Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
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   2009| September-December  | Volume 13 | Issue 3  
    Online since March 3, 2010

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Piezosurgery in periodontology and oral implantology
Hema Seshan, Kranti Konuganti, Sameer Zope
September-December 2009, 13(3):155-156
DOI:10.4103/0972-124X.60229  PMID:20379414
Periodontitis is a chronic inflammatory disease of the tooth-supporting structures. The treatment of this condition is largely based on the removal of local factors and restoration of the bony architecture. Moreover, in the era of modern dentistry, successful implant therapy often requires sound osseous support. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. However, both these methods have their own advantages and disadvantages. Recently, a novel surgical approach using piezoelectric device has been introduced in the field of periodontology and oral implantology. This article discusses about the wide range of application of this novel technique in periodontology.
  15 6,029 1,411
Amlodipine-induced gingival overgrowth
MG Triveni, C Rudrakshi, DS Mehta
September-December 2009, 13(3):160-163
DOI:10.4103/0972-124X.60231  PMID:20379416
Gingival overgrowth represents an over-exuberant response to a variety of local and systemic conditions. Certain anticonvulsants, immuno-suppressive drugs and a number of calcium channel blockers have been shown to produce similar gingival overgrowths in certain susceptible patients. Amlodipine is a comparatively new calcium channel blocker and has been used with increasing frequency in the management of hypertension and angina. Although amlodipine is considered as a safe drug, very rarely it may induce gingival overgrowth also. A rare case of amlodipine-induced gingival overgrowth has been reported herein in a 50-year-old female patient. The treatment aspect included Phase-1 therapy, substitution of the drug, the surgical excision and the maintenance and supportive therapy resulting in excellent clinical outcome.
  9 4,989 717
Evaluation of plasma C-reactive protein levels in pregnant women with and without periodontal disease: A comparative study
Anupriya Sharma, Amitha Ramesh, Biju Thomas
September-December 2009, 13(3):145-149
DOI:10.4103/0972-124X.60227  PMID:20379412
Background and Objectives: Circulating C-reactive protein (CRP) levels are a marker of systemic inflammation and are associated with periodontal disease, a chronic bacterial infection associated with elevation of proinflammatory cytokines and prostaglandins. CRP has been associated with adverse pregnancy outcomes, including preterm delivery, preeclampsia, and intrauterine growth restriction. Furthermore, periodontal disease has been associated with increased risk of preterm low birth weight, low birth weight, and preterm birth. The present study was conducted to assess plasma CRP levels in pregnant women with and without periodontal disease; to evaluate the effect of periodontal therapy on the incidence of preterm delivery; and to compare the incidence of preterm delivery in pregnant women with and without periodontal disease. Materials and Methods: A total of 90 pregnant women aged between 18-35 years with gestational age between 12-28 weeks were recruited and divided into three equal groups (control group, study group, treatment group) of 30 each. Blood samples were taken for estimation of C-reactive protein levels from all groups at 12-20 weeks of gestation, determined using ultrasensitive turbidimetric immunoassay (QUANTIA-CRP US). The treatment group comprised plaque control, scaling, and root planning and daily rinsing with 0.2% chlorhexidine mouth before 28 weeks of gestation. Results: The mean value of C-reactive protein levels in subjects with periodontal disease was higher compared to control group i.e., 1.20 ± 0.247 mg/dl and 1.22 ± 0.250 mg/dl, respectively, compared to 0.713 ± 0.139 mg/ dl ( P = 0.001). The mean value of CRP levels before treatment was greater than the mean value after treatment i.e., 1.22 ± 0.25 compared to 0.84 ± 0.189 ( P < 0.001). The incidence of preterm delivery (< 37 weeks) was 31.7% in the periodontal disease group (study group) compared to 8.3% in the control group ( P = 0.001). The incidence of preterm delivery in the treatment group was 15.0% compared to 31.7% in the nontreatment group (study group). Conclusion: The findings from the study suggest that periodontal disease in pregnant women is associated with increased C- reactive protein levels in early pregnancy, incidence of preterm delivery is higher in pregnant women with periodontal disease compared to healthy controls, periodontal therapy during pregnancy reduces plasma CRP levels and there is decrease in incidence of preterm delivery after periodontal therapy.
