Root coverage with the restoration of non-carious cervical lesions: A systematic review and meta-analysis.

The progression of non-carious cervical lesions (NCCLs) leads to gingival recession (GR), which is restored with restorative materials, using different periodontal plastic surgery procedures. There is no consensus on which technique is superior to others. Therefore, the present systematic review aimed to assess the effectiveness of root coverage (RC) procedures in the restored and unrestored NCCLs in terms of clinical and patient-centered outcomes.We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) while searching 5 databases in addition to the gray literature. The Medical Subject Headings (MeSH) terms and keywords in the title and abstract fields, as well as in headings, were used to search the existing literature for the relevant publications on the effectiveness of RC procedures with the restoration of NCCLs over the past 3 decades (January 1990-July 2021). After applying the inclusion and exclusion criteria, 13 articles were read in full and critically analyzed. The quality analysis was performed using the Cochrane RevMan software.A total of 222 potentially relevant titles and abstracts were found after the initial electronic and manual search, and after removing duplicates. Applying the inclusion and exclusion criteria yielded 23 publications that were further analyzed for relevance and applicability. Following critical analysis, 13 publications were used for validity assessment and data extraction.In the teeth with NCCLs and GR, the restoration of NCCLs does not affect the percentage RC. However, it significantly decreases dentin hypersensitivity, and the patients' perception of esthetics and satisfaction.

Characterization of oleosin genes from forage sorghum in Arabidopsis and yeast reveals their role in storage lipid stability.

MAIN CONCLUSION: Overexpression of forage sorghum oleosin genes in Arabidopsis oleosin-deficient mutant and yeast showed increased germination rate, triacylglycerol content, and protection against lipase-mediated TAG degradation. Plant lipids are an important source of ration for cattle or other livestock animals to fulfil their energy needs. Poor energy containing green forages are still one of the major sources of food for livestock animals, leaving the animals undernourished. This lowers the milk and meat production efficiency, thereby affecting human consumption. Oleosin, an essential oil body surface protein, is capable of enhancing and stabilizing the lipid content in plants. We identified and functionally characterized three forage sorghum oleosin genes (SbOle1, SbOle2, and SbOle3) in Arabidopsis and yeast. Phylogenetic analysis of SbOle proteins showed a close relationship with rice and maize oleosins. Expression analysis of SbOle genes determined a higher expression pattern in embryo followed by endosperm, while its expression in the non-seed tissues remained negligible. Overexpression of SbOle genes in Arabidopsis ole1-deficient mutants showed restoration of normal germination whereas control mutant seeds showed lower germination rates. Heterologous overexpression of SbOle in yeast cells resulted in increased TAG accumulation. Additionally, the TAG turnover assay showed the effectiveness of SbOle genes in reducing the yeast endogenous and rumen bacterial lipase-mediated TAG degradation. Taken together, our findings not only provide insights into forage sorghum oleosin for increasing the energy content in non-seed organs but also opened up the direction towards implication of oleosin in rumen protection of fodders.

Efficacy of microsurgery in treatment of localized or multiple gingival recession: A systematic review.

OBJECTIVE: To address the clinical question whether microsurgery hold an advantage in terms of clinical and patient oriented outcome over conventional macrosurgical procedures in the treatment of gingival recession. MATERIAL AND METHODS: A Literature search on MEDLINE, SCOPUS, EMBASE (Excerpta Medica Database) via Ovid and Cochrane library was conducted in order to investigate clinical studies on efficacy of microsurgery in the treatment of localized or multiple gingival recession as compared to conventional macrosurgical procedures. Publications before May 2020 and grey literature was searched without any language restrictions. Primary outcome considered was change in recession depth and mean root coverage. Whereas, change in clinical attachment level, Change in keratinized tissue, patient oriented outcome like esthetics, pain and discomfort were the secondary outcome. Based on inclusion criteria ten studies were included in systematic review. Data was extracted and analyzed. RESULTS AND CONCLUSION: All the included studies showed improvement in the mean percentage of root coverage or mean root coverage (primary outcome) when microsurgical approach was used. Predictability of complete root coverage is better with microsurgical instrumentation but results are not statistically significant. As far as patient centered outcome is concerned, there is no evidence for recommendation of microsurgery.

