Rohini Mali

Systemic anti-microbial agents used in periodontal therapy.

Periodontitis is an infectious disease with marked inflammatory response, leading to destruction of underlying tissues. The aim of periodontal therapy is to eradicate the pathogens associated with the disease and attain periodontal health. This is achieved by non-surgical and surgical therapy; however, mechanical debridement and topical application of antiseptics may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach micro-organisms at the base of the deep periodontal pockets and furcation areas via serum, and also affect organisms residing within gingival epithelium and connective tissue. Before advising any anti-microbial agent, it is necessary to have knowledge of that agent. The aim of this review article is to provide basic details of each systemic anti-microbial agent used in periodontal therapy. The points discussed are its mode of action, susceptible periodontal pathogens, dosage, its use in treatment of periodontal disease, and mechanism of bacterial resistance to each anti-microbial agent. It might be of some help while prescribing these drugs.

Comparative evaluation of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate for dentinal hypersensitivity: A clinical study.

Background: Calcium sodium phosphosilicate is a recently introduced desensitizing agent which acts by occluding the dentinal tubules and also resists acid decalcification. This study was designed to assess the efficacy of a new toothpaste containing 5% calcium sodium phosphosilicate for the treatment of dentinal hypersensitivity and also compare it with 5% potassium nitrate. Materials and Methods: Sixty patients with the chief complaint of dentinal hypersensitivity were enrolled and randomly divided into two groups. The visual analog scale (VAS) scores were taken for water and air stimuli at baseline, 3 weeks after usage of the respective toothpaste, and 3 weeks after discontinuation of the respective toothpaste. Results: Both the groups showed reduction in hypersensitivity scores at 3 weeks and 6 weeks for air stimulus and cold water. The calcium sodium phosphosilicate group, however, showed significantly reduction in hypersensitivity compared to the potassium nitrate group at any time point for both measures of hypersensitivity. Conclusion: The 5% calcium sodium phosphosilicate group showed immense reduction in dentinal hypersensitivity symptoms. The 5% calcium sodium phosphosilicate showed prolonged effects even after discontinuation as compared to 5% potassium nitrate, due to its dentinal tubular occlusion property.

Guided tissue regeneration in communicating periodontal and endodontic lesions - A hope for the hopeless!

The use of guided tissue regeneration (GTR) has become a standard of care in Periodontology. GTR using membrane barriers and/or bone grafting materials has also been used in periapical surgery. However, the application of the GTR principle, particularly in communicating endodontic-periodontal lesions with loss of the buccal cortical plate, is a very challenging task, with very few reported human clinical studies. An interdisciplinary approach, combining endodontic and periodontal (surgical) procedures can save a tooth in the long run that has been defined as hopeless at the preliminary stage of treatment.

Gingival Recession Coverage Using Free Gingival Autograft- A Case Report

Gingival recession results in a cosmetic deficit and may also affect function.The main indications for root coverage procedures are progressive gingival recession,esthetic demands and root sensitivity. Coverage of denuded roots is one of the most challenging procedures in periodontal mucogingival surgery. Various surgical options have been developed to achieve the root coverage and include the use of free gingival autograft (FGG), subepithelial connective tissue graft, laterally sliding flap, coronally advanced flap, double papilla flap, guided tissue regeneration etc. FGG is a procedure of high degree of predictability when used alone or combined with other technique. However it is technically demanding, time consuming, and the color match of the tissue is often less than ideal. A 25 year old male patient reported with the chief compliant of receding gum and root sensitivity in a lower front tooth (Millers Class II gingival recession with 41). Free gingival autograft was carried out with 41 and complete recession coverage was achieved. Despite the fact that other effective root coverage techniques have been developed, the free gingival graft may still be the best treatment option when recession coverage with an increase in the apicocoronal dimension of the

A comparative evaluation of papillary reconstruction by modified Beagle's technique with the Beagle's surgical technique: A clinical and radiographic study

