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Objective:An inter-relationship between periodontal disease and systemic health has been suspected for centuries, but evidence to explain the connection has only been elucidated in the past few decades. Among the systemic diseases, end stage renal disease has been shown to affect not only the general health of the patient but also oral and periodontal health. This study was undertaken to gain an insight into whether duration of dialysis therapy influences the oral and periodontal health of these patients and also to see if these parameters reflect their biochemical values.Materials and Methods:The study was conducted on 75 patients undergoing dialysis and a control group of 25 subjects. The study group was divided into three subgroups depending upon the duration of dialysis. Oral hygiene and periodontal disease status were measured by Simplified Oral Hygiene Index by Greene and Vermillion and Periodontal Disease Index by Ram-fjord. Biochemical parameters measured were blood urea nitrogen and salivary urea levels. Comparison of these parameters was made between the study and control groups through analysis of variance (ANOVA) and student's t-test.Results:Prevalence of periodontal disease was evident in the dialysis group. Oral hygiene status was poor in comparison with the control group. Clinical and biochemical parameters showed statistically significant difference between the groups rather than within the groups.Conclusion:Oral and periodontal health appeared to be compromised. Their deteriorating general health is anticipated to cause negligence towards oral health care. This population needs comprehensive oral and periodontal care right from the diagnosis of chronic renal failure. There exists a need for communication between nephrologists and oral health care professionals. Longitudinal studies warranted in this regard.

Background Gingival hyperpigmentation poses an esthetic concern to many patients. Techniques available to perform these procedures are mucosal stripping by scalpel, bur abrasion, partial thickness flap, gingivectomy, free gingival grafts, by use of chemotherapeutic agents, electrosurgery, cryosurgery and lasers. This paper compares two different surgical approaches for the treatment of hyperpigmentation with their advantages and disadvantages. Methods Gingival depigmentation procedure of the maxillary gingiva was carried out by scalpel technique and mandibular gingiva by electrosurgical method. Results Both the techniques yielded satisfactory results in eliminating the hyperpigmented areas. Follow-up was done after 1, 2 and 4 weeks and 1 year. At the end of 1 week, patient expressed slight tenderness and discomfort with the mandibular gingiva treated with electrosurgical method. Repigmentation appeared after 1 year on both arches but with less pigmentation on maxillary gingiva compared with mandibular gingiva. Conclusion Scalpel technique offers advantage of being easy, effective, less discomfort with esthetically acceptable results in comparison with electrosurgical method.

Fenestration and dehiscence are said to be anatomical variations of cortical bone and not true pathological entities. They represent window-like defects covered by periosteum and overlying gingiva with or without the intact marginal bone. The etiology of such defects is still unclear, though many hypotheses such as occlusal traumatism, trauma, and variation in root bone angulation have been put forward. Diagnosis of such defects is challenging clinically, and they cannot be appreciated in conventional radiographs. In many instances, they are accidentally discovered during periodontal and oral surgical procedures. These defects, if not treated, can affect prognosis and complicate healing of the affected teeth. Treatment of such cortical bony defects is challenging and involves the use of potential regenerative materials to aid in regeneration. This case report describes the successful management of such a defect, discovered through exploratory flap approach, using PRF in conjunction with bone allograft.

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