Functional characterization of two type-1 diacylglycerol acyltransferase (DGAT1) genes from rice (Oryza sativa) embryo restoring the triacylglycerol accumulation in yeast.

KEY MESSAGE: Two OsDGAT1 genes showed the ability to restore TAG and LB synthesis in yeast H1246. Alterations in the N-terminal region of OsDGAT1-1 gene revealed its regulatory role in gene function. Accumulation of triacylglycerol (TAG) or oil in vegetative tissues has emerged as a promising approach to meet the global needs of food, feed, and fuel. Rice (Oryza sativa) has been recognized as an important cereal crop containing nutritional rice bran oil with high economic value for renewable energy production. To identify the key component involved in storage lipid biosynthesis, two type-1 diacylglycerol acyltransferases (DGAT1) from rice were characterized for its in vivo function in the H1246 (dga1, lro1, are1 and are2) yeast quadruple mutant. The ectopic expression of rice DGAT1 (designated as OsDGAT1-1 and OsDGAT1-2) genes restored the capability of TAG synthesis and lipid body (LB) formation in H1246. OsDGAT1-1 showed nearly equal substrate preferences to C16:0-CoA and 18:1-CoA whereas OsDGAT1-2 displayed substrate selectivity for C16:0-CoA over 18:1-CoA, indicating that these enzymes have contrasting substrate specificities. In parallel, we have identified the intrinsically disordered region (IDR) at the N-terminal domains of OsDGAT1 proteins. The regulatory role of the N-terminal domain was dissected. Single point mutations at the phosphorylation sites and truncations of the N-terminal region highlighted reduced lipid accumulation capabilities among different OsDGAT1-1 variants.

Identification and functional characterization of two acyl CoA:diacylglycerol acyltransferase 1 (DGAT1) genes from forage sorghum (Sorghum bicolor) embryo.

Elevating the lipid content in high-biomass forage crops has emerged as a new research platform for increasing energy density and improving livestock production efficiency associated with improved human health beneficial meat and milk quality. To gain insights of triacylglycerol (TAG) biosynthesis in forage sorghum, two type-1 diacylglycerol acyltransferase (designated as SbDGAT1-1 and SbDGAT1-2) were characterized for its in vivo function. SbDGAT1-2 is more abundantly expressed in embryo and bran during the early stage of the grain development in comparison to SbDGAT1-1. Heterologous expression of SbDGAT1 genes in TAG deficient H1246 strain restored the TAG accumulation capability with high substrate predilection towards 16:0, 16:1 and 18:1 fatty acids (FA). In parallel, we have identified N-terminal intrinsically disordered region (IDR) in SbDGAT1 proteins. To test the efficacy of the N-terminal region, truncated variants of SbDGAT1-1 (designated as SbDGAT1-1(39-515) and SbDGAT1-1(89-515)) were generated and expressed in yeast H1246 strain. Deletion in the N-terminal region resulted in decreased accumulation of TAG and FA (16:0 and 18:0) when compared to the SbDGAT1-1 variant expressed in yeast H1246 strain. The present study provides significant insight in forage sorghum DGAT1 gene function, useful for enhancing the green-forage TAG content through metabolic engineering.

Free Gingival Graft as a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects.

BACKGROUND: Gingival recession is a frequent issue encountered by both the clinician and the patient. This study was aimed to assess the predictability of the free gingival graft as a single step procedure in terms of root coverage and aesthetics in Miller Class I and II mandibular gingival recession. METHODS: Ten patients (4 males, 6 females) aged 25-30 years with a total of 12 mandibular sites having Miller class I and II recession were selected. All recession sites were treated with single step free gingival graft procedure. Clinical parameters like recession depth, recession width, width of attached gingiva, probing depth and clinical attachment level were recorded at baseline, 6 and 9 months. Visual analog score at 1, 6 and 9 months postoperatively was provided. RESULTS: There was a reduction in mean recession depth from 3.66±1.20 to 0.91±0.99 mm suggesting coverage of 82% over a period of 9 months. There was statistically significant gain in clinical attachment level and width of attached gingiva. Aesthetically, it was acceptable by patients as measured by visual analog scores. CONCLUSION: Free gingival graft as a single step procedure is acceptable in terms of root coverage and aesthetics.

