Comparative evaluation of effectiveness with cutback incision and without cut back incision technique on healing in patients between 18 to 65 years of age for socket preservation cases: A randomized controlled trial

Primary closure is the most important step following tooth extraction. Primary closure using cut back incision technique helps in preserving the bone graft in socket and to preserve it in their desired position. To assess the healing outcome with and without cut back incision technique in adult population for the purpose of socket preservation at baseline, 1 week and 4 weeks. In this single blinded randomized controlled trial forty-two sites were planned for extraction with bone augmentation and were randomly divided. In group 1 sockets were preserved using cutback incision technique and in group 2 sockets were grafted without cutback incision technique. Clinical standardized measurements were used to assess the dimensional alterations of the extraction socket. Various non-parametric tests have been used for comparisons. Intergroup comparison showed statistical higher difference on Pain on VAS (p >0.00 6) and KGW (p 0.039) at 1 week and primary healing showed no significant results at all time intervals. The present finding concluded that use of cutback incision technique enhances primary closure and the socket seal of the extraction site with minimal pain, morbidity and low cost.

The effect of horizontal and vertical dimensions of the interproximal space on the existence of interdental papillae – A clinical study

The aim of the present study was to determine the existence of inter dental papilla according to the vertical dimension, horizontal dimension and the combined effects of the vertical and horizontal dimensions of the interproximal space on the existence of interdental papilla.182 interdental sites of 42 periodontitis patients undergoing open flap debridement were included in the study. The existence of interdental papilla was determined based on the Papilla Presence Index (PPI). The vertical dimension (VD) was measured from the alveolar crest to the contact point using UNC-15 probe. Horizontal dimension (HD) was measured from the mesial surface of the distal tooth and the distal surface of the mesial tooth at the level of the alveolar crest using castroviejocaliper. Statistical analysis was done by using independent ‘t’ test, Pearson’s Chi-square test and Trend Chi-square test. The existence of papilla was significantly higher in VD ≤ 5mm (91.5%) compared to VD > 5mm (9.8%) [p< 0.0001]. The existence of papilla was significantly higher in HD < 2mm (97%) compared to HD ≥ 2mm (1.2%) [p< 0.0001]. The contribution of both vertical dimension and horizontal dimension to the existence of papilla was about 61.6% and thus the existence of papilla may be influenced by various other factors (about 38.4%) which were not included in this study.The vertical and horizontal dimensions of the interproximal space gains significance in determining the existence of papilla and further research is needed to analyze the other factors influencing the papilla.

Rare presentation of gingival squamous cell carcinoma of maxillary posterior region mimicking pyogenic granuloma in a non-smoker – A case report

Gingival Squamous cell carcinoma (GSCC) in maxilla is a rare malignant neoplasm especially when compared with mandible. The most common sites of oral carcinoma are being the lateral border of the tongue and the floor of the mouth which is followed by palate, buccal mucosa and rarely in gingiva. The clinical picture of oral carcinoma can be misguided for gingival overgrowth, desquamative lesions, traumatic ulcers or even pyogenic granuloma. Maxillary oral gingival carcinoma is a rare entity especially in a non-smoker. In this case report, a 70-year-old male patient presented with a gingival lesion in maxilla 24,25 region mimicking pyogenic granuloma without having a tobacco history. A thorough clinical, radiographical and histopathological examination was done and led to the diagnosis of GSCC and the treatment was initiated.Creating awareness among practitioners about gingival squamous cell carcinoma mimicking pyogenic granuloma in dental practice.

Comparison of two different probing systems for evaluation of bleeding on probing (BOP)

: Bleeding on probing (BOP) is the best documented parameter in the monitoring of periodontal health and inflammation of the gingival tissues. It is measured as bleeding provoked by applying a probe to the bottom of a sulcus/pocket. Since BoP may be provoked by trauma to the tissues using a periodontal probe hence, probing pressure can be considered as an important factor in the assessment of bleeding on probing. The purpose of the study was to evaluate bleeding on probing by conventional probe and pressure sensitive probe. : 50 subjects (1400 sites) in this split mouth study were evaluated for bleeding on probing by using a conventional periodontal probe and a manual pressure sensitive probe. Gingival Bleeding Index (Ainamo and Bay 1975) was used in the study for assessment of BOP. : More bleeding sites were found in the quadrant associated with the conventional probe as compared to the sites associated with pressure sensitive probe. : Amount of pressure applied during probing can be a significant factor in assessment the periodontal disease activity.

Antibiotic stewardship in health care facilities across Gujarat: A cross-sectional descriptive study

Irrational use of antibiotics is the key contributor to antibiotic resistance. To improve the administration of antibiotics, many programs have been designed at national and international levels; and antibiotic stewardship (ABS) is one of them.The aim of this study was to create awareness and understanding of antibiotic stewardship by estimating its knowledge, attitude and practice (K.A.P) among health care professionals in health care facilities across Gujarat. A cross-sectional descriptive study was carried out among health care professionals in health care facilities across Gujarat. For which a self-administered questionnaire with 15 closed-ended questions with two sections: “Optimal antibiotic use” (no.1-7 questions); and “Responsible antibiotic use” (no.8-15 questions) was disseminated online/ in electronic form. In Dental practitioners, mean scores of knowledge, attitude, practice (K.A.P) regarding “Optimal antibiotic use” and “Responsible antibiotic use” are 6.3682 ± 0.96, 6.2139 ± 1.07, 4.5672 ± 1.51 and 7.1692 ± 1.09, 6.9104 ± 1.25, 5.1443 ± 1.81 respectively.In Medical practitioners, mean scores of knowledge, attitude, practice (K.A.P) regarding “Optimal antibiotic use” and “Responsible antibiotic use” are 6.8201 ± 0.41, 6.7090 ± 0.56, 5.1270 ± 1.62 and 7.6032 ± 0.69, 7.4233 ± 0.82, 5.3492 ± 1.94 respectively.Between the groups, knowledge and attitude regarding “Optimal antibiotic use” and “Responsible antibiotic use” are statistically highly significant (p-value = <0.001). Health care professionals showed higher knowledge as compared to attitude with least practice (K>A>P) regarding antibiotic stewardship in health care facilities across Gujarat. Antibiotic stewardship is fulcrum for the dual face of antibiotics. Equilibrium between individual and societal benefit/risk ratio while making clinical antibiotic decisions will benefit both; individual patients as well as the community.

