Periodontics and Oral Pathology

Periodontics and Oral Pathology

  • Nirmala S.V.S.G added an answer:
    What syndromes, apart from Gorlin-Goltz, are associated with multiple keratocysts?

    A patient presented to us with multiple keratocysts. Work-up did not show features of Gorlin-Goltz syndrome. Before being diagnosed as nonsyndromic or Gorlin-Goltz with partial expression, I need to rule out other possible syndromes. Do you know such? or an article listing them. I couldn't find in PubMed.

    Nirmala S.V.S.G · Narayana Dental College and Hospital

    Dear Omayma,

    I have published an article regarding Conservative Management of Multiple Odontogentic Keratocyst in a Young Patient with 2 Years Follow Up - A case report

    follow the citation: Nirmala SVSG,Sandeep C, Sindhuri V,Vimala Devi P. Conservative Management of Multiple Odontogentic Keratocyst in a Young Patient with 2 Years Follow Up. J Dent App. 2015;2(2): 149-152.

  • Abrão Rapoport added an answer:
    What are the standard care practices for managing xerostomia and its sequelae in cancer patients receiving chemotherapy alone?

    Are there any dental consultations required before commencing chemo? 

    Any fluoride treatment during the course of chemo and later? 

    Abrão Rapoport · University of São Paulo

    Xerostomia is a permanent sequela of mouth cancer, without therapy.We can try the protection of salivary glands  with administration  of protective solutions,advertizing the patients for the limitations of these procedures

  • Ulrich Kritzler added an answer:
    Periodontally accelerated orthodontic and osteogenic techniques - what is your experience?
    As invasive as it is, this technique, with its variants, seems interesting and promising. I would much appreciate learning from your critical opinions and experience.

    I attach one article and list here others, equally easily available on the net.

    Periodontal Accelerated Osteogenic
    Orthodontics: A Description of the
    Surgical Technique
    Kevin G. Murphy, DDS, MS,* M. Thomas Wilcko, DMD,†
    William M. Wilcko, DMD, MS,‡ and
    Donald J. Ferguson, DMD, MSD§

    An Evidence-Based Analysis of Periodontally
    Accelerated Orthodontic and Osteogenic
    Techniques: A Synthesis of Scientific
    M. Thomas Wilcko, William M. Wilcko, and Nabil F. Bissada

    Yener ÖZAT1 Ruhi NALÇACI2

    One-stage Surgical Alveolar Augmentation (PAOO)
    For Rapid Orthodontic Movement. A Case Report.
    1 Ashish Jain, M.D.S
    2 Tarun Das, M.D.S
    3 Rashi Chaturvedi, M.D.S, D.N.B

    Piezocision Assisted Orthodontics: A new approach to
    accelerated orthodontic tooth movement
    Mittal S.K. 1, Sharma R.2, Singla A.3
    Ulrich Kritzler · Private Practice of Orthodontics

    Periodontally accelerated orthodontic and osteogenic techniqueswill speed up tooth movement but will always remain additional invasive techniques. Treatment time can be much faster when you are able to avoid round tripping in using sound biomechanics and in improving time schedules.

    1. Beckwith FR, Ackerman RJ, Cobb CM, Tira DE. An evaluation of factors affecting duration of orthodontic treatment. Am J Orthod Dentofac Orthop. 1999;115(4):439–47.

    2. Sanon M, Taylor DC a, Parthan A, Coombs J, Paolantonio M, Sasane M. Effectiveness and duration of orthodontic treatment in adults and adolescents. J Med Econ. 2012 Jul 4;383–6.

    3. Skidmore KJ, Brook KJ, Thomson WM, Harding WJ. Factors influencing treatment time in orthodontic patients. Am J Orthod Dentofacial Orthop. 2006 Mar;129(2):230–8.

  • John Gabrovsek added an answer:
    What is the role of the host in dental caries infection?
    On the web: Dental caries food for thought
    John Gabrovsek

    Neutrophil leukocytes play the role in all infections including in dental caries infection!

  • Hayfaa Hashim Farah added an answer:
    What is the treatment plan for an 11- year- old boy who is suspected to have amelogenesis imperfecta?