Congenital Double Lip: A Rare Deformity Treated Surgically.

Lip is an important aspect of facial features affecting ones personality. A deformity of the lip characterized by excessive tissue sagging below the usual giving it thicker wider appearance is referred to as double lip. It is a rare occurrence with a proposed male predilection. This article is a report of a 20 years old male with this deformity who presented with the complaint of difficult speech and poor aesthetics. There was no other history patient being systemically healthy. It was successively treated with a simple surgical technique without recurrence over a period of 12 months.

Effect of low-level laser therapy on wound healing after depigmentation procedure: A clinical study.

AIM: The aim of the present study is to evaluate and compare the effects of low-level laser therapy (LLLT) on wound healing after depigmentation procedure. MATERIALS AND METHODS: In this study, 12 patients with bilateral melanin hyperpigmentation were treated with surgical stripping using a blade. After completion of the surgical process and bleeding stasis, any of the symmetrical surgical sites was randomly assigned for LLLT (test site) using a defocused diode laser at 1 mm distance for 5 min. After every laser exposure, the surgical site was coated with plaque disclosing solution (erythrosine) on the 3(rd), 7(th), and 15(th) day. A photograph of the surgical site was taken using a Digital SLR Camera, which was placed at 30 cm distance at 55 mm zoom, 1/100 shutter speed, f 14 aperture size, and ISO 4000 with a ring flash. The area of the stained parts of the photographs was evaluated using image analysis software. RESULTS: At day 3, test site showed 1.26 ± 0.23 mm(2) and control site showed 1.45 ± 0.21 mm(2) stain uptake by the tissue which was statistically significant. At day 7 and day 15, the test sites exhibited 1.24 ± 0.30 mm(2) and 1.12 ± 0.25 mm(2) stain uptake, whereas the control site showed 1.37 ± 25 mm(2) and 1.29 ± 0.28 mm(2) staining, respectively, which were not statistically significant. CONCLUSION: Within the limitations of this study, the findings revealed that LLLT promotes wound healing after depigmentation procedure until the 3(rd) day. On the 7(th) and 15(th) day, the difference in healing was not statistically significant.

Effect of Antimicrobial Photodynamic Therapy as an Adjunct to Nonsurgical Treatment of Deep Periodontal Pockets: A Clinical Study.

Introduction: Deep periodontal pockets pose a great challenge for nonsurgical periodontal treatment. Scaling and root planing (SRP) alone may not suffice in cases where surgical therapy cannot be undertaken. Various recent studies have suggested the use of antimicrobial Photodynamic Therapy (aPDT) for the management of periodontal infections. The aim of this study was to evaluate the effects of using aPDT along with SRP, compared to SRP alone for the management of deep periodontal pockets. Methods: Thirty patients with chronic periodontitis, who met the criteria of having periodontal pockets with depth ≥ 6 mm and bleeding on probing (BOP) in at least 2 different quadrants were included. After SRP, one quadrant was randomly selected for aPDT (test), while another served as control. Clinical parameters i.e. plaque index (PI), modified sulcular bleeding index (mSBI), probing depth (PD) and clinical attachment level (CAL) were measured at baseline, 1 month and 3 months post-treatment intervals. Results: All clinical parameters significantly improved in both groups after 1 and 3 months. At 1-month interval, inter-group difference in mean change was statistically significant (P < 0.05) in terms of mSBI (0.85 ± 0.41in test vs 0.54 ± 0.47 in control group) and PD (1.77±0.86 in test vs 1.3 ± 0.95 in control group). At 3 months interval, no statistically significant difference was observed between test and control groups except in terms of mSBI (0.97 ± 0.45 in test vs 0.73 ± 0.42 in control group). Conclusion: aPDT appears to play an additional role in reduction of gingival inflammation when used along with nonsurgical mechanical debridement of deep periodontal pockets.

