Aims: The present study was undertaken to evaluate the effectiveness of the combination of hydroxyapatite and β-tricalcium phosphate bone alloplast with bioresorbable guided tissue regeneration membrane for the treatment of mandibular grade II furcation defects. Settings and Design: A total of eight patients, four females and four males, in the age group of 18 to 65 years, with bilateral buccal grade II furcation defects in the mandibular molars, participated in the study. Materials and Methods: The following clinical measurements were recorded at baseline as well as three and six months post surgery: The Turesky-Gilmore-Glickman modification of the Quigley Hein plaque index, the Loe and Silness gingival index, Relative Clinical Attachment Level Vertical Probing Depth in the mid-furcation area, and Horizontal Probing Depth in the mid-furcation area. Statistical analysis: Pairwise comparisons within the groups were done by applying the independent student t test. Comparisons were also drawn between the test and the control groups by applying the independent student t test. Results: The mean gain in the relative clinical attachment levels in the test and control groups, at the end of six months, were 2.50 and 1.63 mm, respectively. The mean change in the horizontal probing depth values at the end of six months in the test and control groups were 2.88 and 1.63 mm, respectively. The mean reduction in the vertical probing depth values in the test and control groups were 1.50 and 1.38 mm, respectively. Conclusions: The resorbable GTR membrane with bone material was more effective than open debridement alone, in the treatment of furcation defects.

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Background: Short implants are manufactured for use in atrophic regions of the jaws. Although many studies report on short implants as ≤10 mm length with considerable success, the literature regarding survival rate of ≤7 mm is sparse. Purpose: The purpose of this study was to systematically evaluate the publications concerning short dental implants defined as an implant with a length of ≤7 mm placed in the maxilla or in the mandible. Materials and Methods: A Medline and manual search was conducted to identify studies concerning short dental implants of length ≤7 mm published between 1991 and 2011. The articles included in this study report data on implant length ≤7 mm, such as demographic variables, implant type, location in jaws, observation time, prostheses and complications. Results: The 28 included studies represent one randomized controlled trial, 12 prospective studies and 10 retrospective studies. The survival rate of short implant was found to be increased from 80% to 90% gradually, with recent articles showing 100%. Conclusion: When severe atrophy of jaws was encountered, short and wide implants can be placed successfully.

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Background: The aim of our clinical trial was to assess the efficacy of 0.1% turmeric mouthwash as an anti-plaque agent and its effect on gingival inflammation and to compare it with 0.2% chlorhexidine gluconate by evaluating the effect on plaque and gingival inflammation and on microbial load. Materials and Methods: 60 subjects, 15 years and above, with mild to moderate gingivitis were recruited. Study population was divided into two groups. Group A-30 subjects were advised chlorhexidine gluconate mouthwash. Group B-30 subjects were advised experimental (turmeric) mouthwash. Both the groups were advised to use 10 ml of mouthwash with equal dilution of water for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque and gingival index at day 0, on 14 ^th day, and 21 ^st day. Subjective and objective criteria were assessed after 14 ^th day and 21 ^st day. The N-benzoyl-l-arginine-p- nitroanilide (BAPNA) assay was used to analyze trypsin like activity of "red" complex microorganisms. Results: On comparison between chlorhexidine and turmeric mouthwash, percentage reduction of the Plaque Index between 0 and 21 ^st day were 64.207 and 69.072, respectively (P=0.112), percentage reduction of Gingival Index between 0 and 21 ^st day were 61.150 and 62.545 respectively (P=0.595) and percentage reduction of BAPNA values between 0 and 21 ^st day were 42.256 and 48.901 respectively (P=0.142). Conclusion: Chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. Both the mouthwashes have comparable anti-plaque, anti-inflammatory and anti-microbial properties.