  8 4,660 578
Immunohistological analysis of CD1a + langerhans cells and CD57 + natural killer cells in healthy and diseased human gingival tissue: A comparative study
Sahaya Stelin, Hemalatha Ramakrishan, Avaneendra Talwar, KV Arun, T.S.S Kumar
September-December 2009, 13(3):150-154
DOI:10.4103/0972-124X.60228  PMID:20379413
Background: Cell interaction between dendritic cells (DC) and natural killer (NK) cells in the periodontal milieu is not yet fully known, although these cells are individually known to contribute to the pathogenesis of periodontal disease. Materials and Methods: Fifty subjects (25 males and 25 females) were included in the study. The subjects were divided into three groups: Group A comprised 16 subjects with clinically healthy gingiva; group B 17 subjects with gingivitis; and group C 17 subjects with gingivitis; and group C 17 subjects with moderate periodontitis (PPD ≥ 5 mm and CAL ≥ 3 mm in at least six sites). Gingival samples were collected and immunohistochemical study was done using CD57 and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison for CD1a and Tukey's highly significant difference (HSD) test for CD57. Results and Conclusion: The study showed an inverse relationship between the CD1a+ (langerhans) cells and CD57+ (natural killer) cells. There was a significant increase in CD57+ cells and reduction in CD1a levels as periodontal disease progressed. The significant reduction in CD1a levels in periodontal disease when compared to health could possibly be a result of NK cells down regulating it. Reduction in CD1a levels may result in a low inflammatory response subsequently resulting in tissue destruction.
  8 2,953 368
Oral histoplasmosis
Karthikeya Patil, VG Mahima, RM Prathibha Rani
September-December 2009, 13(3):157-159
DOI:10.4103/0972-124X.60230  PMID:20379415
Histoplasmosis is a systemic fungal disease that takes various clinical forms, among which oral lesions are rare. The disseminated form of the disease that usually occurs in association with Human Immunodeficiency Virus (HIV) is one of the AIDS-defining diseases. Isolated oral histoplasmosis, without systemic involvement, with underlying immunosuppression due to AIDS is very rare. We report one such case of isolated oral histoplasmosis in a HIV-infected patient.
  7 3,656 546
Biograft-HT® as a bone graft material in the treatment of periodontal vertical defects and its clinical and radiological evaluation: Clinical study
KT Chandrashekar, Chhavi Saxena
September-December 2009, 13(3):138-144
DOI:10.4103/0972-124X.60226  PMID:20379411
Aim: To determine the efficacy of Biograft-HT® as a bone graft material in the treatment of vertical defects in generalized chronic periodontitis patients and their clinical and radiological evaluation. Patients and Methods: Twenty patients diagnosed with generalized chronic periodontitis having two or more vertical defects were selected for this study. Clinical parameters like plaque index, gingival index, probing pocket depth and clinical attachment levels were recorded at different points of time over six months. Radiographic evaluation included the depth of the bone defect and the percentage of bone defect fill and was carried out for both the groups at baseline, three months and six months. After recording clinical parameters and administering phase -1 therapy, the sites were randomly treated either with Biograft- HT® or open flap debridement only. Results: At the end of six months there was a significant reduction in the plaque and gingival scores in both test and control groups. There was 64% decrease in probing pocket depth for the test site as compared to 54.52% decrease seen for the control group. Similarly there was an 84.82% gain in clinical attachment level from the baseline to six months post operatively for the experimental group in comparison to 68.83% gain for the control group. Furthermore, 43.57% bone fill was observed for the experimental site whereas only 17.98% of bone fill was evident in the control site. Conclusion: Biograft -HT improves healing outcomes, leads to a reduction of probing depth, a resolution of osseous defects and a gain in clinical attachment, compared with open flap debridement by itself.
