trimester as compared with I trimester and nonpregnant women. CONCLUSIONS: A definite increase in proportions of P. intermedia occurs in subgingival plaque microflora in pregnancy that may be responsible for the exaggerated gingival response.