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The prevention and treatment of periodontal disease is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of the disease. The practice of risk assessment involves dental care providers identifying patients and populations at increased risk of developing periodontal disease. This can have a significant impact on clinical decision making. Risk assessment reduces the need for complex periodontal therapy, improve patient outcome and, ultimately, reduce oral health care cost. The awareness of risk factors also helps with the identification and treatment of co-morbidities in the general population as many periodontal disease risk factors are common to other chronic diseases such as diabetes, cardiovascular diseases and stroke.

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Context: Host responses to periodontal disease include the production of different enzymes released by stromal, epithelial or inflammatory cells. Important enzymes associated with cell injury and cell death are aspartate aminotransferase, alanine aminotransferase (AST, ALT), alkaline phosphatase, acidic phosphatase (ALP, ACP), and gama glutamyl transferase (GGT). Changes in enzymatic activity reflect metabolic changes in the gingiva and periodontium, in the inflammation. Aims: In this article we examined the activity of AST, ALT, GGT, ALP, and ACP in the saliva from patients with periodontal disease, before and after periodontal treatment (experimental group - 20 gingivitis patients and 20 periodontitis patients), and in the saliva from healthy subjects (control group - 20 samples). Settings and Design: Periodontal disease was determined based on the clinical parameters (gingival index (GI), probing depth (PD), and clinical attachment loss (CAL)). Patients with periodontal disease were under conventional periodontal treatment. Materials and Methods: The stimulated saliva of the patient was collected in a sterile test tube and analyzed using the Automatic Analyzer. Results: The obtained results showed statistically significant increased activity of AST, ALT, GGT, ALP, and ACP in the saliva from patients with periodontal disease, in relation to the control group. A significant reduction in the enzyme levels was seen after conventional periodontal therapy. Conclusions : Based on these results, it can be assumed that the salivary enzymes (AST, ALT, GGT, ALP, and ACP) can be considered as biochemical markers for evaluating the diagnosis and prognosis of the functional condition of periodontal tissues in disease and health, and in the evaluation of the therapy effects in periodontal disease.

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Background: It is well-recognized fact that periodontal diseases are caused by multifactorial etiologies, in which microorganisms play an important role. An essential component of therapy is to eliminate or manage these pathogens. This has been traditionally accomplished through mechanical means by scaling and root planning which is ineffective in some of the aggressive periodontal diseases. These aggressive diseases involve particular groups of microorganisms which are not eliminated by mechanical means; and they require anti-infective therapy, which includes local and systemic antimicrobials. This approach of therapy is of interest to periodontist due to the aforementioned shortcomings of conventional methods. Materials and Methods: A manual and electronic search was made for human studies up to March 2011 that presented clinical and microbiological data for the efficacy of a systemic antibiotics in generalized aggressive periodontitis along with scaling and root planning. A systematic approach was followed by two independent reviewers and included eligibility criteria for study inclusion, quality assessment, and determination of outcome measures, data extraction, data synthesis, and drawing of conclusion. Results: Only three randomized controlled human trials qualified, and they concluded that both scaling and root planing (SRP) mono-therapy and SRP with antibiotics proves beneficial in improving clinical and microbiological parameters in aggressive periodontitis. Better results were seen in SRP with antibiotic groups as compared with SRP alone. Conclusion: Because of the insufficient quantity and heterogenecity of studies, no adequate evidence could be gathered to use the beneficial effects of these antibiotics along with SRP in aggressive periodontitis compared with SRP alone.

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Background: Helicobacter pylori is an important gastrointestinal pathogen that is strongly associated with gastritis as well as peptic ulcer disease. Antimicrobial therapy frequently fails to cure H. pylori infection, which suggests there may be sanctuary sites where the organism resides. This study was aimed to assess the role of oral cavity as a reservoir of H. pylori by evaluating the occurrence of the organism in subgingival plaque of dyspeptic patients by polymerase chain reaction as well as culture. Materials and Methods: Thirty chronic periodontitis patients whose biopsy specimens were found to be H. pylori positive with rapid urease test and histopathologic examination were considered as cases and 20 chronic periodontitis patients who never had any symptoms of gastritis or peptic ulcer were taken as controls. Subgingival plaque samples were collected and sent to microbiological laboratory for detection of H. pylori by 16S rRNA based polymerase chain reaction as well as culture. Results: 60% of the samples were found to be positive with polymerase chain reaction in the case group when compared to 15% in the controls. Also, 30% of the cases were found to be positive with culture compared to none in controls. Conclusion: A higher frequency of detection of H. pylori in those patients with positive antral biopsy report was seen. Also, polymerase chain reaction was found to be more sensitive than culture for detection. Thus, we conclude that detection of H. pylori in dental plaque of dyspeptic patients cannot be neglected and might represent a risk factor for recolonization of stomach after systemic eradication therapy.

