Immediate Ridge Augmentation Using Autogenous Tooth Root as a Block Graft in a Periodontally Hopeless Extraction Site: A Pilot Study.

The aim of the our study was to assess the efficacy of autogenous tooth root as a block bone graft in reconstructing the vertical and horizontal dimensions at periodontally hopeless extraction sites both clinically and radiographically. A total of 13 patients having a tooth with periodontally hopeless prognosis and indicated for extraction were included in the study. Following atraumatic extraction, the tooth was processed to create a decoronated cementum-free dentin block which was used to augment the extraction socket. The augmentation of periodontally hopeless socket with tooth block autograft resulted in a gain of clinical ridge width of 5.9 mm radiographically, the apico-coronal defect depth reduced up to 8.2 mm (P = .001), and a gain in ridge width of 5.8 mm postoperatively after 6 months (P = .001). The present study demonstrated the effectiveness of using tooth root as a block graft for ridge augmentation in the periodontally hopeless extraction site making it suitable for implant placement in future.

Maxillary Sinus Augmentation Using Hydraulic Pressure by Lateral Approach and Simultaneous Implant Placement: Clinicoradiographic Study.

The purpose of this study was to assess clinically and radiographically efficacy of maxillary sinus augmentation using hydraulic pressure in a lateral approach with immediate implant placement. In a total of 10 patients having less than 4 to 6 mm of subantral bone height, lateral approach sinus membrane elevation procedure was performed using hydraulic pressure with the help of a specialized water lift kit followed by grafting and simultaneous implant placement. Cone beam computed tomography analysis was used to assess the change in subantral bone height from baseline to the 6 months postoperatively. Radiographically, subantral bone height increased from 3.86 ± 1.423 mm at baseline to 15.49 ± 2.73 mm at 6 months postoperatively with a gain of 11.63 + 2.63 mm (P < 0.001). Thus, it is concluded that hydraulic pressure may be efficiently used in lateral sinus augmentation procedures along with simultaneous implant placement.

Biological activation of bone grafts using injectable platelet-rich fibrin.

Platelet-rich fibrin (PRF) is gaining acceptance as a bioactive surgical additive in regenerative dentistry. However, PRF has only been available in gel or membrane form and is not suitable for injection. Recently, however, a liquid, injectable PRF has been introduced. This paper introduces the concept of injectable PRF and discusses its applications for biologic activation of bone grafts.

An Update on the Protocols and Biologic Actions of Platelet Rich Fibrin in Dentistry.

Platelet rich fibrin (PRF) is a surgical biologic additive that is prepared by manipulation of autologous blood. It has now evolved to become one of the most widely used platelet concentrate in dentistry. It has almost replaced Platelet rich plasma (PRP) for usage owing to its advantages such as being 100% autogenous, easy technique, time and cost effectiveness, superior & prolonged growth factor release. It finds varied applications in dentistry including management of gingival recession, for guided bone regeneration in periodontal, peri-implant and endodontic bone defects. Since its inception in 2001 by Choukroun & co-workers, there has been in-depth research regarding its clinical applications, biologic actions, various technique modifications and optimizations. Several modifications of the conventional protocol like the advanced PRF, injectable PRF, PRF lysate and Titanium-prepared PRF. Hence, the aim of this article to review the biological properties of platelet rich fibrin and the advancement in the PRF technology since its inception.

Assessment of Intraobserver and Interobserver Agreement of a New Classification System for Retrograde Periimplantitis.

BACKGROUND: Retrograde periimplantitis (RPI) is the inflammatory disease that affects the apical part of an osseointegrated implant while the coronal portion of the implant sustains a normal bone-to-implant interface. The aim of the current study was to assess the intraexaminer and interexaminer reliability of a proposed new classification system for RPI. MATERIALS AND METHODS: After thorough electronic literature search, 56 intraoral periapical radiographs (IOPA) of implants with RPI were collected and were classified by 2 independent reviewers as per the new classification system into one of the 3-mild, moderate, and advanced-classes based on the amount of bone loss from the apex of the implant to the most coronal part as a percentage of the total implant length. The IOPAs were assessed twice by the same examiners and both were blinded to each other's observations. RESULTS: The intraobserver agreement ranged from 0.85 to 0.91, which falls under the category of almost perfect agreement. The interexaminer agreement was found to be 0.83, also considered as almost perfect agreement. CONCLUSION: The proposed classification shows good intraexaminer and interexaminer reliability and can be used for treatment planning and prognosis in cases of RPI.