  3 4,266 864
Evaluation of two local drug delivery systems as adjuncts to mechanotherapy as compared to mechanotherapy alone in management of chronic periodontitis: A clinical, microbiological, and molecular study
Sangeeta Singh, Subrata Roy, SK Chumber
September-December 2009, 13(3):126-132
DOI:10.4103/0972-124X.60224  PMID:20379409
Background: Modern concepts of treating inflammatory periodontal disease aim at changes in the subgingival ecosystems within the periodontal pockets to alter the complex microbial community into a microbiota compatible with good periodontal health.Systemic antimicrobial therapy, although effective, involves a relatively high dose with repeated intakes over a prolonged period of time to achieve the required inhibitory concentrations in the sulcular fluid. The adjunctive use of local drug delivery may provide a beneficial response, especially in specific areas where conventional forms of therapy might fail. The aim of this study was to compare the efficacy of two local drug delivery systems, one containing metronidazole and the other containing tetracycline hydrochloride as adjuncts to mechanotherapy in the treatment of chronic periodontitis. Materials and Methods: There were three groups that were labeled as group A (Scaling + Tetracycline), group B (Scaling + Metronidazole), and group C (Scaling alone). A microbiological analysis was carried out to determine the efficacy of these systems in changing the pathogenic flora in deep pockets. In addition, a multiplex polymerase chain reaction was carried out to confirm the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis (Pg), and Tannerella forsythensis in the flora associated with chronic periodontitis. Results: There was clinical improvement in groups A and B, which correlated with an improvement in the microbiological parameters; these results were sustained for 90 days following therapy. In Group C, the flora showed a shift towards baseline at the end of 90 days. Conclusions: According to this study, both the local antibiotic therapies resulted in greater improvement in microbiological parameters when used as an adjunct to mechanotherapy as compared to mechanotherapy alone.
  3 4,835 897
Metabolic syndrome and periodontal disease
Vipin Bharti, Pankaj Khurana
September-December 2009, 13(3):172-174
DOI:10.4103/0972-124X.60234  PMID:20379419
It is important for a dentist to be well informed and updated on the latest research on the association of oral and systemic health. Of late, the metabolic syndrome has gained importance in dental literature, and metabolic syndrome and periodontal disease have been linked. Metabolic syndrome (MeS) is a group of three or more (up to five) interrelated metabolic abnormalities, which increases the risk of cardiovascular morbidity and mortality. Also, both MeS and periodontal disease may be linked through a common pathophysiological pathway. Some studies have been conducted to show such an association and additional studies are required to establish this association. A dental surgeon can play a major role in evaluating patients with MeS and thus prevent the development of overt cardiovascular disease.
  3 3,646 732
Bilateral cervicoenamel projection and its management: A case report with lingual involvement
Nilofar B Attar, Mangesh B Phadnaik
September-December 2009, 13(3):168-171
DOI:10.4103/0972-124X.60233  PMID:20379418
Bacterial plaque has been implicated as the primary etiological factor in the initiation and progression of periodontal disease. Anatomic factors such as cervical enamel projections, enamel pearls, and developmental grooves are often associated with advanced, localized periodontal destruction. Enamel projections and pearls are mostly associated with molars. Enamel projections in the furcation areas of molars have no true attachment and are therefore highly susceptible to the creation of a deep periodontal pocket. A close association has been reported in the past between enamel projection and furcation involvement. Here, we present a case report with bilateral cervical-enamel projection and its management by flap operation with odontoplasty, and regenerative procedure by placement of graft in the osseous defect. Decreased pocket depth and a gain in clinical attachment level were observed on follow-up.
  2 3,530 376
Is anti-platelet therapy interruption a real clinical issue? Its implications in dentistry and particularly in periodontics
A Jaya Kumar, M Meena Kumari, Nupur Arora, A Haritha
September-December 2009, 13(3):121-125
DOI:10.4103/0972-124X.60223  PMID:20379408
The use of anti-platelet therapy has reduced the mortality and morbidity of cardiovascular disease remarkably. A considerable number of patients presenting before a dentist or periodontist give a history of anti-platelet therapy. A clinical dilemma whether to discontinue the anti-platelet therapy or continue the same always confronts the practitioner. Diverse opinions exist regarding the management of such patients. While one group of researchers advise continuation of anti-platelet therapy rather than invite remote, but possible, thromboembolic events, another group encourages discontinuation for variable periods. This study aims at reviewing the current rationale of anti-platelet therapy and the various options available to a clinician, with regard to the management of a patient under anti-platelet therapy. Current recommendations and consensus favour no discontinuation of anti-platelet therapy. This recommendation, however, comes with a rider to use caution and consider other mitigating factors as well. With a large number of patients giving a history of anti-platelet therapy, the topic is of interest and helps a clinician to arrive at a decision.