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Background: Clinical and epidemiological data suggest that negative life experience events, like depression, may contribute to an increased susceptibility to periodontal disease. Aim: To study the association between psychological stress and chronic periodontitis. Materials and Methods: One hundred and eleven dentate individuals, of age 40 years and above, were selected. The clinical examination included, the number of teeth present, plaque index, Probing Pocket Depth, and Clinical Attachment Level. Assessment of Psychological stress levels were done by a questionnaire and were correlated with salivary cortisol levels, which were estimated biochemically by using the Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: Statistical analysis was done by using the student 't' test and Mann Whitney test. According to our observation, chronic periodontitis showed a significant correlation with hypercortisolemia (P<0.0001), work tension (P=0.04), economic problems (P<0.0001), clinical stress syndrome (P<0.0001), plaque index (P<0.0001), and unsecured job (P=0.003). Conclusion: Stress may be considered as an important risk factor for periodontal disease. Routine salivary cortisol assessment may be an economical and useful diagnostic marker to rule out stress in periodontitis patients.

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Background: Obtaining predictable and aesthetic root coverage has become an important part of periodontal therapy. Several techniques have been developed to obtain these results with variable outcomes. The aim of this study was to compare and evaluate the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) in combination with coronally positioned flap in the treatment of multiple gingival recessions in aesthetic areas. Materials and Methods: Total 10 patients were selected for this study, aged between 18 to 40 years and were randomly assigned to one of the groups ADMA and SCTG. The clinical parameters including probing pocket depth, clinical attachment level, gingival recession, width of keratinized tissue were recorded at baseline and at 6 months after surgery and data was statistically analyzed. Results: No significant differences in gingival recession reduction were noted between ADMA and gold - standard SCTG. Within limits of this clinical study, the use of ADMA may represent an acceptable alternative to the SCTG for treating gingival recession. The use of ADMA eliminates the need for the palatal donor site thus represents a less invasive surgery for treating multiple gingival recessions. Conclusions: These results suggest that ADMA may be a useful substitute instead of subepithelial connective tissue graft for root coverage.

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Green tea is a popular beverage nowadays and intake of green tea polyphenols has shown preventive effect against cancer and cardiovascular disease in experimental and epidemiologic studies. Several studies have suggested that green tea catechins, such as epigallocatechin gallate, inhibit periodontal pathogens and reduce the destruction of periodontal tissue. This paper aims to review the role of green tea in inflammatory diseases, especially in periodontal diseases.

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Orofacial granulomatosis (OFG) encompasses conditions characterized by non-necrotizing granulomatous inflammation of the oral and maxillofacial region that present clinically as labial enlargement, perioral and/or mucosal swelling, oral ulcerations, and gingivitis. The unifying term "OFG" has been introduced to integrate the spectrum of various disorders, including Melkersson-Rosenthal syndrome and granulomatous cheilitis (which is sometimes considered to be a monosymptomatic form of Melkersson-Rosenthal syndrome), and has been shown to be associated with Crohn's disease, sarcoidosis, and infectious diseases such as tuberculosis. Although various etiological agents such as food substances, food additives, dental materials, and various microbiological agents have been implicated in the disease process, its precise pathogenesis is yet to be elucidated. Delayed type of hypersensitivity reaction appears to play a significant role, although the exact antigen inducing the immunological reaction varies in individual patients. However, evidence for the role of genetic predisposition to the disease is sparse. The underlying immunological mechanism appears to show some similarities between OFG and Crohn's disease, emphasizing the need for more comparative studies of the two entities. The aim of this article is to report a case of OFG, along with a detailed literature review of the facts and variations associated with its nomenclature, clinical presentation, and etiology. It also projects the challenges that a professional has to face in the diagnosis and treatment planning of such cases.

