Plasma rich in growth factors (PRGF) in non-surgical periodontal therapy: a randomized clinical trial

Abstract The aim of this split mouth, double blinded, randomized clinical trial was to evaluate the clinical efficacy of use of Plasma rich in growth factors (PRGF) as an adjunct to scaling and root planing (SRP) in the treatment of periodontal pockets. Twenty six patients (15 males, 11 females) diagnosed with generalized periodontitis with Pocket Depth > 5mm and plaque index score 4mm necessitating further treatment after 6-month follow-up were significantly lesser for SRP+PRGF group. The use of PRGF technology in non-surgical periodontal therapy, by single intra-pocket application in to periodontal pockets as an adjunct to SRP, in chronic periodontitis patients, was found to be effective in reduction of pocket depth and gain in clinical attachment level

Simultaneous occurrence of pyogenic granuloma at multiple sites associated with bone loss: Report of a rare case

Pyogenic granuloma (PG) is a reactive hyperplasia of connective tissue that occurs in response to low-grade local irritation, traumatic injury, foreign materials, or hormonal causes and rarely associated with bone loss. Although solitary PG is a common lesion in the orofacial region, presence of multiple such lesions at the same time with associated bone loss is rare. In addition, repeated recurrences of such lesions sometimes frustrate the clinician. This article presents a rare case of simultaneous occurrence of PG at multiple sites associated with bone loss in a young female and its management

Oral hygiene status, oral hygiene practices and periodontal health of brick kiln workers of Odisha

Aim and Objective: The aim of this study was to assess the oral hygiene status, oral hygiene practices, and periodontal health among brick kiln workers of Odisha. Materials and Methods: Four hundred and eight subjects (300 males and 108 females) between the ages of 22 and 65 years with mean age of 33.44 ± 2.34 years working in various brick kilns in the district of Khordha, Odisha, participated in the survey. Data were collected through personal interview and clinical examinations. Results: Overall prevalence of periodontal diseases among brick kiln workers was 86.27%. There was a statistically significant difference in the distribution of Community periodontal index (CPI) (P 2, higher prevalence of periodontal disease was seen in subjects older than 50 years of age (86.7%), those brushing once daily only (75.2%), brushing with finger (82.8%), with higher frequency and duration of consumption of tobacco and alcohol, and having a poor oral hygiene (85.5%). Conclusion: The survey among brick kiln workers revealed that the oral hygiene status was poor, they had ill-informed oral hygiene practices and most of them were suffering from periodontal disease

Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions

Efficacy of fresh Aloe vera extract in postoperative healing following periodontal surgery in patients with chronic periodontitis: A randomized clinical trial

Background: Aloe vera is known for its wound healing and anti-inflammatory properties which may be used for periodontal healing. Early healing of the gingival and periodontal wounds promotes the favorable treatment outcome. Aim: To evaluate the efficacy of Aloe vera on wound healing following periodontal flap surgery. Materials and Methods: Fifteen patients with chronic periodontitis requiring periodontal flap surgery were included in this double-blinded, split mouth, randomized, and controlled clinical trial. Sixty interproximal sites were divided into test and control groups. The test sites received an application of fresh Aloe vera extract postoperatively. Postoperative healing was assessed using early healing index (EHI) after the first week and HI after first, second, and third weeks following therapy by a blinded examiner. Results: All patients completed the study (nine male and six female, age range: 30–50 [34.15 ± 3.46] years). Better healing was observed in test sites in comparison to control sites in the first postoperative week as recorded by EHI (P < 0.001) and HI (P = 0.02). However, there were no significant differences between the test and control sites in the second (P = 0.10) and third (P = 0.53) weeks. Conclusion: The application of fresh Aloe vera extract was effective in significantly improving healing scores in the first postoperative week

Predictability and Clinical Stability of Barrier Membranes in Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis

The adjunctive use of GTR membranes helps us to achieve predictable periodontal regeneration. The aim of this systematic review was to evaluate and compare the treatment efficacy of resorbable versus non-resorbable barrier membranes used in guided tissue regeneration in the treatment of intrabony defects in chronic periodontitis patients. The following databases were searched: Medline, the Cochrane Central Register of Controlled Trails (CENTRAL), SCOPUS, EMBASE. Randomized clinical trials (RCTs) published in English languages over the past 25 years were included. The primary outcomes assessed were: change of probing pocket depth (PD), change in clinical attachment level (CAL) and gingival recession coverage (GRC), and intrabony defect fill (IBDF). A total of eight RCTs were included for systematic review. The outcome of GR at a six-month interval revealed a significant difference in treatment effect with a mean difference of 0.42, 95% CI [0.02, 0.81]; Z = 2.09, (p = 0.04) favouring the resorbable membrane group. The intrabony defect depth fill at a 12-month interval revealed a significant difference in treatment effect with MD of 0.79, p = 0.00001; favoring the resorbable membrane group. The resorbable membrane showed a significant improvement in gingival recession coverage and intrabony defect fill, owing to its advantage of avoiding the second surgical intervention