Peripheral ossifying fibroma: A case report

Localized inflammatory or reactive overgrowths are quite more common clinical findings on human gingiva. Most of the lesions are benign and innocuous though some have potency to transfer in to a malignant lesion. These types of lesions are difficult to identify clinically as their appearance are quite similar so only Histopathological evaluation can detect their identity. In this case report we displayed a case of Peripheral Ossifying Fibroma in maxillary anterior tooth region in 32 year old female patient along with clinical, Histopathological evaluation along with present and future treatment details. Peripheral ossifying fibroma (POF) is usually a fibromatic, non neoplastic enlargement of the gingiva which shows areas of calcification or ossification. Synonyms for POF include Peripheral cementifying fibroma, Peripheral fibroma with calcification, Calcifying or ossifying fibrous epulis and Calcifying fibroblastic granuloma.

Evolving paradigms in the field of periodontal medicine: A review

The association between the oral and systemic health has been a matter of discussion since the focal infection theory of the early 20century. This field has evolved with supportable evidence linking poor periodontal status with systemic diseases and extensive research on this complex relationship has given rise to new field of “Periodontal Medicine.” Although the evidence base is quite large on the impact of systemic disorders on periodontium but a smaller but growing evidence base supports an association between poor periodontal health and systemic diseases. Moreover, today’s era of evidence-based medicine and dentistry provides an excellent environment to examine the possible relationships between oral infection and systemic disorders. Therefore, the purpose of writing this review article is to understand the underlying pathophysiology between periodontal health and systemic health with particular focus on the effects of periodontal disease on systemic outcomes.

Periodontally accelerated osteogenic orthodontics- A Literature review

Periodontics and Orthodontics often relates to a symbiotic relationship. Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. This procedure involves the removal of cortical bone that strongly resists orthodontic force in the jaw. Though there are numerous studies done in the literature on PAOO, this review mainly focuses on the various comparative studies employed under this procedure. On the other hand, various modifications of this method such as minimally invasive techniques have been introduced to reduce the patient’s discomfort due to surgical intervention and complications after surgery. The present review focuses on the history of corticotomy, its mechanism of action, and various comparative studies done under PAOO.

A case report on gingival depigmentation by scraping method by scalpel

Smile is the most wonderful gesture of the human being. A Person who is genuinally happy shows his or her pleasure in the form of smile. A beautiful smile for sure enhances individual self confidence. A beautiful smile lies in a harmonial balance between competent lips, size, color, and proper alighnment of teeth and the color of gingival tissues. The normal color of gingival is coral pink as in accordance to British population, and pale pink as in accordance to Indian population. However this gingival pigmentation varies among each and every individual in accordance with the color of the skin, various pigments present in human body like melanin, haemoglobin, carotene. However this melanin when secreted in excess, can lead to brownish, blackish, or bluish discoloration of gingiva, and this discoloration is denoted by the term hyperpigmentation, and the procedure to overcome this hyperpigmentation is called as depigmentation. Present case report is on a 21 years old female whose chief complaint was visual blackish display of gums while smiling. So the procedure depigmentation was done by surgical scalpel by scraping method, and the patient showed better results following two weeks after procedure. Esthetic dentistry is a recently emerging branch. People now a days are much more concern about the gingival esthetics and smile design, as they want their smile to be beautiful in order to boost up their confidence. . One of the gingival esthetic for which the people are concerned are the hyperpigmented gingiva. Gingival depigmentation is the process to remove this abnormal pigmented gingiva. The clinician must have a knowledge as for which condition, which type of gingival depigmentation technique can be applie so as in order to make the treatment successful.

Comparative assessment of serum levels of vitamin d3 in chronic generalised periodontitis patients with type 2 diabetes mellitus and in simple gingivitis patients - A clinico-bio chemical study

The role of vitamin D was well established in bone metabolism as well as in the inflammatory process of a disease. The periodontal disease which is a chronic inflammatory condition with destructive bone metabolism and type II diabetes mellitus which is a metabolic condition with more prone to inflammatory reactions are prevalent in middle-aged patients. Hence the present study is done to assess the vitamin D levels in serum of chronic generalized periodontitis patients with type2 Diabetes mellitus and simple gingivitis patients Two groups with 50 patients of both periodontal disease with type 2 diabetes and 50 simple gingivitis patients of age 35 to 55 years old were recruited in this study. For all the patient's serum 25(OH)D levels, oral hygiene index (OHI), Russel’s periodontal index, and presence of bony defects in radiographs were assessed.After assessment of all the parameters patients with periodontal disease and type 2 diabetes mellitus showed significantly higher proportion levels than the simple gingivitis patients and significantly lower levels in 25(OH)D (<From the results, it was concluded that generalized periodontitis patients with type II diabetes mellitus showed higher levels of 25-hydroxyvitamin D levels than simple gingivitis patients.