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Background: It is now well established that removal of bacterial plaque can reduce the severity of chronic inflammatory periodontal disease. Periodontal disease is seen to progress faster interdentally and plaque control in these areas is of great importance. Various types of interdental cleaning aids have been developed in recent years. This study was aimed at evaluating the efficacy of a newly developed interdental cleaning aid, BrushPick, in a split mouth randomized clinical trial. Materials and Methods: This was a split mouth design study where the quadrant on one side of the oral cavity served as the control while another quadrant on the opposite side served as the test sample. Fifty-seven patients with mild-to-moderate periodontitis, presenting with open interdental embrasures, were selected for the study. After non-surgical periodontal therapy, they were asked to use the BrushPick in the embrasures on one side of the arch in a spilt mouth design study and the embrasures on the other side acted as controls. The Rustogi et al. modified Navy plaque index (RMNPI) and interdental bleeding index (IBI) were recorded at baseline, seven days, 14 days, and 28 days. Statistical analysis: The mean differences between test and control sites were compared using the student " t" test. The mean difference was compared between different durations using analysis of variance (ANOVA). Results: The mean RMNPI was significantly different between the test and control sites at P<0.001 on both days 14 and 28. At 28 days the mean IBI was 0.08 (SD=0.02) for the experimental sites and 0.28 (SD=0.11) for the control sites. The difference was statistically significant at P<0.001. ANOVA showed that the mean RMNPI scores and mean IBI scores showed a statistically significant difference when compared at different durations at the test sites (P<0.0001). But, at the control sites there was no significant change. Conclusion: This study suggested that BrushPick reduces plaque and gingival bleeding in open interdental embrasures. Further large sampled clinical trials and comparative studies using gold standard interdental cleaning aids are required to establish the efficacy of this device.

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Objectives: To assess oral hygiene status, oral hygiene practices and periodontal status among 14-17-year-old visually impaired, deaf and dumb, intellectually disabled and physically challenged and normal teenagers in the district of Nalgonda, South India. Materials and Methods: Seven hundred and fifty teenagers in the age group of 14-17 years, constituting visually impaired, deaf and dumb, intellectually disabled, physically challenged and normal teenagers, were studied. Oral hygiene status and periodontal status were assessed using clinical indices and compared. Results: Among the five groups chosen for the study, the intellectually disabled group had the highest plaque scores and poor oral hygiene. The visually impaired and deaf and dumb had better oral hygiene compared with other disability groups. Physically handicapped showed higher loss of attachment scores and deleterious and parafunctional habits. Normal teenagers had good oral hygiene and lower plaque scores. Oral health status relied basically on proper use of oral hygiene aids and training of the groups by their care takers. Conclusion: Disabled groups showed poor oral hygiene and higher incidence of periodontal disease, which may be attributed to the lack of coordination, understanding, physical disability or muscular limitations. Hence, more attention needs to be given to the dental needs of these individuals through ultimate, accurate and appropriate prevention, detection and treatment.

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Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva.

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Aims and Objectives: To study the prevalence of dentine hypersensitivity and related risk factors in rural population of Punjab, India. Materials and Methods: A total of 650 subjects reporting dentine sensitivity were included in the study comprising of 270 males and 380 females. All the subjects completed an interview and the subjects reporting dentine hypersensitivity were examined further using air syringe to put a blast of air to confirm the diagnosis of dentine hypersensitivity. Periodontal attachment loss and gingival recession of all the sensitive teeth were examined and recorded. Results: The prevalence of dentine hypersensitivity was 25% in the oral test. The subjects receiving the treatment of hypersensitivity were only 15.1%. The older group in the 50-59 years had the highest number (98%) of subjects with dentine hypersensitivity. Most commonly affected teeth were mandibular incisors. The other factors related to dentine hypersensitivity were the socioeconomic status, lower education level, and access to dental care. The periodontal factors related to hypersensitivity were gingival recession and poor oral hygiene. Conclusions: The prevalence of dentine hypersensitivity was 25% in the rural population of Punjab.

