Periodontal disease is a well-regulated response to bacterial infection directed by the inflammatory cells of the host immune system. The host response to injury or insult is implicated to be a vital feature of the majority of periodontal diseases. The excessive activation of neutrophils plays a role in the pathogenesis in diseases such as acute respiratory distress syndrome, rheumatoid arthritis, and periodontitis by contributing to inflammatory tissue injury. In the recent times, there has been a shift of paradigm from a hypo- to hyper-responsive/primed model of neutrophil dysfunction in periodontal etiopathogenesis. The aim of this review is to outline the mechanisms and effects of neutrophil priming, and thereafter, discuss the current controversy that exists regarding the role of primed neutrophils in periodontal etiopathogenesis.

Background: Obesity is one of the systemic conditions which influence the onset and progression of periodontal disease and it is stated that the metabolic changes associated with obesity may contribute to alteration in subgingival microbial flora. Aim: Our study was aimed to quantify and compare the red complex microorganisms in obese or overweight and normal weight participants with and without chronic periodontitis to identify obesity as a risk for the presence of red complex bacteria. Materials and Methods: The study group consisted of 120 participants of age between 20 and 45 years of both the sexes. According to periodontal status, the participants were categorized into four groups as follows: thirty overweight or obese individuals with generalized chronic periodontitis (Group I), thirty normal weight individuals with chronic periodontitis (Group II), thirty overweight or obese individuals with healthy periodontium (Group III), and thirty normal weight individuals with healthy periodontium (Group IV). After the assessment of periodontal parameters, subgingival plaque sample collection was carried out to quantify the red complex bacteria by real-time polymerase chain reaction. Results: Increase in red complex bacterial count was seen in group I compared to other groups. A positive correlation of red complex bacteria with body mass index and waist circumference was seen in Group I and III. Conclusion: In our study, obese individuals with periodontal disease harbored increased red complex bacteria. This states that the obesity could be a risk for the colonization of red complex microorganisms, which in turn may further lead to periodontal inflammation.

Background: To evaluate the presence of titanium particles in the peri-implant mucosa of unloaded single implants. Materials and Methods: Forty participants with single unloaded implants were selected. They were divided equally into two groups: Group 1 with mild and Group 2 with moderate-to-severe peri-implant mucositis. Cytologic smears of peri-implant mucosa were obtained using cytobrush during second-stage surgery. Results: Study states that 60% of participants of Group 2 were positive for titanium particles in peri-implant cytology. Conclusion: This study concludes that the titanium particles might be the initiators of the inflammation around implant.

Introduction: In recent years, a growing interest has emerged with the use of platelet-rich products for the treatment of many clinical conditions in dentistry. Objective: The present study aimed to define the structural characteristics of titanium platelet-rich fibrin (TPRF) and PRF in hypertensive and smoker participants . Materials and Methods: Ten milliliters of blood samples was drawn using a syringe form ninety participants (healthy, hypertensive, and smokers). Five milliliters of blood was transferred to each of dry glass tube and titanium tube. The clot obtained after centrifugation from each tube was processed for light microscopy analysis. Results: The TPRF samples have demonstrated a highly organized and thicker fibrin network with continuous integrity as compared to PRF in healthy participants. The hypertensive and smokers showed less prominent fibrin border between the cellular structures in both the platelet concentrates, but sufficient fibrin mesh network was found in TPRF clot as compared to PRF clot in the test participants. Conclusion: This is the first human histologic study to define the fibrin meshwork in both TPRF and PRF clots in hypertensive and smokers. The platelet activation by titanium offered high characteristics to fibrin network.