    An 11- year- old boy presented to the dental clinic with his father, complaining of poor esthetics and delaying of eruption of teeth. Examination revealed a suspicion of amelogenesis imperfecta ( clinically & radiographically). Teeth present: 11, 21, 31, 16, 26, 36, 46, all primary molars and canines and partially erupted 12,22, 42. Patient  has also angle, class III. Outline the treatment plan for such a case.

    Hayfaa Hashim Farah · University of Khartoum


  • Gururaja Rao added an answer:
    Can antioxidant molecules be used through local/topical drug delivery for oral mucosal lesions?

    The systemic antioxidant therapy is one of the therapeutic options for oral mucosal lesions. In Localized delivery of antioxidant molecules to the oral mucosal lesion, will the oral mucosal cells uptake/absorb the antioxidant molecules? Will the antioxidant molecules perform their action when delivered locally? Which route of delivery (systemic/local) of antioxidant molecules can have better activity?

    Gururaja Rao · AME Dental College & Hospital

    Yes.Anti oxidants are very helpful.Most common anti oxidants like vitamin C is well absorbed also through oral mucosa and sub lingually ,since it is water soluble vitamin.

  • Ramachandra SS added an answer:
    Is there any published literature which gives clear guidelines on when resective or regenerative periodontal surgery should be done ?

    Is there any published literature which gives clear guidelines on when resective or regenerative periodontal surgery should be done ?

    Ramachandra SS · SEGi University College

    Thank u Prof Paulo but the IJPRD artcles are decision tree for soft tissue grafting

    I was searching for root resection versus periodontal hard tissue regeneration.

  • Nirmala S.V.S.G added an answer:
    Is there any simple chairside method for identification of risk group of aggressive periodontitis at an early age of life?

    Aggressive periodontitis attacks people at early age of life and causes extensive bone loss which might lead to early loss of dentition, early detection of patients at high risk to be attacked by this type of periodontitis will help them a lot to be involved in a strict professional and personal preventive program thus minimize the periodontal damage to a large extent .I wonder if any one has ideas about any chairside methods  for early  detection of risk factors and  those who are at a high risk for developing this kind of periodontitis?

    Nirmala S.V.S.G · Narayana Dental College and Hospital

    I do agree with Martin and African Americans are more prone for this and risk may vary from individual to individual.

  • Laura González-Garrido added an answer:
    Which method is more accurate in determining periodontitis in archaeological skeletal remains?

    Some investigators have interpreted the increasing distance between the tooth cervical margin and the alveolar crest as an indication of horizontal bone loss due to chronic inflammatory periodontal disease. But ..... What is going on when continuing eruption had occurred in a high frecuency dental wear population? 

    I sincerely appreciate your taking time to provide your comments and feedback.


    Laura González-Garrido · Universidad de León

    Hi Sandra,

    You have done me a great favour by sending me the reference of this paper. Thank you! Of course, I´m trying to find the way to distinguished both.

    All the best, Laura

    See u!

  • Syed Wali Peeran added an answer:
    Does any one have information about DAS 21 anxiety scale in relation to periodontal status?

    Looking for association of DAS 21 and periodontal status, also looking in to role of stress in Hbac1c levels, DAS 21 and periodontal status

    Syed Wali Peeran · Sebha University

    May be this article is of help for you

  • Arkadiusz Dziedzic added an answer:
    Does anyone have a paper demonstrating differing tollerances of periodontal and gingival fibroblasts to calcium ions?
    I have noticed gingival and periodontal ligament fibroblasts have differing morphologies when cultured with MTA.
    Arkadiusz Dziedzic · Medical University of Silesia in Katowice

    Balto HA. Attachment and morphological behavior of human periodontal ligament fibroblasts to mineral trioxide aggregate: a scanning electron microscope study. J Endod. 2004 Jan;30(1):25-9.

    If you are interested in our results regarding the simple evaluation of chemical composition of different MTA materials, please feel free to contact me. We assessed MTAs with the use of SEM, EDS and XPS techniques.

  • Nirmala S.V.S.G added an answer:
    Is there any KAP model for oral health related quality of life research?

    I am conducting a research about Oral health related quality of life by using OHIP-14. One of my variable for conceptual framework is Knowledge,attitude and practice. I am having trouble with the literature part to support which model do I base on for the KAP part. Is there any model that support KAP and oral health related quality of life? I need to put something to support my variable for my literature review part. If anyone can help, please do. Thank you

    Nirmala S.V.S.G · Narayana Dental College and Hospital

    I do agree with Peter G Robinson

  • Mohammed Sultan Al-ak'hali added an answer:
    Are there any limitations when using free connective grafts alone without covering them by flaps in the treatment of recession around lower incisors?