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Gingival cyst of adult is an uncommon cyst of gingival soft tissue occurring in either the free or attached gingiva. This odontogenic epithelial cyst is most frequently seen near mandibular canine and premolar region, believed to represent the soft tissue counter part of the lateral periodontal cyst. This article presents a case of gingival cyst treated with exicisional biopsy followed by histopathological confirmation and an emphasis on the clinical aspects of this lesion.

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Hemangiomas are common tumors characterized microscopically by proliferation of blood vessels. The congenital hemangioma is often present at birth and may become more apparent throughout life. They are probably developmental rather than neoplastic in origin. Despite their benign origin and behavior, hemangiomas in the oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. This case report presents a case of capillary hemangioma of anterior palatal mucosa in a 13-year-old female.

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Background: The purpose of this study was to evaluate and compare the effect of smoking on the periodontal status and salivary composition of whole saliva in subjects with clinically healthy periodontium and chronic periodontitis. Materials and Methods: The study comprised of 400 subjects equally divided into four groups of non-smokers with clinically healthy periodontium, smokers with clinically healthy periodontium, non-smokers with chronic periodontitis and smokers with chronic periodontitis. Clinical measurements and non-stimulated whole saliva were obtained. Biochemical analysis of salivary total protein, calcium, magnesium and phosphorus was performed. Results: The clinical parameters of probing depth and clinical attachment levels did not reveal any statistically significant differences between the smokers and non-smokers groups. The plaque index and gingival index were significantly higher in smokers with periodontitis (P<0.05) as compared with non-smokers with periodontitis. On biochemical analysis of whole saliva, total protein, calcium, magnesium and phosphorus were reduced in smokers with periodontitis to 0.43±0.50 gm/dL, 3.47±1.49 mg/dL, 0.80±3.87 mEq/L Neo and 18.45±8.77 mg% from 1.70±2.09 gm/dL, 13.89±10.34 mg/dL, 1.26±0.90 mEq/L Neo and 29.23±16.02 mg%, respectively, in non-smokers with healthy periodontium. Conclusion: The present study exhibited reduced concentrations of total proteins, calcium, magnesium and phosphorus in whole saliva in smokers with chronic periodontitis. It may thus be concluded that the analysis of salivary composition could be used as an auxiliary means of diagnosis.

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The objective of this study was to compare the efficacy of scaling and root planing (SRP) alone versus tetracycline fiber therapy used adjunctively with SRP in the treatment of chronic periodontitis sites in maintenance patients. A total of 30 patients with a diagnosis of chronic periodontitis (60 localized chronic periodontitis sites) in the age group of 35 to 55 were selected. None of these patients had received any surgical or non-surgical periodontal therapy and had sites of periodontal pockets measuring 4-7 mm clinically and demonstrated radiographic evidence of moderate bone loss. Two non-adjacent sites in separate quadrants were selected in each patient for monitoring based on criteria that the sites had localized chronic periodontitis. Plaque index (PI) (sillness and loe) and Gingival-bleeding index (GI) (loe and sillness) were measured at baseline and 15 ^th , 30 ^th , 60 ^th , and 90 ^th day. Clinical pocket depth (PD) and microbial analysis (MA) were analyzed at baseline and 90 ^th day. At 0 and 3 months adjunctive tetracycline fiber therapy was significantly better in reducing PI, GBI, (P<0.001) than S and RP alone. In comparison, the reduction in the PD was non-significant at 0 and 3 months (P<0.001). The microbial analysis showed significant reduction in Porphyromonas gingivalis and Prevotella intermedia though there was no significant reduction in the Actinobacillus actinomycetemcomitans. Overall, these results indicate that fiber therapy significantly enhanced the effectiveness of SRP in the management of chronic periodontitis.