Context: Chronic periodontitis (CP) and diabetes mellitus are associated with increased oxidative damage to DNA with formation of 8-hydroxydeoxyguanosine (8-OHdG). The aim of this study was to evaluate the change in gingival crevicular fluid (GCF) levels of 8-OHdG and glycosylated hemoglobin (HbA1c) by 3 months after scaling and root planing (SRP), in CP patients with and without Type II diabetes mellitus. Settings and Design: Sixteen patients with CP, 16 patients with CP and Type II diabetes mellitus (CP-D), and 16 systemically healthy individuals with clinically healthy periodontium who served as controls were included in the study. Materials and Methods: The clinical parameters (plaque index [PI], probing depth [PD], clinical attachment level [CAL], and bleeding on probing [BOP%]), HbA1c levels, and GCF 8-OHdG levels were measured at baseline. All the patients except controls were treated with SRP followed by evaluation of the above-mentioned clinical and biochemical parameters after 3 months. Statistical Analysis Used: Statistical analysis was performed using paired t-test, independent t-test, and Mann–Whitney U-test. Results: After SRP, CP-D group showed a greater reduction in PI, PD, BOP%, and greater gain in CAL when compared to CP patients (P < 0.05). Levels of 8-OHdG and HbA1c in CP-D patients also showed a greater reduction, 3 months after SRP when compared to CP patients (P < 0.05). Conclusions: GCF 8-OHdG levels, HbA1c levels, and clinical parameters were reduced significantly in CP and CP-D patients, with maximum reduction achieved in CP-D patients 3 months after SRP.

Background: There are two limiting factors for determining the dental implant fixture length in mandibular posterior edentulous region: Inferior dental canal and submandibular fossa. Purpose: Submandibular fossa augmentation is a suggested way to overcome the problem of lingual undercut beneath the mylohyoid ridge in implant dentistry. Materials and Methods: Patients with lingual posterior bony undercut that interferes with the placement of a standard implant with a length of 10 mm were enrolled in this study. Results: This method was used for eight patients in 10 sites. Increased implant length and decreasing the chance of sublingual hematoma due to lingual cortical plate perforation are the results of this study. Conclusions: Submandibular fossa augmentation is a new technique to improve the maneuver of oral surgeons to increase dental implant length in the presence of deep lingual bony undercut.

Background: Dental plaque is one of the predominant causes of major oral diseases. Although mechanical and chemical methods are extensively followed to control the development of plaque, plaque-related diseases still persist. Therefore, this necessitates for alternative measures of plaque control, one such alternative is photodynamic antimicrobial chemotherapy (PACT). Materials and Methods: Split mouth randomized clinical trial (CTRI/2017/03/008239) was conducted on 30 participants who reported to the hospital. Participants were asked to rinse their mouth for 1 min using 10 ml of 25 μM erythrosine solutions. Same tooth on both quadrants of the same jaw are selected as the test and control. Intervention used was halogen-based composite curing light with wavelength of 500–590 nm. Plaque sample from the control tooth and test tooth was collected before and after exposure, respectively, and sent to microbiological laboratory for colony count. Results: Logarithmic mean and standard deviation of control group with 10² dilutions of aerobic microbial count were found to be 5.34 ± 0.94, and for experimental group, it was 4.47 ± 1.37. The statistical difference between mean CFU values between aerobic bacterial counts was significant (P = 0.006). Conclusions: Erythrosine-mediated PACT reduces the extent of dental plaque microbial count and has a potential preventive and therapeutic use in day-to-day life and dental clinics.

Background: To assess and compare the effectiveness of two surgical procedures (Beagle's technique and modified Beagle's 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 Beagle's technique, whereas Group B sites were treated by the Beagle's 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 Beagle's technique is an easy and effective technique when compared to the Beagle's surgical technique for papilla reconstruction.

Background: The prevalence of enteric rods and their association with chronic periodontitis has gained prominence recently. Although the prevalence of these organisms from the subgingival plaque sample was reported in the literature, the carriage rate of these rods in our population is lacking. The present study was undertaken to know the carriage rate of enteric rods from our population in patients with periodontal health and disease. Materials and Methods: Eighty-four systemically healthy participants, inclusive of 46 males and 38 females, were selected for the study. The selected participants were subjected to a periodontal examination and were categorized into chronic periodontitis and healthy group. Subgingival plaque samples were taken from all the participants, plated onto McConkey agar plates, and incubated overnight at 37^°C to check for the growth of organisms. The grown organisms were then cultured according to the standard procedures. Results: Prevalence of 71% and 83% of enteric rods in subjects with periodontal health and disease, respectively, was found in our study which was not statistically significant. Conclusion: Although no significant differences exist in the prevalence of enteric rods between healthy and patients with chronic periodontitis, the prevalence rate of enteric rods in subgingival plaque samples is considerably high in our population.