    In the treatment of gingival recession around lower incisors by applying free connective tissue graft along the area of recession, how it is possible to pull the alveolar mucosal flap from the vestibule and inner mucosa of lower lip with the purpose of covering the connective tissue graft over the gingival recession?

    Mohammed Sultan Al-ak'hali · Sana'a University - faculty of Dentistry.

    Solmon O Nwhator   I know that the CTGs are more reliable and more predictable than FGGs. but i mean in the lower anterior recession where it is difficult to cover the connective tissue graft by the flap.

  • Amit Agrawal added an answer:
    Any published literature wherein cases of aggressive periodontitis with positive family history are at more risk for increased periodontal breakdown?

    Is there any scientific data or published article to show that cases of aggressive periodontal disease with positive family history have or are at more risk for increased periodontal breakdown?

    Amit Agrawal · Mahatma Gandhi Vidyamandir

    Oh Ok.


  • Steven E Eckert added an answer:
    Can anyone give me insight on the risk of developing osteonecrosis of the jaw in dental implant patients taking oral bisphosphonates?
    I’m aware that a higher risk is observed in patients receiving bisphosphonates by IV (Gen Dent. 2010 Nov-Dec;58(6):484-92), but am curious to know specifically if recent studies have demonstrated a relationship between oral bisphosphonates, implants and osteonecrosis of the jaw. Is there a risk/relationship? And should implant patients taking oral BPs be informed of this possible additional risk?
    Steven E Eckert · Mayo Foundation for Medical Education and Research

    In general, with ORAL bisphosphonates the risks seem to accumulate FOR TOOTH EXTRACTION with increased length and dosage of bisphosphonate usage.  Three years used to be thought of as a threshold, now that number is being questioned (both ways, too long or too short).  The thing to remember is that tooth extraction is a variable force application, it is relatively uncontrolled.  Not every extraction is the same.  On the contrary, in patients with osteopenia or osteoporosis (situations for which bisphosphonates are often prescribed) implant osteotomy development is a relatively controlled surgery.  Early articles on bisphosphonate usage for implant surgery "suggested" a protective effect but this never seemed to reach statistical significance (p-value was usually > 0.05 but < 0.1.  Those results were not consistently confirmed nor rejected so our "knowledge" is weak.  Dr. Michelinakis' comment on serum CTX is correct, it has been proposed but not universally accepted as a marker of risk for osteonecrosis.  It has become something of a religion, some believe, some reject.

    So this is a rather weak response but a strong response is likely to be wrong, hence the weak response.

  • Rangeeth Bollam Nammalwar added an answer:
    Will diode laser therapy be an effective replacement for periapical surgery in cases of periapical abscess with sinus tract?
    I have been using 910nm diode laser for treating the rct failure cases with periapical abscess forming a sinus tract into the sulcus, and I am seeing a very good prognosis.
    Rangeeth Bollam Nammalwar · Dr. M.G.R. University

    use of diode laser with sodium hypochloride irrigation seems to work well. The fiber should also reach the apical foramen.

  • Caroline Mohamed added an answer:
    In case of apical swelling (with pus): How many day(s) should we keep open the canal to discharge the pus?
    Recently, I have observed in my clinical practice a re-swelling of infected canal after antiseptic dressing. Sometime the tooth become mobile and extruded. Please suggest the possible solution.
    Caroline Mohamed · Libyan International Medical University

    Who told you that science can not be fun?

  • Sunethra Rajapakse added an answer:
    What is the consensus on fluoridated toothpaste for patients with endemic fluorosis?
    Endemic fluorosis
    Sunethra Rajapakse · University of Peradeniya

    thanks Prof Gail for the answer and the reference.