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Context: There has been considerable interest in the use of chemical-assisted root detoxification. Chemical agents have been proposed to facilitate calculus removal. Aims: A study was carried out to analyze the morphological characteristics of the root surfaces after application of Carisolv gel in association with scaling and root planing under scanning electron microscopy (SEM). Settings and Design: The Department of Periodontics of the K. M. Shah Dental College and Hospital, Vadodara, (Gujarat, India). Materials and Methods: Sixty periodontally compromised extracted human teeth were randomly assigned to four groups: (1) scaling and root planning (SRP) alone; (2) passive topical application of Carisolv + SRP; (3) active topical application of Carisolv + SRP; (4) multiple applications of Carisolv + SRP. Carisolv gel was applied to the root surfaces for 30 seconds, followed by scaling and root planing, consisting of 30 strokes, with Gracey curettes in an apical-coronal direction, parallel to the long axis of the tooth. The only exception was group 4, where the roots were instrumented until a smooth, hard, and glass-like surface was achieved. All specimens were further analyzed by SEM. Statistical Analysis: The Analysis of Variance (ANOVA) method was used. Results: Active application of Carisolv gel produced more extensive morphological changes than passive application and SRP alone. When multiple applications of Carisolv with SRP were performed, there was a significant decrease in the smear layer compared to a single application of the gel, either passively or actively. Conclusions: The Carisolv gel failed to remove the smear layer completely, especially with a single application, independently of the method of application. This study documented that the Carisolv gel produced changes in the root morphology of periodontally compromised teeth, only when it was applied actively and multiple times.

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A case describing perio-restorative management of an accidental trauma in the mid portion of root on an upper left canine tooth following an ostectomy surgery is presented here. The traumatized root area was undergoing fast resorption and a chronic periodontal abscess had developed in relation to the lesion. The article illustrates the clinical and radiographic photo series of a periodontal flap surgery done to gain access into a subgingival region for the placement of Glass ionomer restoration on the root and its periodic follow up. The clinical condition of the area suggests 8 mm clinical attachment gain over the restoration and the review radiographs at definite intervals up to 18 months revealed evidence of consistent bone regeneration around the restoration. The article also highlights the various other possibilities, where this restorative material can be effectively used in conjunction with periodontal surgical procedures.

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Aim: The purpose of the study is to determine the thickness of the palatal mucosa by a direct clinical method, and the association of age and gender with the thickness of the palatal mucosa. Materials and Methods : Forty systemically and periodontally healthy Indian subjects participated in the study. The subjects were categorized according to age and gender. The thickness of the palatal mucosa was assessed by bone sounding. Acrylic stents provided 15 consistent locations for the measurement, defined according to the gingival margin and mid-palatal line. Results: The mean thickness of palatal mucosa was 2.48΁0.03 mm, ranging between 2.07 and 3.00 mm, among the participants. The younger age group had significantly thinner mucosa than the older age group. Females had thinner palatal mucosa than males, but not statistically significant. Conclusion: The palatal area from the distal line angle of the canine to the mesial line angle of the palatal root of the first molar provides sufficient donor tissue for grafting procedures. Factors such as body weight and genetic factors need to be further investigated. As the dimension of the soft tissue graft is an important factor influencing the success of the treatment procedure the assessment of the dimension is relevant to clinical periodontics.

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Odontogenic myxoma (OM) is a rare and locally invasive benign neoplasm found exclusively in the maxillofacial region. The radiographic and clinical features are variable, and the diagnosis is therefore not easy. A case of OM of the maxilla is described in a 19-year-old female, previously diagnosed as inflammatory gingival enlargement. Clinical, histological, radiographic, and computed tomographic (CT) scan assessments were done, which were confirmatory for OM. Surgical excision of the lesion was done. The patient was put on periodic recall, as the recurrence rate of the lesion was high. The biological spectrum of OM was highly variable and diagnosis at an early stage was very difficult. Gingival enlargement presentation might not always be an inflammatory reaction. All possible differential diagnosis should be explored and various diagnostic tools utilized, to screen the enlargement.

