Effect of periodontal therapy on serum C-reactive protein levels in patients with gingivitis and chronic periodontitis: a clinicobiochemical study.

AIM: The aim of the present study was to evaluate the effect of periodontal therapy on serum C-reactive protein (CRP) levels in patients with gingivitis and chronic periodontitis. MATERIALS AND METHODS: A total of 60 subjects (30 males and 30 females) were included in the study with 20 subjects in each of the groups classified based on community periodontal index (CPI) scores: I: Healthy, II: Gingivitis, III: Mild periodontitis. Periodontal therapy was performed on groups II and III patients. Venous blood was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using immunoturbidimetric method. RESULTS: The present study demonstrated that the periodontitis group had a higher mean CRP levels (2.49 ± 0.47 ng/ml) as compared to the gingivitis group (1.40 ± 0.32 ng/ml) and healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in group II and 1.30 ± 0.36 ng/ml in group III patients. CONCLUSION: Within the limitations of this study, it can be concluded that CRP level progressively increases from periodontal health to disease. A decrease in CRP levels with periodontal treatment was also observed. CLINICAL SIGNIFICANCE: Due to its opsonizing abilities CRP plays an important role in the innate host defence. It can be hypothesized that CRP is a potential biomarker of periodontal disease. A number of studies have reported elevated serum CRP levels in periodontitis subjects. Long standing periodontal disease and raised CRP levels enhance the risk of cardiovascular disease, cerebrovascular accidents and preterm low birth weight infants. There is also evidence that effective periodontal therapy can lower serum CRP levels. However, the data of interventional studies on CRP in gingivitis and periodontitis is scarce.

Assessment of gingival contours for esthetic diagnosis and treatment: a clinical study.

BACKGROUND: The purposes of this study were to quantify some clinical parameters that are useful as esthetic guidelines when the gingival contour is modified and to compare the left and right sides of the six maxillary anterior teeth. MATERIALS AND METHODS: Two hundred and forty interdental papilla sites in 20 healthy patients were evaluated. Interdental papilla heights of maxillary anterior teeth were measured from the gingival zenith, along with clinical crown lengths. Percentages of papilla height to crown length were computed and defined as papilla proportion, mesial papilla proportion (MPP) and distal papilla proportion (DPP). RESULTS: Mean interdental papilla heights of maxillary teeth was 3.83 mm mesially and 3.8 mm distally. Mean MPP was 43.69% ( n = 120) and DPP was 44.57% ( n = 120). No significant differences were found between MPP and DPP for maxillary incisors ( P ≥ 0.5). CONCLUSION: Papilla proportions were approximately 44% for all tooth groups. Canines demonstrated a trend toward increased distal papilla heights. In the present study the average MPP and DPP of the central incisor (CI), lateral incisor (LI) and canine (CA) measured were 43%, 41%, 46%, 40%, and 42% 51% respectively.

Platform switching: A panacea for bone loss??

The goal of modern implant therapy entails more than just the successful osseointegration of the implant. A successful result must also include an esthetic and functional restoration surrounded by stable peri-implant tissue levels that are in harmony with the existing dentition. In an attempt to improve long-term bone maintenance around implants, a new implant-to abutment connection referred to as "platform switching" has been proposed. It refers to the use of an abutment of smaller diameter connected to an implant neck of larger diameter. Platform switching is a simple and effective way to control circumferential bone loss around dental implants. This short communication aims to present an overview of concept of platform switching in dental implantology.

A novel approach for treatment of an unusual presentation of radicular cysts using autologous periosteum and platelet-rich fibrin in combination with demineralized freeze-dried bone allograft.

Radicular cysts are the most common cystic lesions affecting the jaws. They are most commonly found at the apices of the involved teeth. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. The following case report presents the successful treatment of radicular cysts using autologous periosteum and platelet-rich fibrin with demineralized freeze-dried bone allograft.

A Radiographic comparison of mandibular bone quality in pre- and post-menopausal women in Indian population.

AIM AND OBJECTIVES: The main objective of the study is to assess mandibular bone changes in pre and postmenopausal women with chronic generalized periodontitis using different radiomorphometric indices, mandibular cortical index (MCI), mental index (MI), and panoramic mandibular index (PMI) in Indian population. MATERIALS AND METHODS: Panoramic radiographs of 60 patients visiting the Department of Periodontology were taken and divided in two groups - pre and post-menopausal. Detailed medical and menopausal history was recorded for each patient. All the radiographs were assessed for PMI, MI and MCI and presence of periodontitis. The destructive periodontitis was assessed as distance from the cementoenamel junction to the alveolar crest greater than 2mm. STATISTICAL ANALYSIS: Student-t test was applied to compare mean values of MI and PMI. Intra and inter group comparison of MCI were made using chi-square test. Correlation of age and MI and PMI was found by Pearson's correlation coefficient. RESULTS: MCI, PMI and MI were related to the menopausal status. Patients with C3 category were seen only in post-menopausal group after 54 years of age. Higher mean values for both MI (p<0.05) and PMI (p<0.05) were observed in pre-menopausal group with statistically significant differences. MI showed negative correlation with age in both the groups; however PMI was positively correlated with age. CONCLUSIONS: Radiomorphometric indices could be used by general dentists after a little training to detect post-menopausal women at higher risk of osteoporosis.