  • Chiara Baroni added an answer:
    Why is diode laser irradiation used in intervals with multiple doses of laser?
    In a number of articles, diode laser is used along with scaling and root planing in moderate periodontitis cases. After the first diode laser application, it is used in intervals- on the 4th,7th,9th and 11th day (a total of 4 or 5 applications of diode laser in Periodontal pockets). Is there any standard criteria for using diode laser in intervals with multiple doses of laser?
    Chiara Baroni · University of Bologna
    Does any of you have experience in diode laser remineralisation of hypomineralised enamel?May be using fluoride as an intermediate?How many applications would you suggest?
  • Steven E Eckert added an answer:
    Is there any scientific evidence on the success of Laser-assisted new attachment procedure (the LANAP protocol) in periodontal surgical therapy?
    Steven E Eckert · Mayo Foundation for Medical Education and Research
    The American dental Association has provided a statement on the use of lasers and dentistry. If you go to and then search this topic you will find a pretty well thought out response.

    Here is the section related to the LANAP protocol:
    Laser-Assisted New Attachment Procedure

    A 2007 publication compared the probing depth, attachment gain, and type of attachment from traditional mechanical therapy of advanced chronic periodontitis vs. traditional mechanical therapy that included two intrasulcular applications of Nd: YAG; one aimed at removing the sulcular epithelium and another said to “seal” the pocket.2 In this study, histology was performed on 6 pairs of single-rooted teeth at 3 months. Laser-treated pockets tended to show greater probing depth reductions and clinical attachment gains than non-lased pockets. Based on measurements from notches placed in periodontally involved root surfaces before treatment, lased teeth showed evidence of new cementum while 5 of the 6 control teeth showed a long junctional epithelial attachment. This study concluded that the Laser Assisted New Attachment ProcedureTM (LANAP) can be associated with cementum-mediated new connective-tissue attachment and apparent periodontal regeneration of diseased root surfaces in humans.

    Although the Council is optimistic regarding the potential for lasers to enhance effectiveness in treating periodontitis, dentists should note that this study provides no more than pilot validation for this treatment concept. The study was not blinded, and the sample size was small thereby limiting extrapolation of the results to the general population. Further, pre-treatment notches in the teeth were difficult to place, hard to know exactly where they were placed and are difficult to clearly detect on histological specimens. Moreover, the advanced periodontal destruction initially present in these 6 test teeth make it difficult to extrapolate these results to cases of early and moderate chronic periodontitis, where the anatomic environment, laser energy distribution and clinical outcome may differ substantially. It is also unclear what laser-based “sealing” of a treated periodontal sulcus is and, if real, what benefits it might provide. Additional clinical data from properly designed clinical trials with adequate sample sizes are still required before it can be known to what extent LANAP is safe and effective across the spectrum of patients with chronic periodontitis. The Council therefore cautions clinicians to weigh the available evidence for LANAP when considering the options available for treatment of the periodontal diseases.

