Mahalinga K Bhat

PAOO technique for the bimaxillary protrusion: Perio-ortho interrelationship.

An increasing number of adult patients have been seeking orthodontic treatment, and a short treatment time has been a recurring request. To meet their expectations, a number of innovative techniques have been developed to accelerate orthodontic tooth movement. Significant acceleration in orthodontic tooth movement has been extensively reported following a combination of selective alveolar decortication and bone grafting surgery with the latter being responsible for the increased scope of tooth movement and the long-term improvement of the periodontium. Six patients who have been diagnosed as class I malocclusion with bimaxillary protrusion were selected. A modified corticotomy procedure was carried out The active orthodontic treatment was begun within 1 week after surgery and follow up. All the patients reported the minmalpain and mild swelling 2 days following the surgical procedure. The mean treatment time for these patients was 17.4 months, with the distalization of the canines being mostly completed in 8.5 months. Periodontallyaccelerated osteogenicsorthodontic tooth movement procedure or selective alveolar decortications or corticotomy approach is one of the surgical techniques developed to reduce the time for orthodontic treatment. This newer approach is leading to short orthodontic treatment time and great patient acceptance.

Rare case of asymptomatic mucous membrane pemphigoid.

We are hereby reporting a rare case of desquamative gingivitis associated with the mucous membrane pemphigoid. Desquamative gingivitis is a manifestation of a variety of diseases. It is characterized by epithelial desquamation, erythema, ulceration, and/or the presence of vesiculobullous lesions of gingiva and other oral tissues. This phenomenon can be associated with number of dermatoses, most commonly lichen planus, pemphigus vulgaris cicatricial pemphigoid (benign mucous membrane pemphigoid) and bullous pemphigoid. In aged individuals, desquamative gingivitis often affects their routine life because of associated pain and discomfort. The term pemphigoid applies to a number of cutaneous, immune-mediated, subepithelial bullous diseases characterized by a separation of the basement membrane zone. The term is used because clinically it often appears similar (the meaning of the ‘-oid’ suffix) to pemphigus The pemphigoid includes bullous pemphigoid, mucous membrane pemphigoid and pemphigoid (herpes) gestationis. Among these conditions, bullous pemphigoid and mucous membrane pemphigoid, also known as benign mucous membrane pemphigoid or cicatricial pemphigoid have received considerable attention. Current molecular findings on these two diseases clearly indicate that they are separate entities. However, considerable histological and immunopathological overlap exists between the two diseases such that their differentiation may be impossible based on these two criteria. In many cases, the clinical findings are probably the best cognitive element to discriminate them. The term bullous pemphigoid is preferred when the disease has no scarring and mainly affects the skin. The term cicatricial pemphigoid is commonly used when scarring occurs and the disease is mainly confined to the mucous membrane. Oral mucosal involvement in mucous membrane pemphigoid is often the first and usually the only site of disease involvement. Desquamative gingivitis, vesiculobullous lesions and ulcerations are the common intraoral manifestations. Epithelial sloughing and exposure of painful bleeding surfaces beneath (positive Nikolsky’s sign) is most commonly observed. Period of exacerbation and remission are common and some lesions may remain unrelenting for several years. The gingival lesions are by far the most common intraoral sites affected and the lesions tend to heal with insignificant scarring. Presented herein, is a unique case report in which there was only involvement of the gingiva which remained asymptomatic for more than 15 years without involvement of the other parts of the oral cavity and the other parts of the body A 53-year-old male patient, a bank manager, came to our dental clinic in 1994 complaining of carious teeth which he wanted to get filled. It was the patient’s first dental visit. He did not complain of bleeding or pain. His medical history was of good general health and he was not taking any medications. His personal history and working condition in the bank was recorded to rule out any involvement of stress. At the time of initial presentation, the patient had noticed changes in the gingiva but did not have any complaints regarding the same. On further enquiries about the changes in the gingiva, he reported the appearance of occasional swelling in the gingiva on applying digital pressure. The swelling subsided or the superficial layer would have separated from the underlying tissue. Even during this period, the patient was asymptomatic. The patient reported a normal diet and had not avoided any spicy food because of the changes in the gingiva. He was using the same toothpaste which he had been using since childhood. His personal history revealed that he was not a smoker, was not consuming alcohol and brushing his teeth twice daily. He did not complain of any skin lesions, lesions in the eye or in any other part of the body. However, the patient was referred to the skin specialist and ophthalmologist to rule out any involvement of the skin and eye. In between these periods, the patient was transferred to different places as he was employed in a nationalized bank and did not visit our clinic. He reported that he visited different dentists Geriatr Gerontol Int 2011; 11: 369–373