Fractal Dimension as a Tool for Assessment of Dental Implant Stability&mdash;A Scoping Review

A lot of modalities for assessing implant stability are available for clinicians, but they fail to assess trabecular changes as they are solely dependent on the operator&rsquo;s skills. The use of Fractal Dimension (FD) has evolved to be used as a measure for trabecular changes depicting implant stability before and after implant placement. The objective of this systematic review was to qualitatively analyse the available scientific literature describing the use of FD as a tool to measure implant stability on the basis of trabecular changes. An electronic search in PubMed, Web of Science and Scopus was carried out using relevant keywords, such as: fractal dimension; fractal analysis; dental implants; implant stability; osseointegration, etc. Studies reporting the use of FD as a tool to measure implant stability were included and subjected to qualitative analysis using ROBINS-I and Cochrane risk of bias assessment criteria. Fourteen studies were included in this review. Results showed that FD was found to be used solely as a measure of implant stability in seven studies, out of which six studies showed an increment in FD values. The majority of studies concluded with a statistical correlation between FD and respective other assessment methods used. FD may not serve as a sole indicator of implant stability; however, it can be used as an adjunct to conventional methods along with additional fractal factors

Effectiveness of Hyaluronic Acid Gel Injection with and without PRGF for Management of Interdental Papillary Loss: A Randomized Clinical Trial

Background: To evaluate the effectiveness of hyaluronic acid (HA) gel injection with and without plasma rich in growth factors (PRGF) for the management of interdental papillary loss. Methods: A single blinded randomized clinical trial was carried out on 21 subjects with 34 sites. Patients within the age group 18-45 years who had Class I and II papillary recession in the maxillary anterior region were selected. The sites involved were randomly assigned to Group HA alone and Group HA + PRGF. The patients were recalled 4 weeks after receiving supragingival and subgingival instrumentation. HA or HA + PRGF was injected into the defective papilla at baseline and at 3 and 6 weeks. Image based measurements of Papillary Width (PW), Papillary Deficient Height (PDH), Deficient Area (DA), Deficient Volume (DV) were registered at baseline, 3 weeks, 6 weeks and 12 weeks. A vernier caliper was used to measure the papillary depth in the impression made using additional silicone impression material pre- and post-intervention. Results: There was a significant improvement in the within-group comparison of PW, PDH, DA and DV in both the groups. Group HA + PRGF showed significantly greater improvement in comparison to Group HA alone in terms of PDH, DA and DV at 6 and 12 weeks. Conclusions: Even though HA gel has already been established as a promising injectable agent in the minimally invasive treatment of interdental papillary deficiency, PRGF may also have a significant adjuvant effect when used along with HA. Further clinical studies with longer follow up duration, larger sample size and standardization of the tooth shape are required for a better understanding of the adjuvant effect of PRGF when used along with HA

Efficacy of Sub-Gingivally Delivered Propolis Nanoparticle in Non-Surgical Management of Periodontal Pocket: A Randomized Clinical Trial

Naturally sourced products like propolis are commonly employed for the non-surgical treatment of periodontal pockets. The use of nanoparticle formulations of these natural remedies has the potential to improve treatment outcomes. The aim of the present study was to evaluate the efficacy of sub-gingivally delivered propolis nanoparticles in the non-surgical management of periodontal pockets. Forty patients diagnosed with periodontitis presenting at least one periodontal pocket with a probing pocket depth between 4 and 6 mm were selected. Patients were randomly assigned into the control group (n = 20), which received scaling and root planing (SRP) and saline (SRP + Saline), and the test group (n = 20), which received SRP and sub-gingivally delivered propolis nanoparticles (PRO) into the periodontal pocket (SRP + PRO). The clinical parameters recorded were plaque index (PI), gingival index (GI), relative attachment loss (RAL), probing pocket depth (PPD), and bleeding on probing (BOP). They were assessed at baseline, one month, and three months post therapy. The results indicated that there was a significant improvement in clinical parameters (p p value of p values of 0.0001, 0.001, and 0.05, respectively. The subgingival delivery of propolis nanoparticles showed promising results as an adjunct to SRP in patients with periodontitis presenting periodontal pockets