Lata Goyal

A critical review of the implication of nanotechnology in modern dental practice

Curiosity has its own reason for existing. For thousands of years, mankind has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for mankind today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in oral surgery and orthodontics.

Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patients and association with periodontal disease severity

Objective: C-reactive protein (CRP) is an acute-phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, most of the studies have focused on chronic periodontitis and very few studies are done in patients with aggressive periodontitis. The aim of this study was to determine and compare the relative levels of serum CRP in aggressive and chronic periodontitis patients. Materials and Methods: A total of 75 systemically healthy subjects were divided into three groups: Group I, nonperiodontitis subjects; group II, chronic generalized periodontitis patients and group III, generalized aggressive periodontitis patients. All participants were subjected to quantitative CRP analysis using enzyme-linked immunosorbent assay. Results: Mean CRP levels were significantly greater in both group II and III as compared to group I and group III having greater level than group II. Furthermore, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss. Conclusion: The present study indicates a positive correlation between CRP and periodontal disease severity with particular concern in younger individuals that could be a possible underlying pathway in the association between periodontal disease and the observed higher risk for cardiovascular disease in periodontitis patients.

Recent advances in the management of obstructive sleep apnea: The dental perspective.

Obstructive sleep apnea (OSA) is common in adult population. OSA shows detrimental effects on health, neuropsychological development, quality-of-life, and economic potential and now it is recognized as a public health problem. Despite the availability of expanded therapeutic options, polysomnography and nasal continuous positive airway pressure (CPAP) are the gold standards for the diagnosis and treatment for OSA. Recently, American Academy of Sleep Medicine has recommended oral appliances for OSA. Hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Treatment of OSA can improve vitality, social and daytime functioning, family life and mental health of a person and hence the quality-of-life. Obesity is the main predisposing factor for OSA. Other than obesity, craniofacial abnormalities such as micrognathia and retrognathia, age, ethnic background and genetic predisposition, consumption of alcohol, smoking, and sedatives may also predispose to OSA. Treatment modalities for OSA are behavior modification, diet and medication, CPAP devices, surgical (maxillo-mandibular advancement surgery), and oral appliances. Treatment of a patient with OSA not only improves the physical health of the patients but also the mental and social well-being.

The effect of type 2 diabetes mellitus and smoking on periodontal parameters and salivary matrix metalloproteinase-8 levels.

The present study was carried out to evaluate the effect of type 2 diabetes mellitus (DM) and smoking on periodontal parameters and on the levels of salivary matrix metalloproteinase (MMP-8). One hundred and twenty five subjects were divided into five groups: group 1, systemically and periodontally healthy subjects (n = 25); group 2, systemically healthy subjects but with chronic periodontitis (n = 25); group 3, subjects with type 2 DM and chronic periodontitis (n = 25); group 4, smokers with chronic periodontitis (n = 25); group 5, diabetic-smokers with chronic periodontitis (n = 25). MMP-8 level in saliva was estimated by enzyme linked immunosorbent assay (ELISA) using Quantikine human total MMP-8 immunoassay kit. The result showed that the clinical periodontal parameters and the mean levels of the salivary MMP-8 were significantly higher for diabetic-smokers than other study groups. A highly significant positive correlation (r) between MMP-8 and periodontal parameters was also observed in diabetic-smoker patients. The findings suggest that diabetic-smokers have increased periodontal breakdown and are associated with an increased extent and severity of periodontitis. (J Oral Sci 58, 1-6, 2016).

The influence of type 2 diabetes mellitus on salivary matrix metalloproteinase-8 levels and periodontal parameters: A study in an Indian population.