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Resorption of alveolar bone - a common sequel of tooth loss jeopardizes the functional and esthetic outcome of treatment, especially in the maxillary anterior areas. Therefore, augmentation of deficient alveolar ridges is an important aspect of dental implant therapy. A case of severe maxillary ridge deficiency successfully treated with horizontal ridge augmentation to facilitate implant placement is described. Ridge augmentation was achieved using a combination of autogenous block graft, particulate grafting, and guided bone regeneration (GBR). Follow-up was done next day, after ten days, three months, and six months. Various approaches can be followed in order to achieve an increase in the ridge width. In our case, we used a combination of different techniques for ridge augmentation. A significant improvement in ridge width was noticed at six months thus facilitating the placement of implants.

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Complete or partial absence of the second sex chromosome, with or without a mosaic karyotype, is detected in approximately 1 per 2,500 live-born females. Such a cytogenetic finding coupled with clinical features, such as short stature and ovarian failure, supports the diagnosis of Turner's syndrome (TS). It is typically characterized by the combination of physical features and cytogenetics in females. The presenting clinical features can vary widely among affected individuals. Consequently, whereas short stature and gonadal dysgenesis are almost universal in TS, many other organ systems are affected to varying degrees and at different stages of life. The periodontal status of three females diagnosed with TS has been reported here.

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Objectives: The aim of this study was to evaluate the efficacy of subgingivally administered xanthan-based chlorhexidine gel when used in the maintenance phase following scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and Methods: A randomized, controlled, single-center study was conducted involving 92 sites in 46 systemically healthy patients suffering from moderate to advanced chronic periodontitis with isolated pockets. The selected sites were randomized to two treatment arms: Group A (SRP alone) and Group B (SRP + insertion of chlorhexidine gel after 1 month). The gingival index, plaque index, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and subsequently after 1 month and 3 months. Results: Both the groups showed significant reductions in PPD and CAL at both follow-up visits when compared with the baseline values (P<0.001). Conclusions: The results suggest that the application of xanthan based chlorhexidine gel following SRP in the maintenance phase might be beneficial in treatment of the chronic periodontitis in comparison to SRP alone. Greater improvements may be achieved when antimicrobial agents are used following SRP.

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Aim: The purpose of this study was to evaluate and compare the root surface changes subsequent to the application of citric acid, tetracycline, Ethylenediaminetetraacetic acid (EDTA), and the combination of citric acid and tetracycline, and its influence on the adhesion of a fibrin clot with and without mild disruptive forces. Materials and Methods: A total of 100 periodontally diseased root specimens were grouped into Saline (control Group I), 24% EDTA gel (Group-II), Citric acid (Group-III), Tetracycline (Group IV), and Citric acid + tetracycline (Group V) treatment groups containing 20 in each. After root conditioning, fresh human blood was applied to each root specimen and was allowed to clot. Ten specimens in each group were rinsed in phosphate-buffered saline and designated as 'Non-agitated'. The remaining ten specimens from each group were rinsed in phosphate-buffered saline on a rotary shaker and designated as 'Agitated'. The roots were processed for scanning electron microscopy (SEM) to assess and compare the clot adhesion on them. The scores were compared through standard statistical packages. Results: The highest mean blood clot adhesion score was observed in roots treated with a combination of citric acid and tetracycline, whereas, the least score was observed in roots treated with saline. Conclusion: The root specimens treated with the combination of citric acid and tetracycline as well as citric acid alone, best supported the fibrin clot. Tetracycline alone appeared to be less effective in supporting the clot. EDTA gel of 24% was least effective to promote the adhesion of a fibrin clot.