A Radiographic Classification for Retrograde Peri-implantitis.

BACKGROUND: Retrograde peri-implantitis (RPI) is an inflammatory disease that affects the apical part of an osseointegrated implant, while the coronal portion of the implant sustains a normal bone-to-implant interface. It is a diagnostic and therapeutic dilemma for implantologists. There is lack of a standard classification system and a definite treatment algorithm for the same. This article aims to introduce a classification system for RPI based on the radiographic amount of bone loss around an implant apex. MATERIALS AND METHODS: A search of PubMed database was conducted with the keywords "retrograde peri-implantitis" and "implant periapical lesion." Preoperative intraoral periapical (IOPA) radiographs of implants with RPI in case reports/case series were compiled. A total of 54 lOPAs from 36 articles were compiled and were assessed. RESULTS: Three different classes were proposed. The amount of bone loss from the apex of the implant to the most coronal part of radiolucency was calculated as a percentage of the total implant length and classified into one of the three classes: Mild, moderate, and advanced. Treatment options and prognosis have been suggested for each class. CONCLUSION: The proposed classification may allow for an easy and reproducible radiographic assessment of the RPI lesion and may serve as a guideline to prognosis and treatment planning.

Titanium Corrosion: Implications For Dental Implants.

Titanium has been considered as one of the most biocompatible metals. Studies testing its corrosion resistance have proposed that the titanium oxide layer formed on the metal surface is lost under certain unavoidable conditions to which it is exposed in the oral environment. This questions its property of corrosion resistance in the oral cavity. Hence, there is a need to understand the mechanisms of corrosion, which can help in the long-term stability and function of implants. Here, we review the possible pathways of corrosion of titanium in the oral cavity, its implications and proposed methods of prevention of corrosion.

Oxidized-low density lipoprotein in gingival crevicular fluid of patients with chronic periodontitis: a possible link to atherogenesis.

OBJECTIVE: To investigate a possible link between periodontitis and atherogenesis by examining the levels of anti-oxidized low density lipoprotien (ox LDL) and low density lipoprotien (LDL) in gingival crevicular fluid (GCF) and serum of healthy subjects and chronic periodontitis patients. METHODS: Sixty male subjects (35-55 years) were grouped into 30 healthy individuals and 30 subjects with chronic periodontitis. Serum and GCF samples were obtained from each subject and were assessed for anti-ox LDL and LDL levels. RESULTS: A significant difference (p < 0.001) was found between the anti-ox-LDL levels in GCF of healthy vs chronic periodontitis groups. Also the ratio of GCF anti-ox LDL to GCF LDL was significantly higher (p < 0.001) in chronic periodontitis patients as compared to the healthy group. CONCLUSIONS: A significant rise in ox LDL level in otherwise systemically healthy chronic periodontitis patients may put these subjects at an increased risk of developing atherosclerosis.

Evaluation of the wound-healing potential of the kiwifruit extract by assessing its effects on human gingival fibroblasts and angiogenesis.

BACKGROUND: Oral surgery and surgical interventions in the field of periodontology require the uneventful wound healing of soft tissues to be successful. However, since the oral cavity is exposed to saliva and is a niche for oral microorganisms, wound healing can be delayed, causing pain and discomfort to the patient. Hence, a great deal of interest has shifted to the study of agents that can enhance wound-healing processes. OBJECTIVES: The aim of the present study was to evaluate the oral wound-healing potential of the Actinidia deliciosa (kiwifruit) extract by assessing its effects on the viability, proliferation and migration of human gingival fibroblasts, and its ability to enhance angiogenesis in the chicken chorioallantoic membrane (CAM). MATERIAL AND METHODS: The collection of the A. deliciosa extract and experimentation were carried out in the Maratha Mandal Dental College, Belgavi, India. Human gingival fibroblasts were cultured in a suitable medium and treated with 6.25 µg, 12.5 µg or 25 µg of the ethanolic kiwifruit extract. The MTT cell viability and scratch assays were then carried out in vitro. To determine the angiogenic potential of the extract, solutions of concentrations of 10 µg/mL, 50 µg/mL and 100 µg/mL were transferred to sterile Whatman™ filter paper disks, which were placed on the CAM of 5-day-old Leghorn chicken eggs. RESULTS: The ethanolic extract of A. deliciosa was not cytotoxic to gingival fibroblasts at a dosage of 6.25 µg/mL. In addition, the scratch assay demonstrated the migration of the fibroblasts and the closure of an artificially created wound within 24 h, which is similar to in vivo wound closure. The CAM assay showed that the kiwifruit extract concentrations of 10 µg/mL and 50 µg/mL showed a moderate proangiogenic effect, and a concentration of 100 µg/mL exerted a strong pro-angiogenic effect. CONCLUSIONS: The results demonstrate that the kiwifruit extract is safe to use, can enhance the proliferation and migration of human gingival fibroblasts, and promotes angiogenesis, making it a suitable oral wound-healing agent.

Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects.

Background: Several bone grafting formulations have been given clinically acceptable outcomes in treating intrabony defects. Platelet rich fibrin (PRF), an autologous platelet concentrate holds potential to be used for regenerative treatment. The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with advanced-PRF block (A PRF + i PRF + nanohydroxyapatite [nHA]) compared to nHA alone. Methods: Twenty-eight sites in chronic periodontitis patients having probing pocket depth (PPD) ≥6 mm and 3 walled intrabony defects (depth of ≥3 mm) were selected, randomly allotted into two groups: Group A was treated with A-PRF block and Group B with nHA (Sybograf™). Clinical parameters including plaque index (PI), gingival index (GI), PPD, relative attachment level (RAL) and radiographically linear and volumetric defect fill were assessed using cone beam computed tomography at baseline and 6 months postoperatively. Results: Intragroup comparison using paired t-test and intergroup comparison using unpaired t-test was done. Group A demonstrated significantly higher reduction in PPD and gain in RAL when compared to Group B (P ≤ 0.05) at the end of 6 months. Similarly gain in bone volume was greater in Group A (0.1 ± 0.05) as compared to Group B (0.04 ± 0.02) (P ≤ 0.05). Conclusion: Advanced-PRF block showed significant clinical and radiographic improvement as compared to nHA alone which depicts that, it may be an ideal graft to be used for the treatment of periodontal intrabony defects.

Periodontal probing systems: a review of available equipment.

The periodontal pocket, one of the definitive signs of periodontal disease, is the most common parameter to be assessed by dental clinicians. Periodontal probes have been the instruments most commonly used to locate and measure these pockets. Regular use of periodontal probes in routine dental practice facilitates and increases the accuracy of the process of diagnosing the condition, formulating the treatment, and predicting the outcome of therapy. Advances in the field of periodontal probing have led to the development of probes that may help reduce errors in determining this parameter used to define the state of active periodontal disease. One such advance is the emergence of probes that purportedly assess periodontal disease activity noninvasively. The selection of periodontal probe depends on the type of dental practice: a general dental practitioner would require first- or second-generation probes, while third- through fifth-generation probes generally are used in academic and research institutions as well as specialty practices.

Effect of scaling and root planing on gingival crevicular fluid levels of adrenomedullin in chronic periodontitis patients with and without diabetes mellitus type 2: A clinico-biochemical study.

Background: Increased plasma adrenomedullin levels are usually observed in certain conditions such as diabetes mellitus (DM). Aims and Objectives: To gauge adrenomedullin values in the gingival crevicular fluid (GCF) of healthy individuals, chronic periodontitis (CP) patients with and without DM, and diabetics without any periodontal involvement, prior and after periodontal therapy. Materials and Methods: A total of 120 subjects were segregated into four categories of 30 each: Group 1 (healthy subjects), Group 2 (CP without DM), Group 3 (patients with CP and DM), and Group 4 (diabetics without any periodontal involvement). GCF was collected from all the patients. Nonsurgical periodontal therapy was done in Group 2 and Group 3 patients, followed up for 6 weeks, and GCF was obtained again from the same site. Enzyme-linked immunosorbent assay was used to evaluate the samples. Results: Adrenomedullin level in the GCF was high in diabetics without any periodontal involvement than in healthy individuals and significantly elevated in those with CP and DM. Reduced adrenomedullin was noted 6 weeks postperiodontal therapy. Conclusion: Adrenomedullin levels being higher in diabetics without any periodontal involvement than healthy controls suggest a link between DM and adrenomedullin. Furthermore, infection plays a noteworthy role in the elevation of adrenomedullin, indicating its role in periodontal disease progression.