    So my interpretation, using this statement from the American dental Association is that this procedure may have some potential but there is certainly no definitive hard scientific evidence to show that it is anything more than another way to address a problem.
  • Amit Agrawal added an answer:
    Does anyone have information on drug induced gingival overgrowth in antihypertensive therapy?
    Identification of this problem as early as possible is very important in management. How do I do it?
    There are many new antihypertensive drugs being used. Some of these might have a similar effect? Are there any research papers?
    Amit Agrawal · Mahatma Gandhi Vidyamandir
    Nifidipine, Amlodipine, Cyclosporine all are known to lead gingival overgrowth. But suppose a patient is taking all three drugs simultaneously, then how to proceed.
  • Ting Yu added an answer:
    Has anyone had experience in staining macrophage in periodontal tissue in mice?
    Does anyone have some experience in staining macrophage in periodontal tissue, especially in periodontally-infected (i.e., periodontitis) tissue in mice? Growing attention is paying on macrophage in periodontitis. However, it seems too few macrophages exist in periodontitis, let alone in the tiny gingiva in mice. If I hope to immunostain macrophages in paraffin-embedding jaw from mice, what are the notes during decalcification, tissue processing and immunohistochemistry?
    Ting Yu · Southern Medical University
    Dear Antonius Bronckers, Thank you for your so kind advice in detail ! I'm itching to try the classical TRAP staining method in periodontal tissue. Could you give me a TRAP protocol for parraffin-embedding jaw from mice, since very few articles have descripted this condition in detail? Your suggestions on distinguishing macrophage from osteoclast in periodontal tissue is noticeable and very useful. But I wonder if the TRAP kit will stain any cells other than macrophage and osteoclast, e.g., if any, mast cell or plasma cell? As you said, osteoclast is multicleated (>3 nuleus could be seen as a threshold ) which might be excluded to count macrophage in periodontal tissue? Strictly speaking, there are no specific but more representative markers for macrophage, such as F4/80 and CD68, with which I would try. According to your experience, how many macrophages-like cells could be stained in subepithelial connective tissue?
  • Thejokrishna Pammi added an answer:
    Where can I get paraffin chewing gum?
    This is used to stimulate saliva secretion.
    Thejokrishna Pammi · Terna Dental college, nerul,Navimumbai
    i have use one from Gci Asia [ one that manufactures Fuji IX GP ] in their salivary test kit.
    You can also by in bulk pure paraffin wax , we get in tin and use sharp ice scoops also to make thin waffers. This is workable solution in case above is not available
  • Rajesh Hosdurga added an answer:
    What are the guidelines to assess acute toxicity of in-situ oral gel?
    I am using 2% curcumin gel to treat experimental periodontitis. I wanted to assess the acute toxicity and chronic toxicity of this gel used to apply subgingivally in rat model. Please let me know the answer.
    Rajesh Hosdurga · Yenepoya University
    Thank you Mr. Gulam Husain. I am doing the study following OECD guidelines now.
  • Rajesh Hosdurga added an answer:
    How to develop a sustained drug delivery system for curcumin in the treatment of experimental periodontitis?
    I am working on the effect of topical curcumin on ligature induced periodontitis in wistar albino rats. We have used a gel base which delivers curcumin for 24-48 hours. We confirmed the duration of activity using paw edema method, but the drug release rate is only 60% when the gel is applied and inflammation is induced using 0.1% carrageenan. We have treated 1 group with the same gel.
    Rajesh Hosdurga · Yenepoya University
    Thanks Rajvir. But I am looking to use it as local drug delivery system to treat periodontitis
  • Nathan Alexander Moreau added an answer:
    What is the frequency we have malignant degeneration in odontogenic Cysts? How to do the right diagnosis?
    Odontogenic Cysts/Cancer
    Nathan Alexander Moreau · Hôpital Bretonneau – Hôpitaux Universitaires Paris Nord Val de Seine
    According to recent scientific literature, it seems that the occurence of a primary intra-osseous squamous cell carcinoma arising from degenerated odontogenic cysts is around 0.3 to 3% of cases. (Jain et al. 2013)
    This malignant degeneration seems to occur more frequently in large old cysts, which have gone untreated for several years.
    It seems that the only way to ensure proper diagnosis is through systematic histopathological analysis of "suspect" cysts. On that matter, follow up is paramount.
  • Abdalla El-Mowafy added an answer:
    The use of ozonated oils in endodontics and periodontology - what is your experience and opinion?
  • Aaro Turunen added an answer:
    Which is the most common benign tumor of the oral cavity?
    Between fibroma, lipoma, hemangioma, and lymphangioma.
    Aaro Turunen · University of Turku
    Out of those 4 I agree with the fibroma being most common, however I also agree with Dr. Subramanyam - it arises as a reactive hyperplasia and actually if we want to be slightly cheeky, I´d say lipoma is the most common actual tumor from those four presented by Dr. Mohammed because there are many misdiagnosed vascular malformations labeled as "hemangioma" that are not actual monoclonal tumours :)

    Dr Gianninis answer is also excellent: in order to diagnose disorders of certain parts of the body we must know what cells are present there - I was told a few weeks ago that upon showing a clinical and a histopathologic picture of an oral dysplasia to a student and asking what can be seen there, the student answered that there is cartilage present in the sample. Now, if this had been true from an oral sample it would almost certainly indicate a sarcoma of some sort since cartilage should not be found in the oral cavity at all and it would need to have come from somewhere else!
  • Balsam Fathi added an answer:
    What are the in vivo uses of Lawsonia inermis?
    Is it safe to be ingested? And how can I get rid of the stain? Is Lawsonia inermis toxic and should not be used in vivo? And can I separate the stain from the component that cause therapeutic effects?
    Balsam Fathi · specialist health center
    Thank you sir, i ve read a very old article belongs to 1960 , the author used the herb for the treatment of amoebiasis and diarrhea, the volunteers consumed the leaves water extract (intra oral) , my question is ... Is it safe to be ingested ? and if it is not at what dose it becomes toxic?

About Periodontics and Oral Pathology

Oral pathology, Oral medicine, Dentistry, Periodontology

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