Application of Platelet Rich Fibrin and Osseomold Bone Graft in Different Intrabony Defects – 2 Case Reports

ABSTRACT:    Aims & objectives: The motto behind any periodontal treatment is arrest of periodontal disease and regeneration of lost periodontium. Various treatment strategies have been employed in treatment of intrabony defects, but the best way to obtain regeneration is probably by mimicking the actual occurring events that takes place in the formation of the periodontal tissues at embryonic stage. Conventional open flap debridement falls short of regenerating tissues destroyed by the disease and current regenerative procedures offer a limited potential towards attaining complete periodontal regeneration.Platelet rich fibrin (PRF), a second generation platelet concentrate is widely used in osseous regeneration.Case description: The present study aimed to explore the clinical and radiographical effectiveness of autologous PRF along with the osseomold bone graft in treatment of 2 different cases of intrabony defects in chronic periodontics subjects.Conclusion: Among the 2 subjects, case-1 had 2-wall defect and case-2 patient had 3-wall defect. Both the subjects reported to the department with a complaint of food impaction and with clinically accessible >7-8mm pocket.  Pocket depth was assessed at 1st week, 6months and 9months respectively and radio graphically bone gain was accessed at 3 month and 6 months

Saliva as a surrogate to explore the association between lipid profiles and chronic periodontitis: A case-control study

Background: There is abundance of literature delving into whether periodontal infection contributes to changes in serum lipid profiles. Whole saliva is an important physiologic fluid that contains a highly complex mixture of substances. Research on salivary lipid profiles and chronic periodontitis remains unexplored and limited. This study was designed with an aim to investigate the association between the chronic periodontitis and salivary lipid levels and to make use of saliva as a non-invasive diagnostic aid. Materials and Methods: This case-control study included 60 subjects of which, 40 were diagnosed as having chronic periodontitis based on the probing depth and clinical attachment levels and 20 healthy subjects as control group. Whole saliva was collected and lipid concentrations (total cholesterol (TC), triglycerides (TG), low density lipoprotein [LDL] and high density lipoprotein [HDL]) were assessed by enzymatic methods and the values were read in ultraviolet-Spectrophotometer. Data was analyzed using student′s t test for equality of means. P < 0.05 was considered to be statistically significant. Results: The mean difference in the concentrations of TC and TG in saliva of chronic periodontitis patients were statistically significant (P = 0.02) when compared to the healthy. HDL and LDL concentrations were not statistically significant, but there was a difference in their means. LDL was higher in chronic periodontitis and HDL mean levels were high among the healthy. Conclusion: Increased salivary lipids in chronic periodontitis patients suggest an association between hyperlipidemia and periodontitis. The relatively easy and non-invasive nature of saliva can be used as a diagnostic tool to assess the lipid status. Further research is needed to determine its specificity as a surrogate to serum lipid profiles

Estimation and correlation of salivary thiocyanate levels in healthy and different forms of tobacco users having chronic periodontitis: A cross-sectional biochemical study

Background: Periodontitis is a common inflammatory disease with complex and multi-factorial origin. Tobacco usage has shown its adverse effect on periodontal health. Various components within saliva not only protect the integrity of oral tissues, but also provide clues to local and systemic diseases and conditions. Salivary thiocyanate (SCN) has been shown to be a chemical indicator in smokers and smokeless tobacco users. Noninvasive nature of salivary testing has made it an attractive and effective alternative to blood and urine testing. Limited studies are there comparing and correlating the salivary SCN levels in smokers with chronic periodontitis (CP). However, no studies show correlation of salivary SCN among gutka chewers with CP. Aims and Objectives: The objective of the following study is to estimate, compare, and correlate the SCN levels in periodontally healthy, CP, smokers with CP and gutka chewers with CP subjects. Materials and Methods: Study includes 120 subjects with age 18-55 years, categorized as periodonally healthy (n = 30), CP (n = 30), smokers (n = 30), and gutka chewers (n = 30) with CP. Required clinical parameters such as gingival index, probing depth and clinical attachment loss were recorded and salivary SCN levels were estimated through ultraviolet-spectrophotometer. Results: Mean salivary SCN level were shown to be higher among smokers and gutka chewers with CP as compared to healthy and CP alone. Conclusion: The present study exhibited the significant increase in salivary SCN levels among smokers and gutka chewers when compared to others, concluding that the analysis of salivary SCN levels could be used as an adjunctive means of diagnosis

Lemongrass essential oil gel as a local drug delivery agent for the treatment of periodontitis