RésuméContexte: Des taux plasmatiques d'adrénomédulline accrus sont généralement observés dans certaines conditions telles que le diabète sucré. Buts et objectifs:Évaluer les valeurs de l'adrénomédulline dans le liquide creviculaire gingival (GCF) des individus sains, chroniques parodontite (PC) patients avec et sans DM, et diabétiques sans atteinte parodontale, avant et après traitement parodontal. Matériels et méthodes: Un total de 120 sujets ont été séparés en quatre catégories de 30 chacun: Groupe 1 (sujets sains), groupe 2 (CP sans DM), groupe 3 (patients avec CP et DM) et groupe 4 (diabétiques sans atteinte parodontale). GCF a été collecté de tous les patients. La thérapie parodontale non chirurgicale a été réalisée chez les patients des groupes 2 et 3, suivie pendant 6 semaines et le GCF obtenu à nouveau du même site. Un dosage immunoenzymatique a été utilisé pour évaluer les échantillons. Résultats: taux d'adrénomédulline dans le GCF était élevé chez les diabétiques sans atteinte parodontale que chez les individus sains et significativement élevés chez ceux avec CP et DM. Une réduction de l'adrénomédulline a été notée 6 semaines après la thérapie post-parodontale. Conclusion: les taux d'adrénomédulline étant plus élevés chez les diabétiques sans atteinte parodontale que les contrôles sains suggèrent un lien entre le diabète et l'adrénomédulline. De plus, l'infection joue un rôle rôle important dans l'élévation de l'adrénomédulline, indiquant son rôle dans la progression de la maladie parodontale.

A clinico-radiographic and histomorphometric analysis of alveolar ridge preservation using calcium phosphosilicate, PRF, and collagen plug.

BACKGROUND: Tooth extraction commonly leads to loss of residual alveolar ridge, thus compromising the room available for the implant placement. To combat the post-extraction alveolar loss, alveolar ridge preservation is practiced, with the advent of the biomaterial available. The purpose of this study was to assess the efficiency of calcium phosphosilicate biomaterial in alveolar ridge preservation. Twenty patients indicated for extraction were selected followed by socket grafting using calcium phosphosilicate. Implant placement was done 6 months postoperatively during which a core was harvested from the preserved sockets. Clinico-radiographic measurements of hard and soft tissues were taken at baseline and 6 months post-grafting. RESULTS: There were no significant changes in the radiographic and soft tissue parameters while significant changes in hard tissue parameters with 1.9 mm (p = 0.013) gain in mid-buccal aspect and 1.1 mm (p = 0.019) loss in horizontal bone width were observed. The histomorphometric evaluation depicted the vital bone volume of 54.5 ± 16.76%, non-mineralized tissue 43.50 ± 15.80%, and residual material 2.00 ± 3.37%. CONCLUSION: The implants placed in these preserved ridges presented 100% success rate with acceptable stability after a 1-year follow-up, concluding calcium phosphosilicate is a predictable biomaterial in alveolar ridge preservation.

Effect of scaling and root planing on gingival crevicular fluid level of YKL-40 acute phase protein in chronic periodontitis patients with or without type 2 diabetes mellitus: A clinico-biochemical study.

BACKGROUND: The aim of the present study was to evaluate the gingival crevicular fluid (GCF) levels of YKL-40 acute phase protein in chronic periodontitis (CP) with and without type 2 diabetes and also to assess the effect of periodontal therapy (scaling and root planing [SRP]) on this GCF biomarker and the clinical parameters. YKL-40 is derived from tyrosine (Y), lysine (K), and leucine (L) with a molecular weight of 40 kDa. MATERIALS AND METHODS: A total of 105 individuals (30-60 years) were grouped as 35 individuals each in three groups (Group I - healthy; Group II - CP with diabetes mellitus [DM]; and Group III - CP). Clinical parameters including plaque index, gingival index, probing pocket depth, and clinical attachment level followed by GCF sample collection from test sites were done at baseline and 6 weeks after SRP (among Group II and Group III patients). GCF YKL-40 level was determined by enzyme-linked immunosorbent assay. RESULTS: The mean GCF YKL-40 level at baseline was significantly lower for Group I (309.81 ± 124.93 pg/ml) as compared to Group II (924.88 ± 415.28 pg/ml) and Group III (834.08 ± 270.42 pg/ml), respectively (P < 0.001). The level reduced significantly 6 weeks after SRP for Group II (507.6 ± 265.03 pg/ml) and Group III (499.54 ± 293.38 pg/ml) (P < 0.001). CONCLUSION: The level of GCF YKL-40 in CP patients with or without DM is higher than healthy individuals and the level reduced 6 weeks post-SRP among Group II and Group III. Hence, YKL-40 can be considered as an important biomarker in the diagnosis of CP.