Background: To assess and compare the effectiveness of two surgical procedures (Beagles technique and modified Beagles technique) for the reconstruction of the lost interproximal dental papilla. Materials and Methods: Twenty sites were selected based on the selection criteria which included patients within the age group of 20–50 years and the presence of Class I and Class II recession of the papilla in the maxillary anterior region. They were divided randomly into Group A and Group B. Group A sites were treated with modified Beagles technique, whereas Group B sites were treated by the Beagles technique. The patients were recalled at 1 week, 1 month, 3 months, and 6 months postsurgery. Parameters including classification of loss of papilla height (Nordland and Tarnow), change in vertical dimension, mesiodistal dimension and area of the papillary defect, and radiographic parameters (papilla height and bone crest-root apex distance) were recorded preoperatively and postoperatively. Results: At 6-month postsurgery, there was a statistically significant reduction in vertical dimension, mesiodistal dimension, and area of the papilla defect in Group A compared to Group B. At 6-month postsurgery, there was an increase in the height of the papilla in Group A, whereas there was a decrease in the height of the papilla in Group B. At 6-month postsurgery too, there was a reduction in the mean bone crest-root apex distance in both groups. Conclusion: Thus, the modified Beagles technique is an easy and effective technique when compared to the Beagles surgical technique for papilla reconstruction.

Comparative evaluation of healing after periodontal flap surgery using isoamyl 2-cyanoacrylate (bioadhesive material) and silk sutures: A split-mouth clinical study

Background: Many factors contribute to uneventful and healthy postoperative healing. Hence, closure of periodontal flap postsurgery for the attainment of primary union between flap margins is of utmost importance. Isoamyl 2-cyanoacrylate is a tissue adhesive, which can be used for the closure of elevated flaps to overcome the problems associated with conventional suture material like silk. Aim: This study aims to compare healing after periodontal flap surgery using isoamyl 2-cyanoacrylate (bioadhesive material) and silk sutures. Materials and Methods: The study was carried out on twenty patients who needed flap surgical procedure for pocket therapy. Statistical Analysis Used: Results were subjected to statistical analysis. Paired t-test was used for intragroup postprocedure improvement in each parameter, and independent sample t-test was used for intergroup comparison. Results: Early healing was seen with isoamyl 2-cyanoacrylate during the 1st week when compared with silk. However, no significant difference was seen in the 2nd week when both the materials were compared. Conclusions: It can be concluded that cyanoacrylate aids in early initial healing.

Bilateral Ridge Split and Simultaneous Implant Placement Using Bone Expanders In Edentulous Mandibular Posterior Region : A Case Report

Osseointegration of dental implants is highly predictable when implants are completely embedded into the bone. Sufficient bone quantity is an essential pre-requisite for implant placement in oral implant therapy. Resorption ridges often pose as a hindrance in oral implant placement. Inadequate width of ridge requires advanced surgical techniques in placing implants. One such technique is ridge splitting technique,which helps expansion of narrow ridge with or without fracture of cortical plates. This technique has the advantage of immediate implant placement, incomparison with other ridge widening techniques. In this case study the ridge split technique was done using saw bur and ridge split chisel and simultaneous implant placement was done with bone expanders .This could be considered as a novel technique for implant placement in narrow ridges. ABSTRACT Research Paper Medical Science

Perception of general dental practitioners toward periodontal treatment: A survey.

Periodontology is a fast evolving field where newer insights into existing concepts are changing the face of the traditional periodontal treatment. Constant research is taking place so as to develop a number of newer avenues in the treatment of the periodontal diseases. However, the protocol of management of periodontal diseases in the setup of general dental practice has undergone little change over the last decade. So, a survey was carried out among 100 general dental practitioners by means of a questionnaire to identify the current status of periodontal treatment in dental clinics, the protocol of maintenance therapy, and the general awareness of the dental profession toward periodontal care.