Narinder Dev Gupta

Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail

Abstract Objective. Polypeptide growth factors of platelet rich fibrin (PRF) have the potential to regenerate periodontal tissues. Osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully utilized in periodontal regeneration. The aim of the present randomized, split mouth, clinical trial was to determine the additive effects of PRF with a DFDBA in the treatment of human intrabony periodontal defects. Materials and methods. Sixty interproximal infrabony defects in 30 healthy, non-smoker patients diagnosed with chronic periodontitis were randomly assigned to PRF/DFDBA group or the DFDBA/saline. Clinical [pocket depth (PD), clinical attachment level (CAL) and gingival recession (REC)] and radiographic (bone fill, defect resolution and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. Results. Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the PRP/DFDBA group exhibited statistically significantly greater changes compared with the DFDBA/saline group in PD (4.15 ± 0.84 vs 3.60 ± 0.51 mm), CAL (3.73 ± 0.74 vs 2.61 ± 0.68 mm), REC (0.47 ± 0.56 vs 1.00 ± 0.61 mm), bone fill (3.50 ± 0.67 vs 2.49 ± 0.64 mm) and defect resolution (3.73 ± 0.63 vs 2.75 ± 0.57 mm). Conclusion. Observations indicate that a combination of PRF and DFDBA is more effective than DFDBA with saline for the treatment of infrabony periodontal defects.

Role of salivary matrix metalloproteinase-8 （MMP-8） in chronic periodontitis diagnosis

Periodontitis is an inflammatory disease of the periodontium. Any imbalance between the matrix metalloproteinases (MMPs) secreted by neutrophils and tissue inhibitors initiates the destruction of collagen in gum tissue, leading to chronic periodontitis. This study aimed to correlate salivary levels of MMP-8 and periodontal parameters of chronic periodontitis to establish MMP-8 as a noninvasive marker for the early diagnosis of chronic periodontitis. The study involved 40 subjects visiting the periodontic OPD of Dr. Ziauddin Ahmad Dental College and Hospital, located in Aligarh, U.P., India, from 2011 to 2012. The subjects were divided into two groups: group I consisted of 20 periodontally healthy subjects (controls) while group II consisted of 20 patients with chronic periodontitis. Chronic periodontitis was assessed on the basis of several periodontal parameters, including pocket probing depth (PPD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). Around 3ml of unstimulated and whole expectorated saliva was collected for MMP-8 estimation by ELISA using Quantikine human total MMP-8 immunoassay kits. Data were analyzed using STATISTICA (Windows version 6) software. Salivary MMP-8 levels of groups I and II were 190.91 ± 143.89 ng/ml and 348.26 ± 202.1 ng/ml, respectively. The MMP-8 levels and periodontal status (PPD, CAL, GI, and PI) of groups I and II showed positive and significant correlations (for PPD, r = 0.63, P < 0.001; for CAL, r = 0.54, P < 0.001; for GI, r = 0.49, P < 0.001; and for PI, r = 0.63, P < 0.001). The results of this study demonstrate elevated concentrations of MMP-8 in individuals with chronic periodontitis.

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).

Dental health attitude in Indian society.

Every society provides a unique soil for a health-care programmer to build upon. Indian society is similarly unique in factors such as social mindset, prevalent beliefs and customs. These factors should not be given a passive glance and should be explored carefully giving an adequate weight to each factors background and its progress to the present status in contemporary dental practice. Only a careful scientific analysis of society is therefore the need of the hour for oral health-care programmers.

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.

Combination of bone allograft, barrier membrane and doxycycline in the treatment of infrabony periodontal defects: A comparative trial

Aim The purpose of the present study was to compare the regenerative potential of noncontained periodontal infrabony defects treated with decalcified freeze-dried bone allograft (DFDBA) and barrier membrane with or without local doxycycline. Methods This study included 48 one- or two-wall infrabony defects from 24 patients (age: 30–65 years) seeking treatment for chronic periodontitis. Defects were randomly divided into two groups and were treated with a combination of DFDBA and barrier membrane, either alone (combined treatment group) or with local doxycycline (combined treatment + doxycycline group). At baseline (before surgery) and 3 and 6 months after surgery, the pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF), and alveolar height reduction (AHR) were recorded. Analysis of variance and the Newman–Keuls post hoc test were used for statistical analysis. A two-tailed p-value of less than 0.05 was considered to be statistically significant. Results In the combined treatment group, the PPD reduction was 2.00 ± 0.38 mm (32%), CAL gain was 1.25 ± 0.31 mm (17.9%), and RBF was 0.75 ± 0.31 mm (20.7%) after 6 months. In the combined treatment + doxycycline group, these values were 2.75 ± 0.37 mm (44%), 1.5 ± 0.27 mm (21.1%), and 1.13 ± 0.23 mm (28.1%), respectively. AHR values for the groups without and with doxycycline were 12.5% and 9.4%, respectively. Conclusion There was no significant difference in the regeneration of noncontained periodontal infrabony defects between groups treated with DFDBA and barrier membrane with or without doxycycline.

Quorum sensing: Communication sense of bacteria

The human oral cavity is similar to an ecosystem that is populated by physiologically distinct microorganisms, which successfully live together and thrive by continually adapting and coordinately responding to other organisms in their local environment, to nutrient flux and to other environmental stresses. For survival, oral organisms may express sophisticated intraspecies and or interspecies communication mechanisms that facilitate a coordinated response by members of the microbial community to environmental flux. This review deals with bacterial communicating signaling pathways, the impact that they have on regulating gene expression and its applied aspects.

Oral psoriasis: A diagnostic dilemma

Psoriasis is a chronic, genetically linked, scaly, and inflammatory disease of the skin. Oral manifestations of psoriasis are rare and are often difficult to diagnose. A 35-year-old female presented with gum bleeding, chronic irritation, intolerance to salt and spicy food, and frequent occurrence of painful mouth ulcers with a fissured tongue. Examination of the oral cavity showed desquamations on the buccal mucosa with pedunculated and exophytic growths and also slight gingival enlargements in the anterior segment. The exophytic growths along with gingival enlargement were excised and sent for histopathological examination, which revealed them to be psoriasis. Oral psoriasis is a rare entity and might be confused with other oral mucous membrane dermatoses; hence, it should be considered under differential diagnosis of oral mucous membrane disorders and confirmed histopathologically.

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.

Hemisection as a conservative management of grossly carious permanent mandibular first molar

Hemisection of a molar denotes removal or separation of a root along with its accompanying part of crown. It is a suitable treatment option when the caries, resorption, perforation, or periodontal damage is restricted to one root while the other root is relatively healthy. Hemisection of the affected tooth helps to retain the tooth structure, surrounding alveolar bone, and may also facilitate the placement of fixed prosthesis. This case report describes the hemisection as a successful treatment method to save a grossly carious mandibular first molar with periodontal and periapical involvement. Hemisection and prosthetic rehabilitation yielded a satisfactory result. With careful treatment planning and precise surgical management, undesirable consequences of tooth loss were prevented.