Non invasive and surgical measurement of length of soft tissue from the tip of interdental papilla to the alveolar crest

AbstractBackgroundVarious methods, including clinical and radiographic techniques, can be used to assess periodontal regeneration in interproximal areas. The goal of the present study was to compare the papilla length relative to the alveolar bone crest measured by clinical, intrasurgical, and radiographic techniques.Materials and methodsThe study sample included 250 interproximal papillae in 68 patients with generalized chronic periodontitis. The papilla length from the alveolar bone crest was measured clinically (as the actual papilla length, APL), intrasurgically (as the bone probing length, BPL), and radiographically (as the radiographic bone length, RBL). Measurements were standardized by using acrylic resin stents, XCP rinn, a paralleling technique, and/or a radiographic grid.ResultsThe mean (± standard deviation) for RBL was 4.9±0.8mm, BPL was 5.1±0.6mm, and APL was 5.1±0.6mm. Correlations between RBL and APL and between BPL and APL were 0.918 and 0.943, respectively (both P<0.01).ConclusionsIf the clinical recordings are appropriately standardized, then noninvasive radiographic methods can be used to evaluate the papilla length with good accuracy

Effect of periodontal therapy on maxillary sinus mucous membrane thickening in chronic periodontitis: A split-mouth study

Background. This study evaluated the effect of periodontal therapy on mucous membrane thickening in maxillary sinus in chronic periodontitis patients using radiovisiography (RVG) and cone-beam computed tomography (CBCT). Methods. The study population included 30 patients diagnosed with chronic periodontitis, exhibiting bilateral mucosal thickening of maxillary sinus. The selected sites were randomly assigned to group I (control group - not receiving periodontal therapy) and group II (test group - receiving periodontal therapy). The clinical parameters and mucosal thickening of the maxillary sinus were evaluated at baseline and after 9 months. Results. There was a significant decrease in the PPD, CAL as well as mucosal thickening in group II while, group I showed an increase in these parameters. In group II at the end of 9 months the mean mucosal thickening reduction as assessed by CBCT was 0.76±0.18, 0.73±0.24, 0.88±0.42 and 1.13±0.43 mm at the most anterior point (AP), the most posterior point (PP), the mid-point (MP), point of maximum thickness (MT) as well as in the length of the thickened mucosal lining, respectively. Conclusion. The results of our study indicated a reduction in the mucosal thickening of the maxillary sinus after surgical periodontal therapy. The trial was registered with the Clinical Trial Registry of India (Trial REF/ 2016/02/010805)

Restructuring of dental implant education in India

Various treatment modalities have been proposed and practiced over the years for comforting the functions of individuals with enhanced life expectancy leading to an aging population. These therapeutic modalities are directed toward providing masticatory apparatus to patients with atrophic edentulous ridges. After evolving over several years, clinicians have now been enabled to use dental implants and provide a functionally viable and esthetically pleasing masticatory apparatus to their patients. However, majority of the dentists lack the detailed knowledge, skills, and experience which are necessary and essential for a successful implant therapy. Various training programs have been conducted across the country with the motive to bridge the gap between the clinician and the therapy. However, the existing training programs and courses lack the detailed theoretical inputs and deliberations, which form the very basis for an implicative understanding of the therapeutic modality and thus do not offer desired outcomes many a times. The success of implant therapy depends not only merely in achieving osseointegration of the implant but also providing the esthetic and functional standards, which are in tune with the patient's expectation. Oral implantology cases can be briefly divided based on their complexity as either straightforward or complex placement and/or restoration of implant. To benefit the society at large, it is high time that training programs be proposed with differential skill upgradation with different avenues. The article proposes a few training avenues for the dental professionals which if taken up in the right perspective will restructure the education in oral implantology in our country. Such training avenues need to be brought under regulatory bodies such as the State Health Universities and Dental Council of India so as to achieve a desired standardization and uniformity

Focal fibrous overgrowths: A case series and review of literature

Intraoral fibrous overgrowths of the soft tissues are relatively common and may be benign reactive or neoplastic lesions. A series of 10 lesions is presented which included pyogenic granuloma, fibroma and peripheral ossifying fibroma. Almost all the lesions occurred in the second and third decades and were present in the anterior segment of the jaws, with a distinct female predilection. Majority of these lesions were asymptomatic and the patients reported for treatment only due to the discomfort during function. Histopathologic examinations were done for diagnosis of these lesions. Surgical excision along with removal of causative irritants remains the treatment of choice. The extent of excision should depend on the severity of the lesion, as some of these lesions have a tendency for recurrence. All the patients in this series were closely followed up for a period of 2 years and showed no signs of recurrence