Estimation of Toll-like receptor 9 in gingival tissues of patients with chronic periodontitis with or without hyperlipidemia and its association with the presence of Porphyromonas gingivalis.

BACKGROUND: Recent evidence suggests the interactions between bacterial DNA and nucleic acid receptors to play a role in inflammatory tissue destruction. The current study aims to evaluate the expression of Toll-like receptor 9 (TLR9) in periodontal disease associated with or without hyperlipidemia and to associate it with the presence of Porphyromonas gingivalis. MATERIALS AND METHODS: Thirty participants in the age range of 25-50 years were randomly recruited and divided into three groups, i.e., healthy (Group I), chronic periodontitis without hyperlipidemia (Group II), and chronic periodontitis with hyperlipidemia (Group III). The gingival tissue samples were analyzed for TLR9 using immunohistochemistry, and plaque samples were analyzed for P. gingivalis using polymerase chain reaction. RESULTS: The TLR9-positive cell ratio in gingival connective tissue for Group II and Group III was 0.95 ± 0.03 and 0.94 ± 0.03, respectively, which was significantly higher than that of Group I, with P < 0.001 (0.88 ± 0.04). These groups also demonstrated significantly higher presence of P. gingivalis as compared to Group I with P < 0.001. There was a positive association between TLR9 in gingival connective tissue and presence of P. gingivalis. CONCLUSION: The results of this study reveal a potential role of TLR9 in chronic periodontitis, in association with P. gingivalis. Furthermore, these variables do not show an appreciable change in hyperlipidemics suggesting a weak relation between TLR9 and lipid levels.

Neutrophil priming: Implications in periodontal disease.

Periodontal disease is a well-regulated response to bacterial infection directed by the inflammatory cells of the host immune system. The host response to injury or insult is implicated to be a vital feature of the majority of periodontal diseases. The excessive activation of neutrophils plays a role in the pathogenesis in diseases such as acute respiratory distress syndrome, rheumatoid arthritis, and periodontitis by contributing to inflammatory tissue injury. In the recent times, there has been a shift of paradigm from a hypo- to hyper-responsive/primed model of neutrophil dysfunction in periodontal etiopathogenesis. The aim of this review is to outline the mechanisms and effects of neutrophil priming, and thereafter, discuss the current controversy that exists regarding the role of primed neutrophils in periodontal etiopathogenesis.

Influence of various factors on patient compliance after periodontal therapy: A pilot study.

BACKGROUND: Patient compliance is an important predictor of periodontal prognosis, therapy, and maintenance. Limited studies concentrate up on the factors which affect patient compliance. Thus, the aim of the study is to determine the relationship between sociodemographic data, patient's oral health awareness (OHA) and treatment satisfaction (TS) to patient compliance. MATERIALS AND METHODS: A total of 150 patients were subjected to a prevalidated questionnaire comprising of thirty questions. Questions covered different aspects such as sociodemographic data, OHA, and level of patient TS. Statistical analysis was done using mean, percentages, and Spearman's correlation coefficient. RESULTS: A sample of 150 people was included into the study of which 93 were females and 67 males with a mean age of 38 years. The total OHA scores when divided into three categories such as 5-7, 8-9, and >10 and plotted against number of missed appointments; the difference found was statistically significant (P < 0.001). The mean TS was divided into four subgroups of score >24, 25-27, 28-30, and >31 and then plotted against the average number of missed appointments, and the difference was found to be statistically significant (P < 0.001). The correlation between the OHA score and number of missed appointments was -0.59 (P < 0.001) and TS score and number of missed appointments was -0.40 (P < 0.001). CONCLUSION: Within the limitations of the study, it can be concluded that patient education, OHA, and TS are the variables that influence the patient compliance.

Effect of 1.2% of simvastatin gel as a local drug delivery system on Gingival Crevicular Fluid interleukin-6 & interleukin-8 levels in non surgical treatment of chronic periodontitis patients.