  2 3,518 622
Surgical exposure of an impacted maxillary canine and increasing a band of keratinized gingiva
R Vijayalakshmi, T Ramakrishnan, S Nisanth
September-December 2009, 13(3):164-167
DOI:10.4103/0972-124X.60232  PMID:20379417
An adequate amount of keratinized gingival tissue that is under proper plaque control, is a fundamental requirement for periodontal health. When the teeth erupt uneventfully in the center of the alveolar ridge, an adequate amount of keratinized tissue will surround the erupted permanent tooth. Labially or buccally erupting teeth show reduced dimensions of the gingiva as abnormal eruption of permanent teeth restricts or eliminates the keratinized tissue between the erupting cusp and the deciduous tooth. A lack of attached gingiva poses a potential risk for gingival recession in labially or buccally erupted teeth due to the possibility of accumulation of plaque and/or traumatic tooth-brushing during subsequent orthodontic treatment. A good understanding between the orthodontist and periodontist along with proper management of periodontal tissues, can prevent these problems. Various surgical techniques can be employed to uncover impacted teeth. This paper discusses the validity of utilizing periodontal surgery to increase a band of keratinized tissue in a case of an impacted canine erupting from the alveolar mucosa.
  - 9,767 827
Pocket Singh: Periodontist of the year
D Arunachalam
September-December 2009, 13(3):115-116
DOI:10.4103/0972-124X.60220  PMID:20379406
  - 2,036 336
Role of insulin as a growth promoter in regulating the response of curcumin in human primary gingival fibroblasts: An in vitro study
Jaya Dixit, Umesh Verma, Karamjeet , Ramesh Sharma, Anil K Balapure
September-December 2009, 13(3):133-137
DOI:10.4103/0972-124X.60225  PMID:20379410
Background: The aim of this investigation was to evaluate the biochemical and morphologic changes in human primary gingival fibroblasts (hPGF) treated with curcumin (CUR) and insulin (I) plus curcumin (CUR) in a dose-dependent fashion. Materials and Methods: Human gingival fibroblasts were obtained from gingival biopsies. Curcumin was dissolved in ethanol, diluted with Dulbecco's modified Eagle's medium (DMEM) to obtain dilutions and bovine insulin was dissolved in 0.01 N HCl and diluted with DMEM. Cells were exposed to different concentrations of CUR and insulin (1 µg/ml) plus CUR for next 48 hours at 37°C and cellular growth profile was assessed using sulforhodamine-B (SRB), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and fluorescence-activated cell sorter (FACS). Results: The cell viability in both the treatments at lower concentrations of SRB (1 and 10 µM) and MTT (1 µM) were found to be significantly higher than that observed at higher concentrations, while apoptosis in both the treatments at lower concentrations was observed to be significantly lower than at higher concentrations. Also, the cell viability of I + CUR at lower concentrations of SRB (1, 10 and 25 µM) and MTT (1 µM) were found to be significantly higher than the respective CUR, while apoptosis at higher concentrations (50, 75 and 100 µM), especially at 75 µM was significantly low. The IC 50 of I + CUR of SRB, MTT and FACS were 1.1, 1.0 and 1.4 times higher than respective concentrations of CUR. Conclusions: Insulin (1 µg/ml) exerted cytoproliferative and curcumin exerted cytocidal effects (in a dose-dependent manner) on hPGF. Insulin (1 µg/ml) and curcumin at different concentrations when added together decreased the cytocidal effect of curcumin.
  - 2,720 332
Indian Society of Periodontology: Rise and reach in 17 years
Dilip G Pol
September-December 2009, 13(3):117-119
  - 2,226 209
Greetings from the head office!
MM Dayakar
September-December 2009, 13(3):120-120
DOI:10.4103/0972-124X.60222  PMID:20379407
  - 1,873 201