Association between anxiety, obesity and periodontal disease in smokers and non-smokers: A cross-sectional study

Background. Psychological stress is known to be a relevant risk factor for many inflammatory conditions, including periodontal disease. A few studies have probed the relationship between obesity and periodontal disease. Therefore this cross-sectional study was aimed to examine the relationship between psychological stress and obesity and periodontal disease in smokers and non-smokers. Methods. The participants included 90 patients, equally divided into three groups of non-smokers and periodontally healthy, non-smokers and smokers with untreated moderate-to-severe chronic periodontitis. Socioeconomic data, psychosocial measurements, physical parameters and clinical findings of PPD, CAL, PI and GI were recorded. Results. The clinical parameters were assessed for three groups in three different anxiety levels of mild, moderate and se-vere. Intra-group comparison of PPD and CAL in the three anxiety levels showed increased periodontal destruction with an increase in anxiety levels, the results being statistically highly significant for PPD differences in smokers (P < 0.0001). The mean differences in PPD and CAL in severe anxiety levels between smokers and non-smokers were 0.68 mm and 0.70 mm and both the findings were statistically significant. The mean PPD and CAL in smoker and non-smoker groups in obese patients was higher as compared to non-obese patients and the differences were highly significant (P < 0.001). Conclusion. The results of our study indicated a positive and strong correlation between anxiety, obesity and periodontal disease in smokers and non-smokers. Smoking appears to further attenuate this association

Influence of phase I periodontal therapy on levels of matrix metalloproteinase 1 and tissue inhibitor of metalloproteinase 1

Background: Matrix metalloproteinase-1 (MMP-1) is a member of a family of enzymes that can degrade most extracellular matrix macromolecules. Extracellularly, MMPs are controlled by tissue inhibitors of metalloproteinases (TIMPs) and by mechanisms of pro-MMP activation. Levels of MMPs and TIMPs change during healing, inflammation, and normal tissue turnover. Herein we aimed to evaluate the levels of MMP-1 and TIMP-1 in gingival crevicular fluid (GCF) from periodontally healthy patients (control group) and chronic periodontitis patients before and after phase 1 therapy. Methods: In this study we examined 30 patients who had chronic periodontitis with probing depth sites ⩾5 mm and a clinical attachment level (CAL) ⩾5 mm. We included 30 periodontally healthy patients as a control. Clinical measurements such as plaque (PI) and gingival (GI) indices, papillary bleeding index (PBI), probing depths (PD), and CAL were recorded both before treatment (BT) and after phase I periodontal treatment (AT). Assays for MMP-1 and TIMP-1 were performed with an enzyme-linked immunosorbent assay (ELISA) method. Results: All clinical parameters were significantly reduced at the post-therapy visit. MMP-1 levels were significantly higher in patients BT than the controls; however, the patients AT were not statistically different than the controls. TIMP-1 levels in patients BT were significantly lower than in the controls and significantly lower than patients AT. We observed a significant positive correlation between GCF volume and MMP-1 levels. Furthermore, TIMP-1 levels were significantly negatively correlated with both GCF volume and all clinical parameters. Conclusions: We observed that as the extent of periodontal destruction increases, MMP-1 concentration increases and TIMP-1 concentration decreases in GCF. When chronic periodontitis patients were treated by scaling and root planing (SRP), the average MMP-1 concentrations decreased and TIMP-1 concentrations increased in GCF. Keywords: MMP-1, TIMP-1, Chronic periodontitis, Gingival crevicular flui

Use of colposcopy in diagnosing early dysplastic changes in oral premalignant condition

Purpose: Areca nut, a suspected human carcinogen, is responsible for oral submucous fibrosis (OSMF). Micro colposcopy, a noninvasive technique, can be used for early detection of dysplastic changes in the oral tissues. The aim of this study was to evaluate and compare the effect of areca nut on oral mucosa in healthy controls and those with OSMF using a colposcope. Materials and Methods: The study was conducted on participants with a habit of chewing areca nut and suffering from OSMF. 2% acetic acid was applied on the parts of the gingiva and oral mucosa kept for 2 min and viewed under the colposcope. After a few minutes, Lugol's iodine solution was applied and reviewed under the colposcope. Results: All clinical parameters were higher in Group III (areca nut chewers with OSMF) and Group II (areca nut chewers without OSMF) as compared to Group I (healthy controls) (P < 0.05). Conclusion: Colposcope could aid in the visualization of the changes developed in oral mucosa as an effect in the vasculature of the gingiva