Comparative Evaluation of Pain Scores during Periodontal Probing with or without Anesthetic Gels

Context. The initial periodontal examination which includes full-mouth periodontal probing is one of the discomforting procedures for a patient. Aim. To evaluate the efficacy of two local anesthetic gels in the reduction of pain during periodontal probing using Florida probe in CGP patients in comparison with manual probing. Materials and Methods. Ninety systemically healthy patients with moderate to severe CGP patients were recruited. In each patient, the quadrants were randomly assigned to manual probing with UNC-15 probe, probing with Florida probe, and Florida probing with lidocaine 10% gel and with benzocaine 20% gel. In the quadrants undergoing probing with anesthetic gels, the sites were isolated and the gel was injected using syringe and a blunt-end cannula. Pain was measured using 10 mm horizontal VAS. Statistical Analysis. The analysis was carried out using SPSS version 18. The comparison of mean VAS scores was done using repeated measures ANOVA with post hoc Bonferroni test. Results. Mean VAS for manual probing was significantly more than Florida probing. Further, the mean VAS score for Florida probing was higher than the two gels. Conclusion. It is suggested that the gels might be useful in reducing pain experienced during full-mouth periodontal probing in patients with CGP

Role of antimicrobial peptides in periodontal innate defense mechanism

The periodontal epithelium neighboring the tooth is precise to form a seal and attachment around the tooth. This exclusive function imparts unique challenges to the tissue and leads to certain vulnerabilities allied with periodontal disease, particularly in view of the continual exposure to the bacterial biofilm (dental plaque) that form that is formed on the tooth surface at the junction of the soft tissue. It is obvious that oral epithelial cells can counter unbroken microbial challenges from dental plaque by the production of antimicrobial peptides (AMPs), chemokines and cytokines that boost inflammation and immune response in periodontal tissues. AMPs are early responders of the innate immune system that search and destroy invading pathogens. The large variety of AMPs presumably allows for an effective response to the large variety of microorganisms that invade the mouth and airways. The present paper portrays the association between altered expression of AMPs and some types of periodontitis along with AMPs and their clinical significance in other oral diseases

Comparative evaluation of hemodynamic, vasoconstrictive, and SpO2variability during different stages of periodontal surgery performed using 0.5% ropivacaine or 2% lignocaine HCl (1:80,000 adrenaline) local anesthesia: A randomized, double-blind, split-mouth pilot study

Aim: The aim of this study is to compare anesthetic, hemodynamic, vasoconstrictive, and SpO2variability of 0.5% ropivacaine to the “gold standard” lignocaine (2%) with epinephrine (1:80,000) during periodontal surgery. Materials and Methods: A total of 20 systemically healthy controls meeting the inclusion criteria were selected from the Outpatient Department of Sri Sai College of Dental Surgery. Preoperatively, all participants were infiltrated with 0.5 ml of 0.5% ropivacaine intradermally as test solution to record any allergic reaction. Open flap debridement was performed using local anesthesia containing 2% lignocaine hydrochloride with 1:80,000 epinephrine or 0.5% ropivacaine. Recordings were made of the time of onset, duration of action, the intensity, and depth of anesthesia and various hemodynamic changes throughout the surgical procedure. In addition, blood loss volume and postoperative pain were also assessed. Results: Ropivacaine showed statistically longer duration of action (mean±SD =5.3±0.71 hrs) than lignocaine with epinephrine (mean=2.14±0.98 hrs). Blood loss during flap surgery was comparatively less when performed under ropivacaine. No statistical differences were observed in systolic BP, diastolic BP, SpO2 and heart rate during different stages of periodontal surgery between either of the local anesthetic agents Conclusion: Ropivacaine demonstrates comparable efficacy as lignocaine with added advantage of longer duration of action and superior postoperative pain control. No adverse events from this newer anesthetic were noted, and hence, it can be used safely as a viable local anesthetic for periodontal surgical procedures

Evaluation of breast cancer and its relation with periodontal diseases: An original research

