Deepak Grover

Systemic antibiotic therapy in periodontics

Systemic antibiotics in conjunction with scaling and root planing (SRP), can offer an additional benefit over SRP alone in the treatment of periodontitis, in terms of clinical attachment loss (CAL) and pocket depth change, and reduced risk of additional CAL loss. However, antibiotics are not innocuous drugs. Their use should be justified on the basis of a clearly established need and should not be substituted for adequate local treatment. The aim of this review is to discuss the rationale, proper selection, dosage and duration for antibiotic therapy so as to optimize the usefulness of drug therapy.

Toothbrush 'A key to mechanical plaque control'

Despite the wide range of methods available, mechanical plaque removal with a manual toothbrush remains the primary method of maintaining good oral hygiene for a majority of the population. Several different toothbrushing methods with manual brushes exist. The popularity of various techniques has waxed and waned over the twentieth century. However, no one method of brushing has been found superior to the other. However, plaque control by toothbrushing alone is not sufficient to control gingival and periodontal diseases because periodontal lesions are predominantly interdental. For years dental authorities have instructed their patients on how to brush their teeth correctly. However, many people lack the patience and do not follow dental instructions for more than a brief period. Therefore, studies were initiated in the belief that the introduction of power brushing would help the average person brush his teeth with greater efficiency. The purpose of this article is to update the available information on the toothbrush designs, tooth brushing methods, and the introduction of powered and ionic brushes.

Role of stem cells in cancer therapy: A review

As our understanding of stem-cell behavior rapidly increases, more and more reports suggest that use of stem-cell therapy will extend well beyond regenerative medicine in the near future. Due to their inherent tumoritropic migratory properties, stem cells can serve as vehicles for the delivery of effective, targeted treatment to isolated tumors and to metastatic disease. In vitro , stem cells can readily be engineered by inserting specifically tailored transgenes with anti-tumor effects to create tumor-seeking therapeutic vehicles. More recently, the specific tumor-oriented migration and incorporation of mesenchymal stem cells (MSCs) have been demonstrated in various pre-clinical models, highlighting the potential for MSCs to be used as an ideal carrier for anti-cancer gene delivery. Engineered MSCs are capable of producing specific anti-cancer agents locally and constantly. Astute investigation on engineered MSCs may lead to a new avenue toward an efficient therapy for patients with cancer.

Using a portable sulfide monitor as a motivational tool: A clinical study

AIMS AND OBJECTIVES Bad breath has a significant impact on daily life of those who suffer from it. Oral malodor may rank only behind dental caries and periodontal disease as the cause of patients visit to dentist. An aim of this study was to use a portable sulfide monitor as a motivational tool for encouraging the patients towards the better oral hygiene by correlating the plaque scores with sulfide monitor scores, and comparing the sulfide monitor scores before and after complete prophylaxis and 3 months after patient motivation. MATERIALS AND METHODS 30 patients with chronic periodontitis, having chief complaint of oral malodor participated in this study. At first visit, the plaque scores (P1) and sulfide monitor scores before (BCR1) and after complete oral prophylaxis (BCR2) were taken. Then the patients were motivated towards the better oral hygiene. After 3 months, plaque scores (P2) and sulfide monitor scores (BCR3) were recorded again. STATISTICAL ANALYSIS It was done using SPSS (student package software for statistical analysis). Paired sample test was performed. RESULTS Statistically significant reduction in sulfide monitor scores was reported after the complete oral prophylaxis and 3 months after patient motivation. Plaque scores were significantly reduced after a period of 3 months. Plaque scores and breathchecker scores were positively correlated. CONCLUSION An intensity of the oral malodor was positively correlated with the plaque scores. The portable sulfide monitor was efficacious in motivating the patients towards the better oral hygiene.

Diabetes and Periodontal Disease: A Two-Way Relationship

Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by specific micro-organisms or group of specific micro-organisms, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession or both.1 Periodontal infections can adversely affect the systemic health with manifestations such as coronary heart disease, stroke, diabetes, preterm labor, low-birth weight delivery, and respiratory disease.1 Severe periodontitis often coexists with diabetes and is considered to be the sixth complication of the disease, as both type 1 and type 2 diabetic patients show a three-to four fold increased risk of periodontitis. 2

Segmental cross-sectional assessment of the left impacted mandibular third molar using cone beam computed tomography

The clinical results achieved were comparable when 10 patients requiring gingivectomies were divided in two groups ie one with periodontal dressing and another without periodontal dressing during first post operative week. Initial pre operative conditions were comparable. In each of the two treatments, intragroup comparison demonstrated highly significant reduction in pocket depths, Plaque index(p≤.010) and gingival index(p≤.003) from base line to 1 month whereas distance from stent to gingival(S-GM) remained stable from baseline to 1 month. Inter group comparison showed no statistically significant difference.Clinicians in general practice routinely diagnose impacted mandibular third molars. After clinical assessment of the impacted mandibular third molar, a detailed three-dimensional radiographic assessment is of utmost importance in arriving at a diagnosis and explaining to the patient, the treatment plan and the surgical risks involved in third molar surgery. For decades, orthopantomogram (OPG) has been used to diagnose the type of third molar impaction and in few cases dentists have used intra-oral peri-apical radiographs to assess the angulation and depth of the third molar. Cone beam computed tomography has always been indicated when the root of the third molar is close to the nerve. This cross-sectional study provides an assessment of the angulation of impacted mandibular third molar on the left side using cone beam computed tomographic tomography.

Immediate implant: An approach for better esthetics!!!

Dental implants can be placed in fresh sockets just after tooth extraction. These are called immediate implants. The intention of placing immediate implants is to try to preserve tissue contour, dimension, and also decrease treatment time. The soft and hard tissue changes following tooth extraction are in close relationship to the timing of the implant placement. In spite of similar success rates reported for immediate, early, and delayed placement, it is very important to understand the risk factors related to each procedure, to have careful case selection, and to closely follow the surgical and prosthetic protocols. The paper describes a case of 29-year-old male with right maxillary lateral incisor root stump, treated with extraction of the root stump followed by immediate implant placement.

Cell signalling molecules

All periodontal cells are capable of expressing a broad range of gene products, including matrix proteins, proteases involved in tissue remodeling (such as collagenases) and cytokines. Mesenchymal cells in the periodontal connective tissues encounter a complex array of stimuli that include soluble agents (such as polypeptide growth factors, cytokines, neuropeptide and chemotherapeutic agents), insoluble extracellular matrix proteins and other cells. The mechanisms that permit cells to respond to extracellular stimuli are essential for normal growth and function. Characterization of how these pathways are up-regulated or down-regulated in response to other agents may eventually allow the predictability of periodontal regeneration to be enhanced. The current review aims to provide a comprehensive overview to the various cell signaling pathways and molecules that mediate the periodontal disease process and can serve as a target for periodontal therapy.

Bone regeneration using metronidazole containing collagen sponge in periodontal horizontal bone defect

Attempts to successfully regenerate lost alveolar bone have been a periodontist ultimate dream. Angular defects, at least have a fair chance, but same cannot be said about horizontal bone loss. Hence, this case report on 35-year-old male patient was conducted, to evaluate the bone regeneration using collagen sponge with metronidazole 4.5 mg in horizontal defect. From the presented case, it can be concluded that collagen sponge with metronidazole is clinically and radiographically efficacious in the treatment of a horizontal bone defect. Thus, signifying its role as a regenerative material in the treatment of horizontal bone defects.