AIM: The present study was carried out to evaluate the effect of 1.2% simvastatin gel as local drug delivery (LDD) system on Gingival Crevicular Fluid (GCF) Interleukin -6 (IL-6) and Interleukin-8 (IL-8) levels in chronic periodontitis patients, in addition to scaling and root planing (SRP). METHODS: A total of 46 chronic periodontitis patients were equally divided into two groups. Group I patients were treated by SRP; Group II patients were treated by SRP followed by LDD of 1.2% simvastatin (SMV) gel. Plaque index (PI), Gingival index(GI), Sulcus Bleeding Index (SBI), Probing pocket depth (PPD) and Relative clinical attachment level (CAL) were recorded & GCF samples were collected at baseline (0day) and at 45th day from both the groups. The collected GCF samples were analysed for IL-6 and IL-8 levels with enzyme-linked immunosorbent assay (ELISA). RESULTS: Both the groups showed significant reduction in all the clinical parameters scores and IL-6 and IL-8 levels after non-surgical periodontal therapy (SRP for group I/SRP+1.2% SMV gel for group II) in contrast to baseline values. However, a greater reduction was observed in group II. A non-significant positive correlation was observed between clinical parameters and IL-6 and IL-8 levels except at baseline, a significant correlation was observed between PPD &IL 6 levels in group II. CONCLUSIONS: In adjunct to SRP, 1.2% Simvastatin gel acts as an effective local drug delivery agent for the management of chronic periodontitis.

Differential Diagnosis between Chronic versus Aggressive Periodontitis and Staging of Aggressive Periodontitis: A Cross-sectional Study.

BACKGROUND: Differentiating between chronic periodontitis (CP) and aggressive periodontitis (AgP) is challenging. The aim of this study was to assess the variations in diagnosis between CP versus AgP and the staging of AgP based on the disease-staging index for AgP among periodontists, specialists in oral medicine, and general dental practitioners (GDPs). MATERIALS AND METHODS: Fifteen cases diagnosed as either CP or AgP were included in a "case document" and sent electronically to 75 respondents. Case document included a detailed history with periodontal charting, clinical features, images, and radiographs for all the cases. Diagnosis and staging for the case (if diagnosed as AgP) were requested. A reordered case document (cases in a different sequence) was again sent to respondents after a gap of 1 month. STATISTICAL ANALYSIS: Descriptive statistics including frequency and percentage were calculated. Pearson's Chi-square test was used to analyze the data collected. RESULTS: For the "case document," 10.17% of the responses were different from those of the authors for diagnosis, whereas 4.48% of the responses were different from those of the authors for the staging of AgP. The agreement in the overall responses was in the range of 0.69-0.84, which was considered good. Comparison of the responses for diagnosis showed statistically significant (P = 0.009) difference between specialists in oral medicine and GDPs. CONCLUSIONS: Variations exist among respondents regarding the diagnosis of CP versus AgP. Staging of AgP based on the listed criteria showed low variations.

Knowledge, Attitude, and Awareness among Diabetic Patients in Davangere about the Association between Diabetes and Periodontal Disease.

OBJECTIVE: Diabetes mellitus (DM) is one of the major public health problems. Association of diabetes and periodontitis is widely proven and can influence each other in the development and progression of the disease and its complications, which are largely preventable. Hence, if data could be collected on the knowledge and awareness about the association between DM and periodontal disease, the results could be applied in creating public health campaigns and can bring about lifestyle modification among people. The aim of the present study is to assess the awareness, attitude, and practices of diabetic patients regarding their periodontal health in Davangere city with the objective of enhancing dental health education for this population, which would upgrade their knowledge and awareness. MATERIALS AND METHODS: The present cross-sectional survey was carried out on 600 diabetic patients from various clinics. A time limit of 3 months was set for the data collection which was then subjected to statistical software SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0, and R environment version 2.11.1 for statistical analysis. RESULTS: On correlation of gender and education with overall knowledge of association between periodontal disease and DM, females and participants below secondary school education and lower duration of DM were significantly associated with lack of knowledge. Other questions revealed limited awareness, sources, and need for more information about this association and depicted poor knowledge and attitude toward the oral health. CONCLUSION: Dental professionals need to create awareness about the importance of maintaining good oral health influencing overall general health in diabetic patients. Oral screening and referral by health professionals to dentists may benefit diabetic patients by improving access to dental care.