Er, Cr:YSGG laser for the treatment of ankyloglossia.

Ankyloglossia or tongue-tie is the result of a short and tight lingual frenum causing difficulty in speech, feeding problems in infants due to the limitation of tongue movement. This report presents a case of a 22-year-old female with tongue-tie who complained of difficulty in speech following which she underwent frenectomy procedure with erbium, chromium: yattrium-scandium-gallium-garnet laser without any complications. She was referred to the speech therapist after the procedure.

Diode laser for excisional biopsy of peripheral ossifying fibroma.

Peripheral Ossifying Fibroma is one of the commonest occurring reactive lesions on gingiva. It is associated with local irritational factors and often interferes with speech, mastication and maintenance of oral hygiene, in addition to being aesthetically unpleasant. It is usually treated with surgical excision using scalpel and removal of irritational factors, often resulting in mucogingival defect. Other modalities such as radiosurgery and electrocautery have also been used for its management, but they cause changes in microarchitecture of biopsy specimen, altering the histologic picture for true diagnosis. We are presenting a case of excisional biopsy of this lesion in an adult female using a diode laser with excellent post-operative results, without affecting microarchitecture of biopsy specimen. The patient is being followed for last 1 year and no sign of recurrence has been found. A diode laser may offer a good alternative modality for management of such cases.

Achondroplasia and periodontal disease.

Achondroplasia is a non-lethal form of chondrodysplasia. It is a disturbance of endochondral bone formation which results in characteristic dwarfism. It is transmitted as an autosomal dominant trait, with complete penetrance. De novo mutations cause up to 90% of cases. The mutation rate is estimated to be 0.000014 per gamete per generation. It is a rare disorder with a prevalence of 1:10,000 to 1:50,000 births worldwide. A young female patient suffering from achondroplasia reported with oral manifestations showing features of periodontitis, hypoplasia of the mid-face, deep periodontal pockets, and mobility of teeth. This case report highlights this rare anomaly and its oral manifestations.

Evaluation of ß-tricalcium phosphate in human infrabony periodontal osseous defects: a clinical study.

OBJECTIVE: To evaluate the efficacy of ß-tricalcium phosphate (ß-TCP) (Synthograft, Bicon USA) in periodontal osseous defects in comparison to open flap debridement (OFD). METHOD AND MATERIALS: Twelve patients showing clinical and radiographic evidence of almost identical bilateral infrabony defects were selected. The infrabony defects in the 12 patients were treated with OFD+ß-TCP on one side and OFD on the other side. Clinical evaluation was performed at baseline and 6 months following therapy. RESULTS: No differences in probing depth (PD) reduction or clinical attachment level (CAL) gain were observed, although a statistically significant difference was observed for the defect fill between the two groups. Six months after therapy, sites treated with OFD+ß-TCP showed a reduction in mean PD from 9.67 ± 2.35 mm to 4.00 ± 1.60 mm (P < .05), a change in mean CAL from 9.92 ± 3.15 mm to 5.00 ± 3.86 mm (P < .05), and the mean defect fill was 2.92 ± 0.90 mm. In the sites treated with only OFD, the mean PD was reduced from 7.58 ± 1.08 mm to 2.67 ± 0.65 mm (P < .05), the mean CAL changed from 6.83 ± 1.34 mm to 1.83 ± 1.64 mm (P < .05), and the mean defect fill was 0.83 ± 0.39 mm. Reduction of 5 mm in PD was observed in 5 of the 12 defects (42%); 4 of the 12 defects (33%) gained 3 mm of CAL in the test sites. PD reductions and CAL gains of 3 to 6 mm were measured in the majority of the cases (60% to 75%) regardless of treatment modality. CONCLUSION: Within the constraints of this study, both therapies resulted in significant PD reductions and CAL gains 6 months after surgery. Sites treated with OFD+ß-TCP showed a significant defect fill compared to those treated with OFD alone.