Background: It has been long recognized that periodontal diseases are infections of the periodontium, comprising the bacterial etiology, an immune response, and tissue destruction. Treatment strategies aiming primarily at suppressing or eliminating specific periodontal pathogens include adjunct use of local and systemic antibiotics as part of nonsurgical periodontal therapy. Unwanted side effects and resistance of microorganisms toward antibiotics due to their widespread use have modified the general perception about their efficacy. Research in phytosciences has revealed various medicinal plants offering a new choice of optional antimicrobial therapy. Cymbopogon citratus, Stapf. (lemongrass) is a popular medicinal plant. At a concentration ≤2%, lemongrass essential oil inhibits the growth of several kinds of microorganisms including periodontal pathogens, especially the reference strains Actinomyces naeslundii and Porphyromonas gingivalis, which were resistant to tetracycline hydrochloride. Aims: To evaluate the efficacy of locally delivered 2% lemongrass essential oil in gel form as an adjunct to scaling and root planing, as compared to scaling and root planing alone for the treatment of chronic periodontitis. Materials and Methods: 2% Lemongrass essential oil gel was prepared and placed in moderate to deep periodontal pockets after scaling and root planing. Results: Statistically significant reduction in probing depth and gingival index and gain in relative attachment level were noted in the experimental group as compared to the control group at 1 and 3 months. Conclusion: Locally delivered 2% lemongrass essential oil gel offers a new choice of safe and effective adjunct to scaling and root planing in periodontal therapy

Prevalence of archaea in chronic periodontitis patients in an Indian population

Aim: The aim of this study was to investigate the prevalence of archaea in the subgingival crevices of patients with chronic periodontitis in an Indian population. Materials and Methods: Thirty four chronic periodontitis patients and 16 healthy subjects were included in the study. Thirty four subgingival plaque samples were collected from chronic periodontitis patients, of which 17 samples were from deep pockets and 17 were from shallow pockets. Sixteen subgingival plaque samples were collected from healthy subjects. The presence of archaea in plaque samples was detected by polymerase chain reaction. Results: Prevalence of archaea in chronic periodontitis patients was 29.4% and in healthy subjects was 11.8%, which was not a statistically significant difference. However, prevalence of archaea, in deep periodontal pockets was 47.1%, in shallow periodontal pockets was 11.8% and in healthy sulcus was 12.5%, respectively. Thus, showing a statistically significant difference between prevalence of archaea in deep periodontal pockets (47.1%) and healthy sulcus (12.5%) and also between deep periodontal pockets (47.1%) and shallow pockets (11.8%), respectively. Conclusion: Archaea were detected commonly in severe periodontitis suggesting that these microorganisms might be involved in the pathogenesis of periodontal diseases

The influence of cigarette smoking on blood and salivary super oxide dismutase enzyme levels among smokers and nonsmokers—A cross sectional study

To determine the influence of smoking on blood and salivary superoxide dismutase enzyme levels among smokers, and to demonstrate the significant alterations in the levels of superoxide dismutase in association with patient age, periodontal disease status, smoking duration, and smoking frequency. This study also aimed to evaluate the use of saliva as a biological fluid for disease diagnosis. Ninety males aged 25–56 years were selected and included 30 smokers, 30 nonsmokers with chronic periodontitis, and 30 healthy controls. Clinical parameters such as the gingival index, pocket depth, and clinical attachment loss were recorded. Blood and saliva samples were collected and superoxide dismutase enzyme levels were analyzed using spectrophotometric assay. Superoxide dismutase enzyme levels in the blood and saliva were significantly higher in smokers than in nonsmokers and the controls (p < 0.05). A significant correlation existed between superoxide dismutase levels and clinical parameters. There was also a significant positive correlation between blood and salivary superoxide dismutase levels among the three groups. Systemic and local antioxidant status is affected by periodontal disease and by the impact of smoking. The increased blood and salivary superoxide dismutase enzyme levels in smokers may be an adaptive defense mechanism to counteract the increased reactive oxygen species production induced by smoking. This study emphasizes the importance of saliva as an easy noninvasive tool in diagnosing patients who are more prone to precancerous lesions and conditions, and its importance in patient education and motivation programs for smoking cessation

Association of Interleukin-17 polymorphism (-197G/A) in chronic and localized aggressive periodontitis

Abstract Interleukin 17(IL-17) is a pro-inflammatory cytokine produced mainly by Th17 cells. The present study was undertaken to investigate a possible association between IL-17 A genetic polymorphism at (-197A/G) and susceptibility to chronic and localized aggressive periodontitis (LAgP) in an Indian population. The study was carried out on 105 subjects, which included 35 LAgP patients, 35 chronic periodontitis patients and 35 healthy controls. Blood samples were drawn from the subjects and analyzed for IL-17 genetic polymorphism at (-197A/G), by using the polymerase chain reaction-restriction fragment length polymorphism method. A statistically significant difference was seen in the genotype distribution among chronic periodontitis patients, LAgP patients and healthy subjects. There was a significant difference in the distribution of alleles among chronic periodontitis patients, LAgP patients and healthy subjects. The odds ratio for A allele versus G allele was 5.1 between chronic periodontitis patients and healthy controls, and 5.1 between LAgp patients and healthy controls. Our study concluded that IL-17 A gene polymorphism at (-197A/G) is linked to chronic periodontitis and LAgP in Indian population. The presence of allele A in the IL-17 gene polymorphism (-197A/G) can be considered a risk factor for chronic periodontitis and LAgP