Introduction: Periodontitis is defined as a destructive inflammatory disease involving the supporting tissues of the teeth due to specific microorganisms which results in a progressive destruction of supporting structures of the periodontium. Obesity is excessive body fat in proportion to lean body mass, to such an extent that health is impaired. Obesity, a serious public health problem, relates to a chronic low-grade systemic inflammation and is involved in the development of obesity-linked disorders including insulin resistance, type 2 diabetes, cardiovascular diseases, dyslipidemia, and metabolic syndrome. The accurate process whereby obesity can affect periodontal health is so far unclear. The aim of the present study was to evaluate the association between obesity (using body mass index [BMI] and waist circumference [WC]) and periodontal health and disease using various periodontal parameters. Materials and Methods: A total of 100 participants were randomly taken and were divided into two groups (fifty participants per group). The participants with BMI more than 30 were considered as obese and participants with BMI <30 were considered nonobese. WC was also measured. Gingival index (GI), pocket probing depth (PPD), gingival recession (REC), and clinical attachment level (CAL) were measured by a single examiner. Results: Independent t-test was performed to compare GI, probing depth, gingival recession, and clinical attachment level among obese and nonobese participants. The prevalence of periodontitis was significantly more in obese as compared to nonobese group (P < 0.05 for GI, P < 0.05 for PPD, and P < 0.031 for CAL). Conclusion: Strong correlation was found to exist between obesity and periodontitis. Obese participants could be at a greater risk of developing periodontal disease.

Oral schwannomas (OSs) are rare benign tumors of oral cavity derived from peripheral nerve sheath, composed of proliferation of schwann cells in a characteristic pattern. AS are long-standing lesions which exhibit degenerative changes and atypia due to which they could be mistaken for malignancy. The mean age of occurrence of AS in oral cavity is 43 years, and no case of oral AS has been reported in a pediatric patient so far. Here, we present a rare case of AS of oral cavity in a 10-year-old male child.

The chief goal of combination therapy using guided tissue regeneration along with bone grafts is to optimally and predictably regenerate the periodontal attachment apparatus. The evolution of regenerative therapy along with careful patient selection and treatment planning can have positive results even in cases which are not ideal. The present case report describes a tooth with a questionable prognosis treated successively by endodontic then periodontal therapy using an amniotic membrane along with a bone graft to treat an intrabony defect. The follow-up, 12 months later showed a resolution of the interradicular lesion and a radiographic bone fill.

Pyogenic granuloma (PG) is a nonneoplastic, tumor-like growth commonly seen in the oral mucosa or skin. Although nonpathological, its existence might lead to complications such as secondary infections or diastema formation. Hence, surgical removal of the growth seems mandatory. Histopathologic and radiographic evaluation is essential for accurate diagnosis and to rule out malignancy. A 28-year-old systemically healthy female patient reported with a swelling which involved the interdental space of maxillary left central and lateral incisors. The lesion initially developed as a “pimple-like” swelling and gradually increased in size over 2 years. It was managed in a novel method by reflecting a papilla preservation flap, excising the lesion from inside the flap till healthy tissue was visible, and then exposing to diode laser to prevent recurrence. Subsequent histopathologic examination confirmed the diagnosis of PG. This novel, less invasive esthetic procedure employed a papilla preservation flap and laser irradiation technique. This simple modification not only helped in healing by primary intention and producing a good esthetic outcome but also showed no recurrence till date.

New and innovative surgical techniques are necessary to help the clinician ensure the best results and satisfy patient's expectations. One such periodontal problem that has been challenging to the dental practitioners and impacts the oral health quality of life of patients has been gingival recession. When present anteriorly where esthetics is a major concern, patient centric parameters too become paramount. Root coverage esthetic score (RES) evaluation helps to keep the patient outcomes in mind. This case reports the successful treatment of a wide anterior mucogingival defect using epithelial embossed connective tissue graft which was evaluated for the first time using RES.

Smokeless tobacco is used orally or nasally without burning tobacco. This is equally harmful as smokers due to the tobacco content and can cause oral cancer as well as systemic effects such as nicotinic dependence. Many other oral conditions have also been reported in association with smokeless tobacco. This paper presents features of tobacco pouch keratosis and aims to highlight the oral effects of smokeless tobacco, management, and guidelines for dentists in educating and counselling tobacco users.