Introduction: The aim of this case-control study was to evaluate the association between periodontitis and breast cancer in a sample of adult Brazilian women. Material and Methods: This was a hospital-based study, which included 67 cases and 134 controls (1:2). Women were selected consecutively between April, 2013 and June, 2015 among those attending the Department of Gynecology at the University Hospital of Santa Maria. Cases were selected among women diagnosed with breast cancer (ICD-10 C50), and controls were matched for age (T2 years), and smoking status (never, former and current smoker). Conditional logistic regression was used to model the association between periodontitis and breast cancer with and without adjustment for potential confounders. Four case definitions for periodontitis were used. Results: Cases had significantly greater clinical attachment loss than controls (P=.04). After adjusting for important covariates, women diagnosed with periodontitis had two to three times higher odds of breast cancer than women without periodontitis depending on the case definition of periodontitis (P<.05). Conclusions: A significant association was observed between periodontitis and breast cancer

Comparison of laser and cautery in maxillofacial surgical procedures: An original research

Aim: The purpose of the present study was to evaluate the comparison of laser versus cautery usage in various maxillofacial surgical procedures. Methodology: In this randomized double-blind clinical trial, 40 individuals were randomly allocated to two groups: group 1 (G1) consisted of 20 individuals assigned to treatment with diode laser and group 2 (G2) consisted of 20 individuals assigned to treatment with electrocautery. The following transoperative parameters were evaluated: bleeding, temperature, and surgical technique parameters (energy deposited on tissue, flow rate, and time of incision). The postoperative parameters evaluated were as follows: pain, functional alterations (chewing, speaking), analgesic medication intake, swelling, healing of the wound area, and patient satisfaction. Results: Among the 40 individuals included in the study, four (two in G1 and two in G2) did not complete the entire follow-up. Therefore, 36 individuals (18 in G1 and 18 in G2) participated. Participants in G1 and in G2 had similar demographic characteristics. No difference regarding the trans- or postoperative parameters evaluated was observed between G1 and G2 (p > 0.05). Also, no difference regarding the time for healing was observed between groups. Conclusion: Diode laser seems to be as effective and safe as electrocautery when applied under similar conditions

Efficacy of local use of probiotics as an adjunct to scaling and root planing in chronic periodontitis and halitosis: A randomized controlled trial

Objective: Periodontitis is known to have multifactorial etiology, involving interplay between environmental, host and microbial factors. The current treatment approaches are aimed at reducing the pathogenic microorganisms. Administration of beneficial bacteria (probiotics) has emerged as a promising concept in the prevention and treatment of periodontitis. Thus, the aim of the present study is to evaluate the efficacy of the local use of probiotics as an adjunct to scaling and root planing (SRP) in the treatment of patients with chronic periodontitis and halitosis. Methods: This is a randomized, placebo-controlled, double-blinded trial involving 32 systemically healthy chronic periodontitis patients. After SRP, the subjects were randomly assigned into the test and control groups. Test group (SRP + probiotics) received subgingival delivery of probiotics and probiotic mouthwash, and control group (SRP + placebo) received subgingival delivery of placebo and placebo mouthwash for 15 days. Plaque index (PI), modified gingival index (MGI), and bleeding index (BI) were assessed at baseline, 1 and 3 months thereafter, whereas probing depth (PD) and clinical attachment level were assessed at baseline and after 3 months. Microbial assessment using N-benzoyl-DL-arginine-naphthylamide (BANA) and halitosis assessment using organoleptic scores (ORG) was done at baseline, 1 and 3 months. Findings: All the clinical and microbiological parameters were significantly reduced in both groups at the end of the study. Inter-group comparison of PD reduction (PDR) and clinical attachment gain (CAG) revealed no statistical significance except for PDR in moderate pockets for the test group. Test group has shown statistically significant improvement in PI, MGI, and BI at 3 months compared to control group. Inter-group comparison revealed a significant reduction in BANA in test group at 1 month. ORG were significantly reduced in test group when compared to control group. Conclusion: Within the limitations of the study, the present investigation showed that the adjunctive use of probiotics offers clinical benefit in terms of pocket depth reduction in moderate pockets and reduced oral malodor parameters