T. P. Chaturvedi

Evaluation of metronidazole nanofibers in patients with chronic periodontitis: A clinical study

Aim: Prevention of periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found to be inadequate in achieving periodontal health in chronic periodontitis, local antimicrobial agents are used as an adjunct to scaling and root planing (SRP), which produces encouraging results. In the present study, an attempt was made to develop a low-dose controlled-release delivery system for the treatment of periodontal infections. A new sustained release drug system of poly e-caprolactone (PCL) nanofibers containing metronidazole (MET) was successfully electrospun and evaluated clinically for periodontal diseases. The retentive nanofibres were shown to provide a controlled delivery of the drugs. Materials and Methods: Nanofibers were prepared with MET in PCL by electrospinning technique. The drug-coated nanofibers provided sustained effect up to a period of 11 days (264 h) and followed first-order release. Forty sites in seven patients (four females and three males) with chronic periodontitis (5–8 mm probing depth) were allocated in two experimental treatment groups: Group A treated with SRP + MET nanofibers and Group B treated with SRP alone (control group). All these patients were evaluated clinically for probing depth (PD), plaque index (PI), and gingival index (GI). Results: Both the treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PD, PI, and GI. Conclusion: Combination of SRP + MET nanofibers (Group A) resulted in added benefits, compared to the control group.

Pyogenic Granuloma - Hyperplastic Lesion of the Gingiva: Case Reports

Pyogenic granuloma is a reactive hyperplasia of connective tissue in response to local irritants. It is a tumourlike growth of the oral cavity, frequently located surrounding the anterior teeth or skin that is considered to be neoplastic in nature. It usually arises in response to various stimuli such as low-grade local irritation, traumatic injury, hormonal factors, or certain kinds of drugs. Histologically, the surface epithelium may be intact, or may show foci of ulcerations or even exhibiting hyperkeratosis. It overlies a mass of dense connective tissue composed of significant amounts of mature collagen. Gingiva is the most common site affected followed by buccal mucosa, tongue and lips. Pyogenic granuloma in general, does not occur when excised along with the base and its causative factors. This paper presents some cases of a pyogenic granuloma managed by surgical intervention.

Familial Florid Cemento-Osseous Dysplasia: A Rare Manifestation in an Indian Family

Florid cemento-osseous dysplasia (FCOD) is one of the uncommon dysplasias affecting the maxillofacial region. The age group may vary from 19 to 76 years and typically presents in the 4th and 5th decades. In most cases patients do not have hereditary basis of disease, and only a few familial cases have been documented. As far as we know this is the 1st reported case of familial FCOD in an Indian family. The mother and son exhibited multiple sclerotic masses in both jaws. The mode of transmission appeared to be autosomal dominant with variable phenotypic expression.

Root coverage with bridge flap.

Gingival recession in anterior teeth is a common concern due to esthetic reasons or root sensitivity. Gingival recession, especially in multiple anterior teeth, is of huge concern due to esthetic reasons. Various mucogingival surgeries are available for root coverage. This case report presents a new bridge flap technique, which allows the dentist not only to cover the previously denuded root surfaces but also to increase the zone of attached gingiva at a single step. In this case, a coronally advanced flap along with vestibular deepening technique was used as root coverage procedure for the treatment of multiple recession-type defect. Here, vestibular deepening technique is used to increase the width of the attached gingiva. The predictability of this procedure results in an esthetically healthy periodontium, along with gain in keratinized tissue and good patients acceptance.

Van der Woude Syndrome Associated with Hypodontia: A Rare Clinical Entity

Van der Woude syndrome (VWS) is usually underreported and frequently not diagnosed. The phenomenon that cleft lip and palate are regularly combined in the same pedigree makes it unique. A meticulous examination of a patient with lip pits may reveal a hidden form of a cleft, for example, submucous. This paper presents a case of VWS in a ten-year-old boy with characteristic orofacial features. Special emphasis has also been given on the need for appropriate genetic counseling.

Immediate placement of implant in fresh extraction socket with early loading

Implant placement in maxillary anterior region has most aesthetic challenges in implant dentistry because tooth loss lead to bone resorption and collapse of gingival architecture, which lead to aesthetic compromise and inadequate bone for implant placement. Immediate implant placement into fresh extraction socket reduces the treatment time, cost, preserved the gingival aesthetic and increases the comfort of the patient. This article describes the procedure for immediate implant placement in fresh extraction socket and early loading of implant with zirconia crown. Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Cement retained zirconia crown was used for early loading. Implant was successfully loaded and was functional during 36 months follow up period. Immediate placement and early loading of dental implant provides advantages like fewer surgical procedures, shorter treatment time, and improved aesthetic and psychological confidence.

Oral rehabilitation of a patient with sub - total maxillectomy.

This clinical report describes oral rehabilitation of a patient with sub-total maxillectomy with palatine process of maxilla and horizontal plate of palatine bone intact to retain the maxillary obturator. Clinical examination has been performed to know the amount of favorable undercuts to be used for retention of the obturator for better functional efficiency. Successful prosthetic reconstruction of hemimaxillectomy defect is a challenging procedure that requires multidisciplinary expertise to achieve acceptable functional speech and swallowing outcomes. This article describes the oral rehabilitation of a patient with sub-total maxillectomy with a maxillary obturator. Oral rehabilitation of sub-total maxillectomy patient is a challenging task. Obturation of the defect depends on volume of the defect, and positioning of remaining hard and soft tissues to be used to retain, stabilize, and support the prosthesis. A maxillary obturator for edentulous patient must provide for retention, stability, support, patient comfort, and cleanliness.

Surgical Management of a Rare Case of Congenital DoubleUpper Lip.

Congenital double lip is a rare developmental anomaly which usually involves the upper lip. It may occur in isolation or as a part of Aschers syndrome. The occurrence of double lip may result in facial deformity especially when patient attempts to talk, smile, or even try to show the teeth. It affects esthetics and also interferes with speech and mastication. Although surgery may be undertaken to facilitate speech and mastication, majority of cases are operated for cosmetic reasons. A case of congenital double upper lip which was surgically treated for cosmetic reason is reported.

SEM Analysis and Management of Fracture Dental Implant

Implant fracture is one of the important biomechanical complications which can present with a considerable problem to the patient as well as the dental surgeon. The aim of this case report is to describe the management of a case of fractured endosseous dental implant in premolar region and microscopic evaluation of the fractured implant segment using scanning electron microscopy. In most of such cases, complete removal of the fractured implant has been a preferred treatment option. In the present case, fractured implant segment was successfully removed and rehabilitated immediately with larger diameter implant. It was found that retrieved fracture segment had a diameter of 3.3 mm, and SEM analysis shows fatigue fractures which may be the result of excessive overloading and use of small diameter implant which enhances fatigue failure.

Full Mouth Rehabilitation of a Patient with Severely Worn Dentition - A Systematic Clinical Approach

(Ex. Service Senior Resident, Department of Prosthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University) (Professor & Dean, Department of Orthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University) 3 (Associate Professor, Department of Prosthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University) (Assistant Professor, Department of Prosthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University) (Associate Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University)