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Aim: In the present study, a new electronic model "ROBOTUTOR" was designed to compare the efficacy of different modes of dental health education for demonstration of the Bass toothbrushing technique and also to evaluate its efficacy with different modes of dental health education in patient understanding. Materials and Methods: Total 150 subjects were randomized into two groups, Group 1 (Questionnaire) and Group II (Investigators). Subjects with history of gingivitis and only mild periodontitis were included. Demonstration of Bass technique was given to each subject with the help of three different modes, i.e., ROBOTUTOR, clinician, and audio-video aids. Results: The result was evaluated in terms of effectiveness, ease of understanding, attraction, and recollection. In the present study, the best mode of education is clinician demonstration and the least effective one is the audio-video mode. In contrast, the ROBOTUTOR model was found to be more attractive than the other two. Conclusion: Although demonstration by clinician is the best, it is time consuming and not feasible for community purpose. ROBOTUTOR would thus save clinician's chair side time and help in effective demonstration of the brushing technique.

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Background: Osteopontin (OPN) is a bone matrix derivative, whose levels reflect active lesions of aggravated periodontal disease accompanied by alveolar bone resorption. OPN is also a component of human atherosclerotic plaque, suggesting a role of OPN in cardiovascular diseases. The present study was conducted to assess and compare plasma OPN levels in subjects with healthy periodontium and generalized chronic periodontitis and to evaluate the effect of scaling and root planing on Plasma OPN levels of generalized chronic periodontitis subjects. Materials and Methods: 40 gender matched subjects were divided into two equal groups, Group I- Healthy and Group II- Generalized chronic periodontitis, based on the Periodontal Disease Index. Blood samples were collected from the subjects at the time of clinical examination (Group I, II) and two months after Scaling and Root planning of Group II. Plasma OPN level was determined using a OPN Enzyme Immunometric Assay Kit (Quantikine). Results: The mean value of plasma OPN levels in subjects with generalized chronic periodontitis was higher (153.08 ng/ml) as compared to the subjects with Healthy periodontium (55.09 ng/ml). After treatment of generalized chronic periodontitis group, the level of plasma OPN decreased to 91.53 ng/ml. Conclusion: The findings from the study suggest that Plasma OPN levels were highest in plasma from sites with periodontal destruction; however, scaling and root planing resulted in the reduction of OPN levels.

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Background: Chlorhexidine (CHX) and Tetracycline (TET) are the two antimicrobial agents used in the management of periodontal infections, due to their antimicrobial potency and substantivity. The benefits and limitations of an antimicrobial agent can only be assessed by determining their relative toxicity to microbes and host cells. Objectives : (1) To detect the effects of CHX and TET on neutrophil viability and functions in vitro. (2) To compare the effects of CHX and TET on crevicular blood neutrophils. Materials and Methods : Crevicular blood was collected using 5-μl pipette, stored in EDTA-containing vacutainers and sent for evaluation of Cell Viability- Neutrophils would be mixed with 0.25 volume of 0.4% trypan blue in Hank's balanced salt solution (HBSS) and counted to assess the viability. Chemotaxis- Evaluated under agarose slides, a total of 100 μl crevicular blood Neutrophils-0.2% BSA or HBSS-0.2% containing concentration of CHX and TET. Oxidative Metabolism- would be assessed using nitro blue tetrazolium. In all experiments, three concentrations of TET (0.1%, 0.05%, 0.025%) and CHX (0.01%, 0.005%, 0.0025%) respectively were used. N-Formyl methionyl leucyl phenylalanine (1 μm) in the presence of 2 μg/ml cytochalasin B will be used as the activating agent. Neutrophils would be treated with CHX and TET similarly to that for chemotaxis. Results : TET comparatively has less deleterious effects on neutrophil functions as compared with that of CHX with statistically significant results for all parameters tested. Conclusion: From this study, it is inferred that CHX and TET do cause certain changes in neutrophil functions.

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The Article has been Retracted due to Duplicate Publication

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