Journal of Indian Society of Periodontology

Publications in this journal

• Article: Response to "Gingival squamous cell carcinoma: A diagnostic impediment".

  Poramate Pitak-Arnnop, Alexander Hemprich, Kittipong Dhanuthai, Niels Christian Pausch
  Journal of Indian Society of Periodontology 07/2012; 16(3):300-1.
• Article: Horizontal ridge augmentation using a combination approach.

  C Rachana, N Sridhar, Anand V Rangan, V Rajani
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):446-50.
• Article: Assessment of thickness of palatal mucosal donor site and its association with age and gender.

  Anu Kuriakose, Saranyan Raju
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  ABSTRACT: 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. 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. 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. 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):370-4.
• Article: Clinical attachment level gain and bone regeneration around a glass ionomer restoration on root surface wall of periodontal pocket.

  K R Biniraj, Mohammed Sagir, M M Sunil, Mahija Janardhanan
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):442-5.
• Article: Effect of insertion of xanthan-based chlorhexidine gel in the maintenance phase following the treatment of chronic periodontitis.

  Ashish Verma, Swati Sanghi, Dimple Grover, Shweta Aggarwal, Rajan Gupta, Nymphea Pandit
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  ABSTRACT: 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. 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. Both the groups showed significant reductions in PPD and CAL at both follow-up visits when compared with the baseline values (P<0.001). 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):381-5.
• Article: Oral hygiene and periodontal status of teenagers with special needs in the district of Nalgonda, India.

  Nazia Ameer, Rajababu Palaparthi, Madhukar Neerudu, Sunil Kumar Palakuru, Harinath Reddy Singam, Satyanarayana Durvasula
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  ABSTRACT: 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. 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. 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. 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):421-5.
• Article: Buccinator muscle repositioning.

  Om N Baghele
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  ABSTRACT: Anatomical aberrations and abnormalities are frequently associated with functional, psychosocial, and emotional problems. One such aberration is crestal attachment of frenum or muscle on the alveolar processes of the jaws. Crestal attachment of buccinator muscle is a rare phenomenon, which may pose various problems in routine oral exercises/functions or restoring the edentulous area. A case of abnormal buccinator muscle attachment is presented here, which was relocated apically by surgical means using an acrylic stent. The healing was uneventful and significant apical repositioning was observed. A fixed bridge was fabricated and the long-term results of the restorative therapy were assured because the patient could maintain the oral hygiene well after the muscle repositioning operation.
  Journal of Indian Society of Periodontology 07/2012; 16(3):456-60.
• Article: Not why! Why not?

  Balaji Manohar
  Journal of Indian Society of Periodontology 07/2012; 16(3):297.
• Article: Treatment of grade II furcation involvement using resorbable guided tissue regeneration membrane: A six-month study.

  Deepti Khanna, Sumit Malhotra, D Venugopal Naidu
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  ABSTRACT: 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. 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. 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. 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. 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. The resorbable GTR membrane with bone material was more effective than open debridement alone, in the treatment of furcation defects.
  Journal of Indian Society of Periodontology 07/2012; 16(3):404-10.
• Article: Prevalence of gingival enlargement secondary to calcium channel blockers in patients with cardiovascular diseases.

  Priya Pedaballi, Rajasekar Sundaram, Mythili Ramachandran
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  ABSTRACT: The purpose of the present study was to determine the prevalence and extent of gingival overgrowth in patients treated with calcium channel blockers for cardiovascular diseases. Calcium channel blockers are widely used in the treatment of hypertension, vasoplastic angina, and cardiacarrythmias. Gingival overgrowth resulting from the use of calcium channel blockers is of primary concern to dentists. The purpose of the present study is to determine the prevalence and extent of gingival overgrowth in patients treated with calcium channel blockers for various cardiovascular diseases, to assess their periodontal status and to correlate the factors like age, sex, duration, dosage, type of drugs that result in gingival overgrowth. A cross-sectional study was done in cardiac patients treated with calcium channel blockers, visiting The Railway hospital, Perumbur, Chennai. Information regarding medical history, type, duration, dosage of medication were recorded and analyzed. The periodontal condition of the patients was assessed using the plaque index, gingival index, calculus index, papillary bleeding index, and extent of gingival overgrowth using appropriate indices. The data was later subjected to statistical analysis. In this study, a total of 213 cardiac patients (145 males and 68 females) who met the inclusion and exclusion criteria were screened. The patients were between 19 and 69 years. From the results of the present study it can be concluded that gingival overgrowth does occur with calcium channel blockers. Elderly males appeared to be more susceptible to the development of drug-induced gingival overgrowth, which was independent of dosage, duration of drug administered but the presence of local factors seemed to aggravate the same.
  Journal of Indian Society of Periodontology 07/2012; 16(3):430-5.
• Article: Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans.

  Annapurna Ahuja, C S Baiju, Vipin Ahuja
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  ABSTRACT: 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. 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. 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. 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):317-23.
• Article: Odontogenic myxoma presenting as localized inflammatory gingival enlargement: A diagnostic dilemma.

  Rameshwari Singhal, Aparna Singh, Pavitra Rastogi, Jaya Dixit
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):461-4.
• Article: Short implants: A systematic review.

  I Karthikeyan, Shrikar R Desai, Rika Singh
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  ABSTRACT: 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. 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. 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. 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%. When severe atrophy of jaws was encountered, short and wide implants can be placed successfully.
  Journal of Indian Society of Periodontology 07/2012; 16(3):302-12.
• Article: Efficacy of a new interdental cleaning aid.

  Fouzia Tarannum, Mohamed Faizuddin, Shanmukha Swamy, M Hemalata
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  ABSTRACT: 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. 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. The mean differences between test and control sites were compared using the studentt test. The mean difference was compared between different durations using analysis of variance (ANOVA). 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. 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):375-80.
• Article: Comparison of fibrin clot adhesion to dentine conditioned with citric acid, tetracycline, and ethylene diamine tetra acetic acid: An in vitro scanning electron microscopic study.

  Tanuj Minocha, Aparna Rahul
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  ABSTRACT: 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. 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. 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. 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):333-41.
• Article: Comparative evaluation of effects of chlorhexidine and tetracycline on neutrophil viability and functions in vitro.

  Jyothi Dundappa, K Kanteshwari
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  ABSTRACT: 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. (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. 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. TET comparatively has less deleterious effects on neutrophil functions as compared with that of CHX with statistically significant results for all parameters tested. From this study, it is inferred that CHX and TET do cause certain changes in neutrophil functions.
  Journal of Indian Society of Periodontology 07/2012; 16(3):342-9.
• Article: Orofacial granulomatosis: A case report with review of literature.

  Abha Parag Rana
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):469-74.
• Article: Gingival cyst of adult: A rare case.

  Vijayalaxmi V Malali, T S Satisha, A K Jha, S K Rath
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):465-8.
• Article: Risk assessment for periodontal disease.

  Elizabeth Koshi, S Rajesh, Philip Koshi, P R Arunima
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  ABSTRACT: 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.
  Journal of Indian Society of Periodontology 07/2012; 16(3):324-8.
• Article: Prevalence of dentine hypersensitivity: A cross-sectional study in rural Punjabi Indians.

  Jagjit Singh Dhaliwal, Pooja Palwankar, Paramjit K Khinda, Sachinjeet K Sodhi
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  ABSTRACT: To study the prevalence of dentine hypersensitivity and related risk factors in rural population of Punjab, India. 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. 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. The prevalence of dentine hypersensitivity was 25% in the rural population of Punjab.
  Journal of Indian Society of Periodontology 07/2012; 16(3):426-9.