Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade-II Furcation Defects: A Quasi-Experimental Study

ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.

Metastasis in Sinonasal Region Revealing a Silent Primary: A Series of 2 Cases with Review of Literature.

Metastasis to the nasal cavity and paranasal sinuses are very rare and only few cases have been reported so far. Metastatic nasal mass with silent primary renal cell carcinoma (RCC) is even rarer. So are giant cell tumors which rarely affects soft tissues whether superficial or deep. These rarely occur in nasal cavity. We would like to discuss 2 cases-one being a 74 year old female with a solitary asymptomatic extensive metastatic lesion in sinonasal area of silent primary renal cell carcinoma and other being a 38 year old female multiple lytic expansile lesions in facial and skull bones who was previously treated for giant cell tumor of long bone-tibia. We aim to bring their occurrence to notice as they are rare, to highlight importance of these tumors in differential diagnosis of sinonasal masses and treatment options for the same.

The Expression of B7-H3 Molecule in Periodontal Disease.

STATEMENT OF THE PROBLEM: T cells have been shown to play a role in the etiopathogenesis of periodontal disease. B7-H3, a costimulatory molecule, is found to be associated with regulation of T cell function in some tumoral tissues, as well as autoimmune and inflammatory diseases. PURPOSE: The aim of this study was to investigate the expression of B7-H3 molecule in healthy and diseased gingival tissue samples. MATERIALS AND METHOD: Gingival samples were taken from 2 groups (A and B) representing periodontal health and periodontal disease, respectively. These were paraffinized and processed to carry out immunostaining to identify B7-H3 expression. The slides were then examined under light microscope to assess the positive staining in epithelium and connective tissue. The intensity of positive staining in epithelium and the number of positive cells in the connective tissue were evaluated. Statistical analysis was done using kappa analysis and independent t-test. RESULTS: Kappa analysis revealed good inter-examiner agreement for both the groups (group A: 0.718; group B: 0.797). Intensity of staining in the epithelium ranged from intense to moderate for both the groups. In the connective tissue, there was a statistically insignificant decrease (p value= 0.415) in the number of positive cells from group A (mean labeling index: 50.28±26.09) to group B (mean labeling index= 41.37±25.29). CONCLUSION: B7-H3 molecule has been found to be expressed in gingival tissue samples; however, it showed a statistically insignificant decrease in periodontal disease group compared to healthy group.

Plasma cell leukemia with pleomorphic plasma cells--a case report.

A case of plasma cell leukemia showing mostly pleomorphic plasma cells in the form of convoluted and multilobated nuclei with some having bilobed nuclei and internuclear bridges is being reported for its rarity of occurrence. Patient presented with congestive cardiac failure and features of nephropathy. There were no lytic lesions in the bone. Serum electrophoresis did not show any M-band while urine electrophoresis demonstrated Bence Jones protein confirming a light chain only type of myeloma. Patient is in remission 5 months after diagnosis. The significance of recognising such pleomorphic plasma cells is discussed.