Objective: Although many studies reported more severe periodontal disease and the existing proinflammatory conditions in patients with diabetes but only few have examined the effect of type 2 diabetes mellitus (DM) on salivary matrix metalloproteinase-8 (MMP-8) level and other periodontal parameters. This study aims to evaluate the effect of type 2 DM on salivary MMP-8 levels and periodontal parameters, which might be useful in monitoring periodontal disease in diabetes. Materials and Methods: A total of 90 subjects were selected for the study and were divided into three groups: Group I included 30 healthy subjects; Group II included 30 subjects without type 2 DM but with chronic periodontitis, and Group III included 30 subjects with type 2 DM and chronic periodontitis. Periodontal parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), and clinical attachment level (CAL) were taken. The salivary MMP-8 level was estimated by Quantikine Human total MMP-8 immunoassay kit using ELISA method. Results: The mean value of the salivary MMP-8 of Group III was highest followed by Group II and Group I, the least. The other periodontal parameters PI, GI, PPD, CAL, was comparatively highest for Group III. Conclusion: This study suggests that diabetes is associated with an increased prevalence, extent, and severity of periodontitis. Furthermore, the increased levels of MMP-8 indicate the influence of diabetes on their salivary concentration.

Periodontal ligament distraction: A simplified approach for rapid canine retraction

Distraction osteogenesis is a method of inducing new bone formation by applying mechanical strains on preexisting bone. The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of “distracting the periodontal ligament” is proposed to elicit rapid canine retraction in two weeks. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 mm/day, immediately after the extraction. Canine was distracted 6.5 mm into the extraction space within two weeks.

Diagnosis and management of nonsyndromic hereditary gingival fibromatosis in a 13 year old girl: Report of a rare case.

Hereditary gingival fibromatosis is a rare condition characterized by various degree of gingival overgrowth. It usually develops as an isolated disorder but can manifest with multisystem syndrome. We are here presenting a case of a 13-year-old girl who presented with severe enlargement of gingiva covering all most the entire crown involving both maxillary and mandibular arches. Differential diagnosis includes drug-induced and idiopathic gingival enlargement. Excess gingival tissue was removed by full mouth gingivectomy and sent for histopathological examination. Postoperative course was uneventful and patients esthetics improved significantly. A 12 month postoperative period shows no recurrence.

A critical review of the management of deep overbite complicated by periodontal diseases

Traumatic deep overbite complicated with periodontal problems is a challenging problem for a periodontist as well as for an orthodontist. A thorough and systematic approach to periodontal and occlusal examination, etiological factors, diagnosis and treatment planning is essential for better treatment results. In such cases prevention of disease is better than its treatment therefore.

Grinspan syndrome with periodontitis: Coincidence or correlation?

Grinspan syndrome is a syndromic complex which comprises a triad of hypertension, diabetes, and oral lichen planus. It remains an enigmatic condition that whether it is separate entity or drug-induced lichenoid reaction emerging due to medications used to treat hypertension and diabetes. Diabetes is related to long-term hyperglycinemia leading to accelerated destruction of both nonmineralized connective tissue and bone leading to periodontitis. Moreover, there is also a possible link between cardiovascular disease and periodontitis. Here, we are presenting a case with the symptomatic triad fulfilling the diagnostic criteria of Grinspan syndrome. A 50-year-old female with type 2 diabetes mellitus and vascular hypertension came with the chief complaint of bleeding gums and severe burning sensation of the oral cavity. In addition, she was having generalized alveolar bone loss and clinical attachment loss. To the best of our knowledge, this coexistence has not been reported earlier. This needs further evaluation so that the preventive measures can be taken at early stage.

Treatment of Angle Class I Malocclusion with Severe Bimaxillary Protrusion using Miniscrew Implants and Periodontal Ligament Distraction

Bimaxillary dentoalveolar protrusion is common in Asian population. In this patient with procumbent upper and lower lips, excessive lip strain, proclined and protruded maxillary and mandibular incisors with vertical growth pattern, an acceptable treatment result, was achieved with 4-first-premolar extractions. This case report is presented with the aim, to describe the treatment approach for bimaxillary dentoalveolar protrusion using miniscrew implants for anchorage in upper arch and periodontal ligament distraction for canine retraction in lower arch and then retraction of incisors into the newly formed bone distal to lateral incisor. Treatment was completed in 18 months. The patient profile was improved, with reduction in lip procumbency, decrease in lip eversion and protrusion, and decrease mentalis strain. Dentally, the interincisal angulation improved significantly because both the maxillary and mandibular incisors were uprighted after space closer.